Constructing a Healthy Region: Zeeland, the Netherlands

Objective: to critically evaluate the construction of a “healthy region” in the coastal province of Zeeland in the Netherlands, as an example of the growing intertwining of tourism with health and lifestyle issues. What... [ view full abstract ]

Objective: to critically evaluate the construction of a “healthy region” in the coastal province of Zeeland in the Netherlands, as an example of the growing intertwining of tourism with health and lifestyle issues. What are the motives for this development? Who are actors? What interests are at stake? How do residents and visitors perceive this?
Methods: a single case, qualitative case study approach was used. Documents regarding “health region” development were collected and selected on their relevance regarding health, health policy and health tourism and analysed using critical discourse analysis. Interviews and focus group meetings were held with politicians and officials, health authorities, entrepreneurs in tourism and health, residents and visitors.
Results: demographic factors (ageing, shrinking population), leading to a possible decline of liveability and changes in the tourism market were the main motives for governments and entrepreneurs to start the development of health tourism. This can be explained by the increasing costs for health care, the growing emphasis by the Dutch government on individual responsibility for health and increasing interest in health and lifestyle. This was also decisive for the health authorities to start a so-called “Vital Revolution”, inspired by the “Blue Zones” projects, which should lead to substantially higher health levels in the region than overall, making the province attractive both for (new) residents and investors. The interviewed tourists mainly come to Zeeland to relax and enjoy the environment, which is not directly related to health, although they stress the importance of health. Residents feel rather indifferent towards the aim of becoming a “healthy region”. Although health in general is considered as of main importance, the attributed value differs individually.
Conclusion: the idea of a “healthy region” is primarily motivated economically. In the rhetoric of the actors the concept of “health” is brought as positive and desirable for everyone and health authorities stress that “healthy residents” are positive for “the” economy. Differences of interest and meanings than can be given to health are obscured. Tourists and residents clearly reflect this, which leads to the recommendation that a “healthy region” can only be achieved when residents are fully involved.