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How can we make sure that people can and want to live as healthily as possible? This is the key question informing the research of Hans Brug, recently appointed non-salaried professor of Health Behaviour at the University of Amsterdam’s Faculties of Social and Behavioural Sciences (FMG) and Medicine (AMC-UvA).

Hans Brug FMG dean

As FMG dean, Hans Brug was already a professor of Healthy Behaviour and the Promotion of Health. In September 2018, Brug left the FMG to become the director-general of the National Institute for Public Health and Environmental Protection (RIVM). His chair has been renamed Health Behaviour and is based both at the FMG and at the Faculty of Medicine (AMC-UvA). Brug’s appointment is an unpaid part-time one for several hours per week.

What does the renaming of your chair mean in practice?

‘The most important change is that my new appointment covers two faculties. Healthy behaviour has both a biomedical and a social-behavioural sciences component. This chair combines those two aspects nicely.’

Your appointment is for only a few hours per week. What can you do in that time?

‘It’s true that it’s only a couple of hours, but in my primary role at the RIVM I’m mainly concerned with the same topic: how to ensure a healthy population in a healthy living environment. Specifically, my appointment as a professor means that I will teach the odd guest lecture and normal lectures, and that I will contribute to scientific research into healthy behaviour.’

What is the societal impact of this chair?

‘People’s habits and vices – whether they smoke, what they eat, whether they get enough exercise and sleep – are key to their health and the risk of disease, including the main causes of death in the Netherlands: cancer and cardiovascular disease. Such diseases can be partially avoided and postponed through healthy behaviour. As a result, my focus is on research and research-based perspectives for action with regard to healthy and unhealthy behaviour, and how healthy behaviour can be promoted and facilitated. This not only concerns the behaviour of the general population, but also that of caregivers, care providers and policy makers, since they have the power to promote and facilitate healthy behaviour in others or to discourage unhealthy behaviour. To do this effectively, we require insights into the underlying causes of unhealthy behaviour, such as inequality. The healthy life expectancy of more highly educated individuals is much higher than that of those who are less well educated, and this is mainly due to healthy behaviour or the absence thereof. How can we reduce these differences?
Moreover, this chair reinforces the ties between the UvA and the RIVM. The RIVM carries out scientific research and uses scientific insights to formulate the best possible and reliable advice regarding health and a healthy living environment. Improved scientific outcomes allow us to provide better recommendations and perspectives for action to policymakers and professionals alike – also when it comes to healthy behaviour.’

What fascinates me is why people do what they do and what we can do to change their behaviour

What interest does this topic hold for you personally?

‘Speaking for myself, being in good health gives me great pleasure as it allows me to do the things I like doing, such as touring on my racing bicycle. The average Dutch person considers good health to be one the most important things in life. However, this does not mean that people always put their money where their mouth is when it comes to staying or becoming as healthy as they can be. What fascinates me is why people do what they do and what we can do to change their behaviour!’

Attempts to influence people’s behaviour are not always popular. Only recently, Dutch daily De Telegraaf led with a screaming headline of ‘Meat to be rationed’.

‘Promoting healthy behaviour often affects things that people find comforting, fun or tasty, so criticism is to be expected. Although this shouldn’t overly distract us, we should make the effort to listen to it. After all, we can’t force people to live more healthily, but we can promote and facilitate healthy choices to the best of our ability. Healthy behaviour must be easy to implement. The WHO has been imploring us to “make the healthy choice the easy choice” for years, and there is scope for the healthy choice to become the default choice more often. At the Ministry of Health, Welfare and Sport, for example, your attention is drawn to the stairs as an alternative to the lift, and as you climb the stairs you will come across entertaining quotes to keep you motivated. Meanwhile, at the RIVM canteen, the offer has become ever healthier and we’ve introduced “meatless Mondays” to make healthy eating easier and more natural. These are minor examples, but measures to make smoking more expensive and limit the number of smoking areas also fit this pattern.’

What would you like to have achieved in, say, four years’ time?

‘In four years’ time, we will have obtained further insights into why people do what they do when it comes to healthy and unhealthy behaviour and further insights into how we can incorporate this into professional practice and new policies, for I hope my chair will be able to forge ties between scientists, policymakers and professionals. Personally, I hope I will have become a little wiser and been able to increase my knowledge a bit further.'