Cohort profile: the Healthy Life in an Urban Setting (HELIUS) study in Amsterdam, The Netherlands

PurposeEthnic minority groups usually have a more unfavourable disease risk profile than the host population. In Europe, ethnic inequalities in health have been observed in relatively small studies, with limited possibilities to explore underlying causes. The aim of the Healthy Life in an Urban Setting (HELIUS) study is to investigate the causes of (the unequal burden of) diseases across ethnic groups, focusing on three disease categories: cardiovascular diseases, mental health and infectious diseases.ParticipantsThe HELIUS study is a prospective cohort study among six large ethnic groups living in Amsterdam, the Netherlands. Between 2011 and 2015, a total 24 789 participants (aged 18–70 years) were included at baseline. Similar-sized samples of individuals of Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Turkish and Moroccan origin were included. Participants filled in an extensive questionnaire and underwent a physical examination that included the collection of biological samples (biobank).Findings to dateData on physical, behavioural, psychosocial and biological risk factors, and also ethnicity-specific characteristics (eg, culture, migration history, ethnic identity, socioeconomic factors and discrimination) were collected, as were measures of health outcomes (cardiovascular, mental health and infections). The first results have confirmed large inequalities in health between ethnic groups, such as diabetes and depressive symptoms, and also early markers of disease such as arterial wave reflection and chronic kidney disease, which can only just partially be explained by inequalities in traditional risk factors, such as obesity and socioeconomic status. In addition, the first results provided important clues for targeting prevention and healthcare.Future plansHELIUS will be used for further research on the underlying causes of ethnic differences in health. Follow-up data will be obtained by repeated measurements and by linkages with existing registries (eg, hospital data, pharmacy data and insurance data).

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Serum carotenoid concentrations and their association with ethnic differences in type 2 diabetes within the Healthy Life in an Urban Setting (HELIUS) study

Public Health Nutrition ◽

10.1017/s1368980019004968 ◽

2020 ◽

pp. 1-10

Author(s):

P Flores Sanchez ◽

M Muilwijk ◽

M Nicolaou ◽

MB Snijder ◽

RJG Peters ◽

...

Keyword(s):

Type 2 Diabetes ◽

Ethnic Groups ◽

Ethnic Differences ◽

Vegetable Intake ◽

Fruit And Vegetable Intake ◽

Urban Setting ◽

Healthy Life ◽

Helius Study ◽

Serum Carotenoids

Abstract Objective: Studies have reported an inverse association between a diet rich in fruits and vegetables and type 2 diabetes (T2D), but data on high-risk ethnic minority groups is limited. We investigated whether serum carotenoids, as biomarkers for fruit and vegetable intake, mediate ethnic differences in the prevalence of T2D. Design: Age-adjusted serum carotenoid concentrations were compared using ANCOVA. A cross-sectional analysis was performed using Cox regression to estimate prevalence ratios (PR) and their 95 % CI of the association between serum carotenoid concentrations and T2D. To study whether serum carotenoids potentially mediate the differences in the prevalence of T2D across ethnic groups, we compared PR of the model including known risk factors and the model additionally adjusted for serum carotenoid concentrations using the Dutch group as reference. Setting: A study among six ethnic groups living in Amsterdam, the Netherlands. Participants: Data on 204 Dutch, 203 South Asian Surinamese, 204 African Surinamese, 203 Turkish and 200 Moroccan-origin participants from the Healthy Life in an Urban Setting (HELIUS) study were used. Results: Serum carotenoid concentrations differed across ethnic groups. After adjusting for confounders, the serum concentrations of total carotenoids (PR 0·67, 95 % CI 0·54, 0·84), α-carotene (PR 0·57, 95 % CI 0·42, 0·77), β-carotene (PR 0·45, 95 % CI 0·32, 0·63) and β-cryptoxanthin (PR 0·73, 95 % CI 0·58, 0·92) were inversely associated with T2D. Despite the associations, serum carotenoids did not mediate the ethnic differences in the prevalence of T2D. Conclusions: The limited contribution of serum carotenoids to ethnic differences in T2D suggests that a focus on increasing fruit and vegetable intake alone will not likely eliminate ethnic differences in T2D prevalence.

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Ethnic Disparities in CKD in the Netherlands: The Healthy Life in an Urban Setting (HELIUS) Study

American Journal of Kidney Diseases ◽

10.1053/j.ajkd.2015.07.023 ◽

2016 ◽

Vol 67 (3) ◽

pp. 391-399 ◽

Cited By ~ 11

Author(s):

Charles Agyemang ◽

Marieke B. Snijder ◽

David N. Adjei ◽

Bert-Jan H. van den Born ◽

Pietro A. Modesti ◽

...

Keyword(s):

The Netherlands ◽

Ethnic Disparities ◽

Urban Setting ◽

Healthy Life ◽

Helius Study

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SARS-CoV-2 antibody prevalence and correlates of six ethnic groups living in Amsterdam, the Netherlands: a population-based cross-sectional study, June–October 2020

BMJ Open ◽

10.1136/bmjopen-2021-052752 ◽

2022 ◽

Vol 12 (1) ◽

pp. e052752

Author(s):

Liza Coyer ◽

Anders Boyd ◽

Janke Schinkel ◽

Charles Agyemang ◽

Henrike Galenkamp ◽

...

Keyword(s):

The Netherlands ◽

Ethnic Groups ◽

Population Based ◽

Cross Sectional Study ◽

Urban Setting ◽

Antibody Prevalence ◽

Calendar Time ◽

Cross Sectional ◽

Healthy Life ◽

Small Children

ObjectivesIt has been suggested that ethnic minorities have been disproportionally affected by the COVID-19. We aimed to determine whether prevalence and correlates of past SARS-CoV-2 exposure varied between six ethnic groups in Amsterdam, the Netherlands.Design, setting, participantsParticipants aged 25–79 years enrolled in the Healthy Life in an Urban Setting population-based prospective cohort (n=16 889) were randomly selected within ethnic groups and invited to participate in a cross-sectional COVID-19 seroprevalence substudy.Outcome measuresWe tested participants for SARS-CoV-2-specific antibodies and collected information on SARS-CoV-2 exposures. We estimated prevalence and correlates of SARS-CoV-2 exposure within ethnic groups using survey-weighted logistic regression adjusting for age, sex and calendar time.ResultsBetween 24 June and 9 October 2020, we included 2497 participants. Adjusted SARS-CoV-2 seroprevalence was comparable between ethnic Dutch (24/498; 5.1%, 95% CI 2.8% to 7.4%), South-Asian Surinamese (22/451; 4.9%, 95% CI 2.2% to 7.7%), African Surinamese (22/400; 8.3%, 95% CI 3.1% to 13.6%), Turkish (30/408; 7.9%, 95% CI 4.4% to 11.4%) and Moroccan (32/391; 7.2%, 95% CI 4.2% to 10.1%) participants, but higher among Ghanaians (95/327; 26.3%, 95% CI 18.5% to 34.0%). 57.1% of SARS-CoV-2-positive participants did not suspect or were unsure of being infected, which was lowest in African Surinamese (18.2%) and highest in Ghanaians (90.5%). Correlates of SARS-CoV-2 exposure varied across ethnic groups, while the most common correlate was having a household member suspected of infection. In Ghanaians, seropositivity was associated with older age, larger household sizes, living with small children, leaving home to work and attending religious services.ConclusionsNo remarkable differences in SARS-CoV-2 seroprevalence were observed between the largest ethnic groups in Amsterdam after the first wave of infections. The higher infection seroprevalence observed among Ghanaians, which passed mostly unnoticed, warrants wider prevention efforts and opportunities for non-symptom-based testing.

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I.5 Type II diabetes among Ghanaian residents in the Netherlands; how do they compare with other ethnic groups? The HELIUS study

Diabetes Research and Clinical Practice ◽

10.1016/s0168-8227(14)70007-5 ◽

2014 ◽

Vol 103 ◽

pp. S2 ◽

Cited By ~ 1

Author(s):

K. Meeks ◽

E. Beune ◽

M. Snijder ◽

R. Peters ◽

K. Stronks ◽

...

Keyword(s):

The Netherlands ◽

Ethnic Groups ◽

Type Ii Diabetes ◽

Type Ii ◽

Helius Study

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Contribution of short sleep duration to ethnic differences in cardiovascular disease: results from a cohort study in the Netherlands

BMJ Open ◽

10.1136/bmjopen-2017-017645 ◽

2017 ◽

Vol 7 (11) ◽

pp. e017645 ◽

Cited By ~ 5

Author(s):

Kenneth Anujuo ◽

Charles Agyemang ◽

Marieke B Snijder ◽

Girardin Jean-Louis ◽

Bert-Jan van den Born ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

The Netherlands ◽

Sleep Duration ◽

Ethnic Differences ◽

Urban Setting ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Short Sleep Duration ◽

Short Sleep

ObjectivesWe analysed association between short sleep duration and prevalence of cardiovascular disease (CVD) in a multiethnic population living in the Netherlands, and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD, independent of CVD risk factors.Methods20 730 participants (aged 18–71 years) of the HELIUS (Healthy Life in an Urban Setting) Study were investigated. Self-reported sleep duration was classified as: short (<7 hours/night) and healthy (7–9 hours/night). Prevalence of CVD was assessed using the Rose Questionnaire on angina pectoris, intermittent claudication and possible myocardial infarction. Association of short sleep duration with prevalent CVD and the contribution of short sleep to the observed ethnic differences in the prevalence of CVD were analysed using adjusted prevalence ratio(s) (PRs) with 95% CI.ResultsResults indicate that short sleep was associated with CVD among all ethnic groups with PRs ranging from 1.41 (95% CI 1.21 to 1.65) in Moroccans to 1.62 (95% CI 1.20 to 2.18) in Dutch after adjustment for age, sex and conventional CVD risk factors. The independent contributions of short sleep (in percentage) to ethnic differences in CVD compared with Dutch were 10%, 15%, 15%, 5% and 5% in South-Asian Surinamese, African-Surinamese, Ghanaian, Turkish and Moroccan, respectively.ConclusionShort sleep contributed to ethnic differences in CVD independent of well-known CVD risk factors particularly in Surinamese and Ghanaian groups. Reducing sleep deprivation may be a relevant entry point for reducing increased CVD risks among the various ethnic minority groups.

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Gender and socioeconomic inequalities in health and wellbeing across age in France and Switzerland

10.1553/populationyearbook2021.res2.2 ◽

2021 ◽

Author(s):

Anna Barbuscia ◽

Chiara Comolli

Keyword(s):

Mental Health ◽

Probability Model ◽

Age Groups ◽

Physical And Mental Health ◽

Healthy Life ◽

Inequalities In Health ◽

Health And Wellbeing ◽

Great Relevance ◽

Linear Probability ◽

Rich Countries

There is increasing evidence that wellbeing is unequally distributed across sociodemographicgroups in contemporary societies. However, less is known about thedivergence across social groups of trajectories of wellbeing across age groups.This issue is of great relevance in contexts characterised by changing populationstructures and growing imbalances across and within generations, and in whichensuring that everyone has the opportunity to have a happy and healthy life courseis a primary welfare goal. In this study, we investigate wellbeing trends in Franceand Switzerland across age, gender, and socioeconomic status groups. We use twohousehold surveys (the Sant´e et Itin´eraires Professionnels and the Swiss HouseholdPanel) to compare the unfolding inequalities in health and wellbeing across agegroups in two rich countries. We view wellbeing as multidimensional, followingthe literature highlighting the importance of considering different dimensions andmeasures of wellbeing. Thus, we investigate a number of outcomes, includingdifferent measures of physical and mental health, as well as of relational wellbeing,using a linear regression model and a linear probability model. Our findings showinteresting country and dimension-specific heterogeneities in the development ofhealth and wellbeing over age. While our results indicate that there are gender andeducational inequalities in both Switzerland and France, and that gender inequalitiesin mental health accumulate with age in both countries, we also find that educationalinequalities in health and wellbeing remain rather stable across age groups.

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The national strategy for suicide prevention in the Netherlands: on the road to zero suicides

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1216 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

G Franx

Keyword(s):

Mental Health ◽

The Netherlands ◽

Suicide Prevention ◽

Public Awareness ◽

Vulnerable Groups ◽

National Strategy ◽

The Road ◽

Public Awareness Campaign ◽

First Results ◽

On The Road

Abstract Background In the Netherlands, 1829 persons (11.6/100.000) ended their life by suicide in 2018. Two out of three suicides concern men, most of them in the age group of 50-55. Suicide amongst youth is rising, especially amongst youngsters between 10-25. Around 40 persons a day, predominantly young and female, are treated in Dutch hospitals after having attempted suicide. Only 40% of those who die by suicide have been in touch with healthcare professionals. These figures made the Dutch government to put in place a national strategy for suicide prevention. Methods This strategy follows the WHO's guidance and covers a range of measures in public health as well as in the health care sector. Its implementation is coordinated by “113 Suicide prevention”, the national centre of expertise on suicide prevention in the Netherlands. Results A broad package of measures is being implemented simultaneously, targeting the entire population as well as specific vulnerable groups, such as youngsters, persons with LGBT related issues and persons with mental health needs. We initiated several collective preventive measures, such as media guidelines for safe reporting, a public awareness campaign against stigma, reduction of access to deadly means or places; selective prevention initiatives, e.g. training over 3400 of gatekeepers to detect and address suicidal thoughts with desperate persons; and indicated suicide prevention strategies including screening, treatment and follow up of patients with suicidal behaviour in general practice or mental health hospitals. In this presentation the different components of the Dutch strategy for suicide prevention will be described more in detail, and experiences and first results of the different components will be addressed. Conclusions The relevance of the Dutch national strategy is related to the broad package of measures implemented simultaneously in many domains of society, but closely monitoring and evaluating the effect stays challenging.

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