Addi van Bergen

Chapter 7 150 translate complex evidence into simple stories [25]. This last step, translation into simple stories, has been missing until now. The interviews with socially excluded citizens in Utrecht, Amsterdam and The Hague presented in Chapter 6 painted a picture of the daily lives and aspirations of people, the problems they are facing, how they are dealing with these problems and what support they need (Chapter 6). It is in the lived experience of people that theory becomes tangible and concrete. As one of the professionals pointed out in response to the interview results: ‘ This is certainly recognisable. We see these people every day ’. [26, 27] Barrier 2: Translation of results into local public health policy: a larger policy story The second barrier to the research application mentioned by GGD epidemiologists and local policymakers is the difficulty of translating the SEI-HS results into policy actions. Translating epidemiological data into public health policy is generally complicated. Regarding public health in the Netherlands, De Goede et al. explained this by the complexity of the local policy process, in which the knowledge, opinions, and interests of multiple actors have to be taken into account, and epidemiological findings cannot be transformed directly into action [28]. For a broad concept as SE, this is all the more true: ‘ The domains are sometimes that kind of broad, that it is difficult for municipalities to take concrete measures on the basis of the index.’ [GGD epidemiologist] [23] Another complicating factor is that to tackle SE and its impact on health, an integrated approach 5 is required in which the public health sector collaborates with other local policy sectors. Involving the appropriate policy sectors, e.g., housing, spatial planning, education, work, participation and income, and welfare, in the local public health policy dialogue is, however, difficult to achieve [29]. ‘ If you really want to have an effect, then the presentation of the SE results should be given at different tables inside a municipality.’ [GGD epidemiologist] [23] Some GGDs solve this problem by translating the SE results into terms more aligned with current local policies, such as loneliness and poverty. However, what gets lost in this approach is the essence of SE – its multidimensionality, accumulative character and clustering of problems. De Goede et al. [28] suggest that given the complexity of the policy process, it is probably better not to focus too much on the use of epidemiological data for 5 Outside the Netherlands this approach is more commonly known as Health in All Policies [29].