TY - JOUR
T1 - Lifestyle versus social determinants of health in the Dutch parliament
T2 - An automated analysis of debate transcripts
AU - van Baar, Jeroen M
AU - Shields-Zeeman, Laura
AU - Stronks, Karien
AU - Hagenaars, Luc L
N1 - Publisher Copyright:
© 2023
PY - 2023/6
Y1 - 2023/6
N2 - Although public health scholars increasingly recognize the importance of the social determinants of health (SDOH), health policy outputs tend to emphasize downstream lifestyle factors instead. We use an automated corpus research approach to analyse fourteen years of health policy debate in the Dutch House of Representatives' Health Committee, testing three potential causes of the lack of attention for SDOH: political ideology, by which members of parliament (MPs) from some political orientations may prioritize lifestyle factors over SDOH; lifestyle drift, by which early attention for SDOH during problem analysis is replaced by a lifestyle focus in the development of solutions as the challenges in addressing SDOH become clear; and focusing events, by which political or societal chance events, known to the public and political elites simultaneously, bolster the lifestyle perspective on health. Our analysis shows that overall, the committee spent most of its time discussing neither SDOH nor lifestyle: healthcare financing and service delivery dominated instead. When SDOH or lifestyle were referenced, left-leaning MPs referred significantly more to SDOH and right-leaning MPs significantly more to lifestyle. Temporal effects related to election cycles yielded inconsistent evidence. Finally, peak attention for both lifestyle and SDOH coincided with ongoing political debate instead of exogenous, unforeseen focusing events, and these peaks were rendered relatively insignificant by the larger and more consistent attention for health care. This paper provides a first step toward automated analysis of policy debates at scale, opening up new avenues for the empirical study of health political discourse.
AB - Although public health scholars increasingly recognize the importance of the social determinants of health (SDOH), health policy outputs tend to emphasize downstream lifestyle factors instead. We use an automated corpus research approach to analyse fourteen years of health policy debate in the Dutch House of Representatives' Health Committee, testing three potential causes of the lack of attention for SDOH: political ideology, by which members of parliament (MPs) from some political orientations may prioritize lifestyle factors over SDOH; lifestyle drift, by which early attention for SDOH during problem analysis is replaced by a lifestyle focus in the development of solutions as the challenges in addressing SDOH become clear; and focusing events, by which political or societal chance events, known to the public and political elites simultaneously, bolster the lifestyle perspective on health. Our analysis shows that overall, the committee spent most of its time discussing neither SDOH nor lifestyle: healthcare financing and service delivery dominated instead. When SDOH or lifestyle were referenced, left-leaning MPs referred significantly more to SDOH and right-leaning MPs significantly more to lifestyle. Temporal effects related to election cycles yielded inconsistent evidence. Finally, peak attention for both lifestyle and SDOH coincided with ongoing political debate instead of exogenous, unforeseen focusing events, and these peaks were rendered relatively insignificant by the larger and more consistent attention for health care. This paper provides a first step toward automated analysis of policy debates at scale, opening up new avenues for the empirical study of health political discourse.
KW - Corpus research
KW - Health policy
KW - Lifestyle
KW - Political discourse
KW - Social determinants of health
UR - http://www.scopus.com/inward/record.url?scp=85152632783&partnerID=8YFLogxK
U2 - 10.1016/j.ssmph.2023.101399
DO - 10.1016/j.ssmph.2023.101399
M3 - Article
C2 - 37114238
SN - 2352-8273
VL - 22
SP - 1
EP - 10
JO - SSM - Population Health
JF - SSM - Population Health
M1 - 101399
ER -