In the period 2001-2004, residents of big cities like Amsterdam, Rotterdam, Utrecht and The Hague were less positive about their own health than people elsewhere in the country. Big-city dwellers tend to have a less healthy lifestyle and more often use health care facilities.
Less healthy and more visits to the GP
Nearly a quarter of residents of Amsterdam, Rotterdam, Utrecht and The Hague rated their condition in the category less healthy. Outside the big cities, people were more positive; less than one fifth of people living elsewhere describe their condition as less healthy. In the four largest cities in the Netherlands, more people consult their GP, medical specialist, physiotherapist and an institution for mental health care at least once a year than in the rest of the country. Alternative healers, on the other hand, were not very popular among big-city dwellers. Fewer people living in the four largest cities visited their dentist at least once a year.
Annual use of health care facilities, 2001-2004
More nicotine, less exercise
There were more smokers among residents of the four big cities than in the rest of the country and fewer big-city dwellers complied with the Dutch standard for healthy exercise. Yet, the average big-city resident was not fatter than their fellow countrymen elsewhere. Nor was there any difference in the number of heavy drinkers, i.e. persons who drink at least six glasses of alcohol at least once a week. Teetotallers, on the other hand, are obviously overrepresented in the four largest cities.
Typically, non-western foreigners and people from the lower socio-economic strata are in poorer health, have unhealthier lifestyles and more frequently make use of health care facilities. This demographic and socio-economic pattern with respect to health problems is observed in the four big cities as well as in the rest of the country. The vulnerable groups in the four largest cities appear to be hit even harder.
Less healthy, 2001-2004
Health problems of vulnerable groups
Big-city dwellers in the two low-income brackets considerably more often report a poor state of health than people in low-income brackets outside the big cities. The same pattern can be observed among low-income groups and non-western foreigners with respect to GP visits.
Contact with GP, 2001-2004
Overrepresentation of vulnerable groups in big cities
The overrepresentation of vulnerable groups, like non-western foreigners and people on low incomes partly accounts for the poor state of health of residents of large cities. Living in a big city in itself contributes negatively towards health and usually the vulnerable groups are struck hardest.
Ferdy Otten and Frans Frenken