Bridging disciplines to tackle health challenges

Reflecting on eight Years of Smarter Choices for Better Health

A little over eight years ago, the idea for an interdisciplinary research group dedicated to improving health began to take shape. Since then, dozens of researchers have contributed to Smarter Choices for Better Health (SCBH), producing lots of publications. While the initiative has achieved significant success, its future remains uncertain.

Health inequality, chronic diseases, and healthcare affordability are major societal challenges. In 2017, the Erasmus Initiative SCBH was launched to address these pressing issues. “Our goal was to foster collaboration between the Erasmus School of Health Policy and Management (ESHPM), Erasmus School of Economics (ESE), and Erasmus MC”, explains Hans van Kippersluis, scientific director of the project. “And I can say that gap between disciplines has definitely been bridged over the past years.”

“Arguably the most striking example of this interdisciplinary success in the early days was bringing together Eddy van Doorslaer from ESE/ESHPM and Johan Mackenbach from Erasmus MC. These two researchers were both studying health inequalities from slightly different angles and were both giants in their respective fields. They had never got the chance to work together until SCBH brought them into the same project.”

A personal highlight

One of Van Kippersluis’ personal highlights was a research project conducted with patients from Erasmus MC. “I have a background in econometrics and economics and worked together with behavioural economists, health scientists, cardiologists and a health psychologist to develop a lifestyle intervention for women with pre-eclampsia, also known as pregnancy poisoning. These women have a six to eight times higher risk of cardiovascular disease.”

Despite coming from different academic backgrounds, the team shared a common goal: helping these women improve their health. “We ended up creating an app in collaboration with Avegen Inc that incorporated motivational interviewing techniques from psychology, planning tools for exercise, and economic incentives to encourage engagement. This project really benefited from interdisciplinarity. Psychologists are great at motivating people, while economists understand how to create effective incentives. The participants had to invest something as a commitment to their own success. It was an incredibly rewarding project to work on. That’s what Smarter Choices for Better Health is all about; people from different backgrounds coming together to solve complex health issues.”

“Another highlight was clearly the Seed Grant scheme, where over the years we were able to fund 15 promising projects from junior researchers, most of whom were initially not affiliated with Smarter Choices for Better Health. Through the scheme exciting research was funded, and we were able to grow the network in this way.”

Tackling smoking

Hanging in Van Kippersluis’ office is a tile that reads: ‘I am working on a smoke-free generation’: a mission he has been committed to since the inception of SCBH. While progress has been made, a new challenge has emerged: vaping.

SCBH is working with Erasmus MC and the Trimbos Institute to develop strategies to help parents quit smoking. “One idea involves offering gift cards as an incentive to quit smoking. While potentially effective, it might also be controversial in society as non-smokers don’t receive the same benefits. Funding such programmes is also a challenge. We are currently investigating public support, piloting the implementation and bringing together stakeholders how such a scheme could be sustainably embedded into regular care.”

Uncertain future

Although interdisciplinary research comes with a host of benefits, there is also some challenges, Van Kippersluis explains. “I am fortunate to have a permanent position at the university, but many PhD students and junior researchers aren't in such a secure situation. At the end of the year, most will be evaluated based on the number of publications they’ve contributed to in relevant journals. For economists working across disciplines, this may mean they are publishing their research in health journals, for example. But scholars mostly get judged by the amount of research they’ve published in qualitative journals within their field. I deeply admire the commitment of these young researchers to the cause of SCBH, even if it potentially complicates their careers.”

Currently, it is unclear whether SCBH will continue beyond 2026. “The board of the University is supportive, but our funding ends at the end of this year, and nothing is guaranteed,” Van Kippersluis explains. “We are in the second four-year funding cycle, and while it’s obvious that no board can commit to 15 years of funding, more long-term stability would be valuable. Researchers need certainty and commitment to fully invest in the project.”

The uncertain political landscape adds to the challenges, but Van Kippersluis remains hopeful. “Despite these difficulties, we are determined to continue. This project has brought together incredible researchers and has made a real impact. We just need the right support to keep going.”

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Interview by Tim Koning
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