The quality of our living environment, both physical and social, influences our health. Think for example of how clean the air is, proximity to nature, friends or family. It is important that our living environment keeps us healthy (clean water or no noise pollution), stimulates us to be physically active (cycling, walking), is safe, invites us to participate in society, and stimulates self-reliance so that we can continue to live longer and healthier in our environment.

With the SPRStrategic Programme RIVM RIVMNational Institute for Public Health and the Environment theme "Environment and health", RIVM aims to explore how the Netherlands can continue to provide for healthy citizens in a healthy living environment in the future.

Challenges

Society faces a number of major challenges (transition tasks): the transition to sustainable energy (energy transition), adjustments to the consequences of climate change (climate adaptation), efficient (re)use of raw materials (circular economy), the organisation of cities and rural areas, and the influence of technological developments on this (data flows, 'smart city').

There are also challenges in the area of public health. For example, the population is getting older (an ageing population), people are living independently for longer, there are many people with unhealthy lifestyles (e.g. lack of exercise, smoking), and there is an increase in chronic diseases and loneliness.  In addition, there are concerns about the increasing resistance to antibiotics and it is important to limit exposure to pathogens via water and animals as much as possible.

Innovative and integrated solutions

To meet all these challenges, it is important to come up with innovative and integrated solutions. Within the theme "Environment and health", RIVM wants to develop, together with the partners involved, knowledge about how the environment can be designed in such a way that it promotes and protects health. Innovative solutions are needed to tackle these problems nationally and regionally.

The challenges for the living environment must take into account what this means for health and vice versa. That is why it is important to bring together the generally separate worlds of health and living environment and to work integrally towards a healthy living environment. In doing so, we want to focus on 'linking opportunities' between the aforementioned transition tasks and health.

RIVM has both expertise in the field of the living environment and health and is part of many networks: an excellent starting point for shaping the necessary integrated approach. In addition, RIVM has experience in translating knowledge gained in practice into policy by underpinning the effect of measures and by sharing the lessons learned from local interventions.

Partners involved

RIVM develops integral knowledge in the field of the living environment and health together with partners. These partners are both public institutions, such as the Municipal Health Service (GGD), municipalities, provinces, water boards, and environmental services, and private, such as designers. The national governments and umbrella organisations, such as the Association of Netherlands Municipalities (VNG Vereniging Nederlandse Gemeenten), the Union of Water Boards, and the Interprovincial Consultation (IPO Interprovinciaal Overleg), are also important partners. Citizens are central to this programme.

Research

Within the SPR theme "Environment and health" RIVM is conducting the following nine research projects:

Farmers and their neighours

What
In Venray, livestock farmers, residents and the municipality aim to gain insight into air pollution concentrations and the sources that contribute to the pollution. That is why they are jointly measuring the air quality and the perceived odour nuisance with the help of RIVMNational Institute for Public Health and the Environment .

We are also investigating to what extent measuring air quality and perceived nuisance together can increase confidence between farmers, residents and the local government and enhance the dialogue about local solutions and options for a healthy and sustainable local livestock farming system.

Why 
People living near livestock farms suffer from odour nuisance and are worried about their health. In addition, farmers would like to know to what extent emissions from their stables contribute to concentrations of air pollutants and odour. Local policy is aimed at maintaining and increasing support for the livestock sector. RIVM helps both residents and farmers to measure air quality and is therefore a trusted advisor to all parties. By bringing the local stakeholders - farmers, residents and the municipality together, they can jointly measure and work towards solutions for a healthy living environment in the vicinity of livestock farms.

How 
Farmers and residents will be involved in the research questions and will carry out measurements on their own premises. Residents living near motorways will also be involved. Through interviews, questionnaires and observations during the joint sessions, RIVM will investigate the aspect of "trust". Based on the results, a practical guide will be drawn up with lessons learned and perspectives for action for policymakers and advisors, such as the Municipal Public Health Service (GGD).
 

This project is also part of the SPRStrategic Programme RIVM theme Perception and Behaviour.

Road trip towards Envionmental Health Data Virtualization & Dashboard

What and why
Digibeter aims to improve the coherence and accessibility of information about the living environment and health. This makes RIVMNational Institute for Public Health and the Environment 's information products more useful, for example, for regional and local partners. This is also important because of the implementation of the Environment and Planning Act.

Approach
RIVM will develop information and communication products tailored to the needs of the target groups. This involves providing access to information on current topics such as climate, air quality, energy, the living environment and the social environment. It examines how information on health tasks for professionals can be cleverly linked to other social tasks and ambitions. This information on the RIVM website will also become more easily accessible. For this purpose, a landing page Environment and Health will be developed on the RIVM website. Finally, efforts will be made to develop a prototype for a "healthy living environment" dashboard.

Collaboration
Digibeter cooperates with Municipal Public Health Centres in Brabant, TELOS (Tilburg University Knowledge Centre), Municipal Public Health Centres in the East Region and the province of Utrecht.

Healthy climate

What
RIVMNational Institute for Public Health and the Environment takes stock of the effects of climate change on the health of people in the Netherlands. Examples of these health effects are: heat stress and associated higher morbidity and mortality, sleep deprivation, increase in infectious diseases, increase in severe allergy symptoms for sensitive people through an extended pollen season, and changes in air quality.

Why 
There are already many initiatives to prevent climate change and limit its consequences. RIVM is mapping out which instruments and measures have been developed to counteract the adverse  effects of climate change. Also, what positive effects of climate change can be stimulated. Local authorities are also being asked to identify their needs for knowledge and possible measures. On this basis, we want to offer options for action in local climate policy and help develop policy instruments. These include environmental visions and regional adaptation strategies.

How
This project will make an inventory of the effects of climate change on the health of people in the Netherlands. It will identify the instruments and measures (intervention strategies) for countering adverse effects and promoting positive effects of climate change and measures for climate adaptation and mitigation. We focus on questions and needs for knowledge among professionals at the local level (municipalities, provinces and GGDs). Based on this, we want to derive options for actions to support, in particular, local climate policies and instruments, such as environmental planning plans and regional adaptation strategies.

In collaboration with
Windesheim University of Applied Sciences, Province of Overijssel, Municipal Public Health Service GGD IJsselland, and others.
 

Healthy Enviroment Explorer (GLOVE)

What
RIVMNational Institute for Public Health and the Environment is developing a tool for a healthy living environment that helps municipalities to develop environmental visions, environmental plans and the management of outdoor space.

Why
A healthy living environment is an important goal of the new Dutch Environment and Planning Act. With the arrival of this new act the development and maintenance of a healthy living environment is also explicitly the responsibility of local authorities. However, it is still unclear for many local authorities how the various quantitative and qualitative health impacts should be assessed. RIVM will assist them by developing an explorer for a healthy living environment.
RIVM wants to make the knowledge about the quantitative and qualitative relationships between living environment and health available as well as possible in order to be able to design healthy cities, villages, neighbourhoods and districts. The tool will be developed together with future users into a clickable user interface in relation to the various work processes in municipalities, the development of environmental visions, environmental plans and the management of outdoor space.

How 
The first step within this project consists of an exploration of the quantitative and qualitative aspects with regard to health that should be taken into consideration in the design phase of an environmental plan. In addition, the relevant future trends in the urban area are mapped. This knowledge is translated into interaction with users into a draft assessment framework for a healthy living environment. 

Collaboration
In order to involve the right future users in the project, there will be a collaboration with the two ZonMw projects in Utrecht and Groningen in which RIVM is also involved. 

Working together on healthy design principles with a special focus on (frail) older people (GOUD)

What 
RIVMNational Institute for Public Health and the Environment will develop a roadmap for a healthier design of the physical and social environment of (frail) older people. All in collaboration with municipalities, spatial designers, housing corporations and interest groups for older people. RIVM will describe the relevant steps for healthy design, provide an overview of healthy design principles and the related evidence base, and offer an overview of participation methods.

Why 
The ageing society makes special demands on the design of the living environment. But we see that current spatial designs still pay little attention to the health of vulnerable elderly people. In addition, designers still make little use of scientific knowledge about the influence of the living environment on health. Furthermore, vulnerable elderly people are not yet sufficiently involved in the design. In this project, we want to build bridges between these currently often separate worlds. In this way, we want to contribute to a healthier design of the living environment of (vulnerable) older people.

How 
We will examine whether and, if so, how design processes already pay attention to the health of vulnerable older people. We collect knowledge about the influence of the social and physical environment on health. We also look at what is known about how to incorporate the wishes and needs of older people into the design process. We do this on the basis of literature and interviews. We look into a case study and contribute our knowledge when asked to do so. Based on this knowledge, we develop a step-by-step plan for the design of a healthy design for the physical and social environment, with special attention for and involvement of vulnerable older people.

Collaboration
We use the insights and advice of a sounding board group. It consists of spatial designers, representatives of the municipality, public health services, internal project advisors, representatives of the elderly, and other relevant experts.

Small Area estimates for Policymakers extra (SMAP+)

What 
RIVMNational Institute for Public Health and the Environment aims to provide figures on public health, lifestyle, participation and physical environment in neighbourhoods and districts. We are going to refine a previously developed method to apply the method to various databases and to improve the estimates and presentation of the results.

Why 
For many projects, RIVM cooperates at a regional level. Regional and local parties have indicated that they need figures at the lowest possible geographical level. An overview of these needs has been made.
We want to improve our knowledge and skills in this area to gain a stronger position on small area estimation in the field of public health, health care and physical environment. We also want to improve collaboration with municipalities, health care services parties, (regional) partnerships, Municipal Public Health Centres (GGD ‘en in Dutch) and academic workplaces. The same applies to the collaboration between the domains of public health, health care and the physical environment regarding district and neighbourhood data. We expect different information needs from every perspective, all with a link to people's health.

How 
We will cooperate with three regions, each of them have a different perspective: 1) Groningen has the perspective of public health 2) Regio Oost has the perspective of physical environment 3) Haaglanden has the perspective of health care. We expect that every perspective has its specific need for data, although will have a link to the health status of people.

In collaboration with 
Aletta Jacobsschool, Province of Groningen, Hanzehogeschool Groningen, Academische Werkplaats Publieke Gezondheid Noord-Nederland, Gezondheidsregio Gelderland Midden, GGD Gelderland-Zuid, GGD Noord- en Oost-Gelderland, GGD Twente, GGD IJsselland, and the consortium Gezond en Gelukkig Den Haag (in which are represented: LUMC campus The Hague, Municipality of The Hague, Haaglanden Medical Centre, Reinier Haga Group, General Practitioners' organisations region Haaglanden, Florence, Parnassia Sophia Rehabilitation and Welfare).
 

Supporting local public engagement in living environment and health (IDEE)

What 
RIVMNational Institute for Public Health and the Environment wants to involve citizens in the development and use of knowledge of a healthy living environment. This project aims to gain more insight into how RIVM can do this effectively. It is based on our social mission to contribute to a healthy living environment with information and knowledge.

Why
There is an increasing number of citizens' initiatives in the field of environment and health. Local authorities are also increasingly actively involving residents in environmental and health policy and activities. This is partly due to the new Environmental Planning Act. The expectation is that policy will be more in line with the perspectives, priorities and experiences of residents and will therefore become more successful. Nevertheless, there is often a lack of tools to give proper shape to civic participation. RIVM can provide information and knowledge to local government parties and citizens for the design of, for example, a healthy neighbourhood or sustainable schoolyard, the measurement of noise pollution, or combatting tiger mosquitoes.

How 
RIVM will explore how citizens can best be involved in the development of initiatives in several case-studies. For each case-study,  RIVM will collaborate with local and regional parties, citizens and citizens' initiatives. We will look into the need for information and support, and how we can fulfil this need. All cases are evaluated so that RIVM can develop further in terms of citizen participation in the healthy living environment. The lessons learned are actively shared with stakeholders and interested parties.

In collaboration with 
Municipality of Apeldoorn, Province of Overijssel, Municipal Public Health Service and, if possible, an environmental service.
 

Quality check for urban water and green (WATCHURG)

What
RIVMNational Institute for Public Health and the Environment will develop a quality check to estimate the risks of urban water and adjoining green space. Local and regional parties will be able to use this instrument independently. This tool for microbiological risk assessment will also offer action perspectives through modules with background information.

Why 
Water and green space in cities have a positive effect on the health of the population. In healthy cities, people are increasingly invited to meet urban water and green. In addition to positive effects, urban water and green may also be a risk for public health. For example, when urban water is microbiologically contaminated or when ticks spread in public green areas, which may result in the exposure of citizens to pathogens. It is therefore important to consider possible health risks when planning, designing, implementing and managing urban water and green areas, and to limit these risks as much as possible. 
At present, local and regional authorities do not always take these risks into account. They lack knowledge and expertise, awareness of the problems or a concrete perspective for action.

How 
In interviews, municipalities, water boards, public health services and provinces, among others, can explain their problems and needs with regard to urban water and green space. Existing tools and available data will also be inventoried. With the results of the interviews and the collected data, the quality check will be developed and then applied in practical situations with urban water and green space. The quality check will be equipped with modules with background information, and action perspectives will be developed based on the needs of stakeholders, literature data and expertise of the team members.

Collaboration
The project will collaborate with local partners. These will be selected based on the first phase of the project.
 

Collaboration in regional and local levels for healthy living environments (SLIM)

What 
RIVMNational Institute for Public Health and the Environment wants to improve cooperation with local and regional partners who work towards a healthy living environment. Insight is needed into how this cooperation can be improved. It should also become clearer how RIVM can support local and regional partners in their need for knowledge and information.

Why 
Collaboration is key to the improvement of a healthy living environment. A healthy living environment is influenced by many factors, such as the facilities in a neighbourhood, air quality (such as fine dust and odour nuisance), night-time light, noise, but also the social environment and (traffic) safety. As a result, various partners are needed to jointly create a healthier living environment. In addition, major social agendas  in the Netherlands such as the National Climate Agreement , the Care Agreement and the Environmental Planning Act, call for practical implementation at local and regional level with several partners.

How
SLIM will provide an evidence-base regarding (successful) collaboratives aimed at improving healthy living environments at the regional and local level. The evidence-base will include context-specific tools and guiding principles to improve the collaboration. The collected evidence will be shared with regional networks. The results will be disseminated through practical tools and peer-reviewed scientific papers.