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Luc Hagenaars

2022–23 Dutch Harkness Fellow; Postdoctoral Researcher in Integrated Health Policy Analysis, Amsterdam UMC

Headshot of Luc Hagenaars

Placement: University of California, San Francisco

Mentor: Laura Schmidt, Ph.D., M.S.W., M.P.H., Professor, Philip R. Lee Institute for Health Policy Studies and Department of Humanities and Social Sciences, UCSF School of Medicine

Project: The Dynamics of Upstream Obesity Prevention Policy Processes at the Local Level

Luc Hagenaars, Ph.D., M.Sc., is a 2022–23 Dutch Harkness Fellow in Health Care Policy and Practice. He specializes in the analysis of health policy processes through combined systems thinking and applied theory. His primary area of interest is complex public health problems, including the obesity pandemic. In his research, Hagenaars aims to understand what policy can contribute to tackling these problems, and the factors that contribute to policy adoption. He has extensive experience in developing health policy through his previous work at the Dutch Ministry of Health, where he successfully put “health in all policies” on the national agenda. His doctoral research focused on how the financial sustainability of health care systems can be improved through increased prevention and decreased bureaucracy, which he operationalized through examinations of sugar-sweetened beverage taxes and the components of administrative costs within health systems. Hagenaars received his Ph.D. from the Radboud University Medical Center, Nijmegen, and his M.Sc. in global health from Maastricht University.

Project Overview: With more than two-thirds of the adult U.S. population experiencing overweight or obesity, tackling upstream causes in the physical, social, and digital obesogenic environments is of prime concern for health equity and the financial sustainability of health care. Nonetheless, there consists a considerable lifestyle drift: problem analysis tends to focus on upstream causes, but solutions are generally sought in less effective downstream approaches targeting individual behavioral change. Politics explains this lifestyle drift. Politicians and the general public mostly see obesity as an individual, rather than a collective, problem.

Application of theories from the political sciences in case studies where upstream policies were enacted can help unravel how to change the currently dominant individualized obesity policy image. Despite the U.S. experiencing relatively high obesity prevalence, local governments serve as incubators of innovation. The California Bay Area is known specifically as fertile ground for public health policy primers. This project will investigate the policy processes of innovative upstream obesity prevention measures enacted by public bodies as well as large private organizations (universities, hospitals), in the Bay Area and potentially elsewhere. Qualitative research will be structured using theories of the policy process to ensure theoretical replication of findings. In addition, techniques from the complexity sciences (e.g., causal loop diagrams) will be used to visualize the system of the selected obesity prevention policy processes. Upon returning to the Netherlands, U.S. case studies will be compared to the Amsterdam Healthy Weight Approach, to foster cross-national learning.