The Rotterdam Local Health Information System 1987-2000: From Rebus and the health barometer to the health monitor

Abstract

In this article the development of the Rotterdam Local Health Information System is sketched. Started as an offspring of the Healthy Cities Project of the WHO, the focus was very much on neighbourhoods. The data were presented by a software program, REBUS Vision. It was relatively new to gather information at the neighbourhood level, so not much consideration was given to the relative importance of data for research questions. This led to the need to condense the vast amount of data into some summary figure, the health barometer, which chose the 27 most important available neighbourhood indicators and divided these data into six groups leading to six scores in which a neighbourhood could be compared with the city mean, other neighbourhoods, or itself in time. Although REBUS Vision and the health barometer were reasonably successful, a frequently occurring criticism was that there was too much emphasis on the signalling of public health problems. This has led to the development of a health monitor that not only signals public health problems but also tries to identify determinants and to offer solutions on a health policy and promotion level.