The Upstream Team is founded and coordinated by a small group of mostly young researchers that are embedded within the Department of Epidemiology and Data Science at the Amsterdam University Medical Center - location VUmc, part of the Amsterdam Public Health Research Institute. We closely collaborate with renowned experts in and across the domains of environment, lifestyle behaviours and chronic diseases.
Jeroen Lakerveld, PhD
"Our environment matters for our behaviour and health.
It is complex, but it matters."
'I would consider myself to be an ‘upstreamist’, as I truly believe that our environment shapes our behaviour and thus our health. For some more than others – and for very few in a simple, linear way.
In several projects we try to entangle what environmental characteristics (or clusters of characteristics) matters for whom, and how. Nationally, but also in international settings. As an epidemiologist I am interested in the individual and environmental determinants of lifestyle behaviours and risk of non-communicable chronic diseases. To do so I think it is of utmost importance to get the picture - or the 'exposome' - as complete as possible by mapping all types of exposures and lifestyle behaviours in a longitudinal way, and find measures and methods to make sense of these data.'
Joreintje D. Mackenbach, PhD
“An ounce of prevention is worth a pound of cure” – Benjamin Franklin
'I am particularly interested in understanding why and how our living environments influence behaviours and health, with the aim to support the primary prevention of lifestyle-related chronic diseases through upstream interventions. This stems from the idea that behavioural choices are always made within a local context such as our social network or our neighbourhood, and influenced by the broader national and global context. I am trained as an epidemiologist but aim to integrate insights and methods from other disciplines such as geography and psychology in my work in order to better understand how the social, built, economic and political environment influences our behaviours and health.'
Maria Gabriela M. de Pinho, PhD
"When “I” is replaced by “We” even Illness becomes Wellness" – Unknown Author
'People's behaviour and health status largely depend on the context in which they live – the upstream factors. Considering the challenges and opportunities of these upstream factors fascinates me. In the last decades we witnessed overweight and obesity become an epidemic. As a nutritionist interested in Public Health I decided to focus on how we can improve environments to enable people to behave healthier, and so reduce the health burden. Within this perspective I obtained my Bachelor and Master degree in Nutrition from Federal University of Santa Catarina, Brazil. Then, pursuing new challenges and opportunities to learn from and share knowledge with colleagues from different disciplines I started my PhD trajectory at the VUmc University Medical Center and the Amsterdam Public Health research institute in Amsterdam. My main research interests are in the individual and upstream determinants of dietary behaviours and obesity.'
Nicole R. den Braver
"Treatment without prevention is simply unsustainable.” – Bill Gates
'I am fascinated by unravelling the how’s and why’s of behaviour and health status. I like to study complex issues in epidemiology, find the right tools and methods to do so and attempting to peek inside the black box. This interest was ignited during my master at the Wageningen University with a specialization in Epidemiology and Public Health, where during my education I have been involved in different projects at different places. I have studied associations between nutritional intake and disease, as well as behavioral constructs and lifestyle behaviour change in preventing type 2 diabetes. Now I am wondering what shapes these patterns of behavior and health at a higher level, namely by looking at the environment that one lives in. The environment is immensely complex, containing built environment, perceptions of environment, social environment, and the interactions between these constructs. The ENDEAVOR project enables me to pursue my interests in a PhD project. I am eager to get a grasp on these concepts and apply advanced epidemiological and statistical methods to contribute to our understanding of these pathways.'
"A man's health can be judged by which he takes two at a time - pills or stairs.” – Joan Welsh
'I strongly believe that adjustments to the environment can promote healthy living, and in turn prevent chronic diseases. During my bachelor Health and Life Sciences at the VU University I became convinced that prevention is better than cure. My interest in prevention was further fuelled during my master Health Sciences (specialization Prevention and Public Health) and internship at the VU University Medical Centre, department of Epidemiology and Biostatistics. By tackling upstream factors such as social disadvantage and social inequities we can improve health and diminish health disparities. Therefore, my PhD project will help tackle social inequities stemming from socio-economic status by helping make the healthy choice a cheaper choice.'
"The idea is to die young, as late as possible" – Ashley Montagu
'Growing old in optimal health – who does not want that? How to accomplice a high age, free from chronic diseases and disabilities, is a question that keeps on intriguing me. With a background in Nutrition and Dietetics and Health Sciences, I have experienced and learned about the impact of dietary choices and lifestyle behaviours on the prevention of several diseases, along with the major influence of social inequalities. Not all of us receive equal opportunities in life and not all dietary and lifestyle choices are a conscious choice of the individual.
I am convinced that environmental adjustments to promote healthy choices and behaviours, specifically targeting those who are at high risk of chronic diseases, can enhance equal chances of longevity in optimal health. During my PhD research for the SUPREME NUDGE project, I will focus on the implementation and evaluation of a large scale supermarket intervention trail, which aims to improve cardiometabolic health through nudging dietary behaviours and physical activity among low socioeconomic status adults.'
Geography has shaped our ancestors to what we are today and will no doubt keep telling us how to move and how to eat for the rest of our days. I know from my daily shopping routine how easy my ecological principles are outsmarted by compelling geographic factors like walk- or cycle distance. The common supermarket located between home and work wins often from the organic food shop which is slightly off route. So location does matter: change location –> change behavior.
Being a geographer myself I do not question if spatial variables matter for our health, but how they matter. Happily, within the Upstream Team I have plenty of space in the GECCO project to indulge myself with the collection and construction of relevant environmental variables and I may be able to support you to link these environmental-level data to your individual-level data. If you look for a specific spatial variables, need assistance in using GIS or have a good idea, I am happy to help you!
''Without the curiosity that moves me, that drives me, that encourages me to research, I neither learn nor teach'' – Paulo Freire
'It is reassuring to read in the Constitution of the World Health Organization (WHO) that “the enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being”. However, unfortunately, that still does not happen “without distinction of race, religion, political belief, economic or social condition”. I truly believe that research in public health has an essential role in reducing health inequalities and in promoting a healthy environment for people. My interested in Public Health (Nutrition) led me to pursue a BSc in Nutrition by the Federal University of Santa Catarina (Brazil) and a MSc in Epidemiology by Radboud University. Later, as researcher at the division of Human Nutrition at Wageningen University, I further developed my skills. Within my PhD trajectory, I aim to unravel the link between the social setting in which people live (the so-called social environment) and their cardiometabolic health.'