Joyce Molenaar

10 CHAPTER 1 (future) parents or caregivers are a central focus in optimizing children’s health and wellbeing and reducing health inequities (8, 40). Early life health inequities are known as unjust, unnecessary and preventable differences in health between different (social) groups (41). This can be related to, for example, income, ethnicity, immigration status, education, living circumstances, gender or sexual orientation. The concept of health inequities is frequently used interchangeably with health disparities. Moreover, it is at times mixed-up with health inequalities, which refers more broadly to measurable differences in health between groups, without a moral judgement (41). One example of health inequities is seen in life expectancy (2019 – 2022): individuals with a higher educational level in the Netherlands live 5 years longer, and 14 years longer in good health, compared to individuals with a low educational level (42). Also for perinatal health outcomes during pregnancy and childbirth, inequities exist between and within high-income countries (43). For example, across Dutch municipalities, preterm birth rates ranged from 2.4% to 11.7% in 2021 (mean: 6.6%) (44). There are also large differences in perinatal outcomes between neighbourhoods with varying levels of socioeconomic status, as demonstrated well by the work of researchers from Rotterdam (28, 45-47). Figure 1. Conceptual framework ‘Leveraging early opportunities to advance health equity across the life course’ by the National Academies of Sciences, Engineering, and Medicine (2019) (8).

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