Health

Healthy or unhealthy living environment

The quality of the living environment in the Netherlands has improved since 1990, partly thanks to the policy pursued. The air and surface water have, for example, become cleaner and exposure to soil contamination has reduced. What is more, measures to combat legionnaires' disease, a ban on asbestos and environmental requirements on products (e.g. chipboard, motors, tyres and fuel) have proven to be successful.

However, there are still environmental factors which are harmful to people's health. For example air pollution, noise and an unhealthy indoor environment may lead to health problems, or cause people to become ill or die prematurely. This all depends on the harmfulness of the environmental factor, on how much you are exposed and on personal factors.

Living environment and life phases

The way in which the living environment influences people's health is not the same for everyone, nor in each life phase. This is not only because (groups of) people differ in exposure and sensitivity, but also because there is a difference as regards the possibility of avoiding risks or protecting oneself against them. In some phases in life people are more sensitive to the health effects of certain environmental influences than in others. Children, for example, are still growing and developing and are therefore more vulnerable than adults. Consequently, children are more sensitive to noise than older people because they are in a life phase in which their thought processes are still developing. Daily exposure to noise can cause them to suffer a learning delay which is difficult to make good in later life. In addition, the extent to which children play outside can lead to higher exposures to certain (chemical) substances. The way in which the living environment is organised also determines people's health. For example, the elderly have more accidents on uneven pavements.

A relatively new term is 'healthy life cycle' which means that someone completes many or all phases of his or her life in a good state of health and well-being.

Greenery in the neighbourhood, opportunities and risks

The living environment also offers possibilities for exercising, playing or meeting other people. Greenery and nature in the neighbourhood are important in order to relax and recover from day-to-day stress. However, plants or animals can also cause allergies and transmit infectious diseases. In the Atlas of the Living Environment you can find information about environment-related (infectious) diseases such as Q fever and Lyme disease. You can obtain information about other (infectious) diseases from the Centre for Infectious Disease Control (RIVM) and RIVM's Public health and health care website.

The health risks of air, noise, soil, water and greenery are described under the various themes. On this page you can find general information about the influence of the living environment on people's health.

edited January 19th 2018

Influence of the living environment on people's health

According to recent estimates roughly 3-7% of the disease burden in the Netherlands can be attributed to the living environment. Air contamination and noise are the most important causes of health issues. The influence of our living environment on people's health is limited compared to other factors, such as smoking, insufficient exercise, alcohol and obesity. Nevertheless a poor environment can pose significant health risks. New and persistent problems, such as climate change and traffic density, require continuous attention. What is more, the way in which we experience our living environment also affects our health. This means stress or negative feelings due to, for example, noise pollution.

The living environment also has an indirect influence on people's health. The living environment can encourage people to engage in healthy behaviour through, for example, play and meeting areas and by facilitating walking, cycling or sport. Information about the healthy design and organisation of the living environment can be found in the Healthy Design Guide [GezondOntwerpWijzer].

The infographic below refers to a number of various factors which contribute to the total disease burden (that is the loss of health caused by diseases). These factors can be influenced (to varying degrees).

The most important illnesses which are related to the living environment

  • Exacerbation of complaints relating to ailments such as asthma, chronic bronchitis and cardiovascular diseases by, for example, air pollution.
  • Serious nuisance, sleep disturbance, reduced capacity to concentrate and hampering of daily activities due to noise.
     

Stress and worry

In addition to health issues, environmental factors can also lead to stress and worry. Worry was the most commonly reported complaint to the Municipal Public Health Services (29%) in the period 2009-2010. The majority of complaints which people report relate to the indoor environment. The main culprits are mould, damp, pests and inadequate ventilation. People are often concerned about the health risk of asbestos and mould. The lack of control that people have over these risks plays an important role in this respect. You can read more about this in the Environmental Data Compendium.

Vulnerable groups

Not everyone is equally sensitive to harmful environmental factors. Children, the elderly, the chronically ill and pregnant women belong to the so-called vulnerable groups. What is more health and illness are not equally distributed across the different population groups and areas of the Netherlands. You can find more information on this subject on RIVM's Public health and health care website and in the Guidelines for the identification and protection of high-risk groups [Leidraad voor identificatie en bescherming van hoogrisicogroepen] published by the Health Council of the Netherlands [Gezondheidsraad].

edited January 19th 2018

Health as an integral part of policy

While, in recent decades, policymakers have primarily been inward looking as regards their own area of expertise, the current trend is to combine forces prompt as many fields as possible. Whereas the focus in recent decades in the case of living environment and health was primarily sectoral, such as soil contamination, drinking water quality or air pollution, nowadays it is important to regard health, the environment and spatial planning as part of the same whole.

A crucial aspect in this respect is to engage with experts from urban planning, the environmental field and health prevention at the very beginning of the development and/or construction processes. In this way health can also acquire an equal place in the planning process. Everyone can benefit, even before work starts, from each other's knowledge and insights and also take health aspects into account. Various initiatives such as the Healthy Design Platform [Platform Gezond Ontwerp] and the Healthy Urban Living Knowledge Centre [Kenniscentrum Healthy Urban Living] are contributing to the timely integration of health into policy plans.

In the report entitled Space and Health [Ruimte en Gezondheid], from 2015, an assessment is made of the relationship between spatial planning and health from these spatial, environmental and health domain.

Health essential aspect of the Environmental and Planning Act [Omgevingswet]

This integral approach, whereby health is included as an essential issue, can also be found in the Environmental and Planning Act. This new law was adopted in mid 2015 by the Dutch House of Representatives and is coming into effect in 2018. The Environmental and Planning Act obliges the state, the provincial governments and municipalities to draw up an environmental vision which also takes account of the importance of a healthy living environment. Thanks to amendments the law has become stricter in the field of health. For example the law now makes it possible to refuse an All-in-one Permit for Physical Aspects if, in the opinion of the municipality, exceptional circumstances apply which can lead to detrimental consequences for people's health if the permit is granted.

National approach to the environment and health

In addition to regular environmental and health policy the government implemented the National Approach to the Environment and Health [Nationale Aanpak Milieu en Gezondheid] (NAMG) in the period 2008-2012. The NAMG was intended to place a number of challenging environment and health assignments onto the agenda which cannot be tackled collectively. This took place alongside the measures which are already being taken to improve air quality, protect soil and water, reduce noise pollution and limit the risks of hazardous substances and radiation.

The NAMG focused on:

  • a healthier indoor environment in buildings;
  • a healthy design and organisation of the living environment and healthy mobility;
  • good quality information about the living environment;
  • identifying and monitoring environmental and health problems.
     

The state took the initiative of bringing together the parties involved, varying from government bodies, implementing organisations and (semi) public organisations such as housing corporations and schools, to knowledge institutions, interest groups and companies. Under the direction of the NAMG they managed to identify responsibilities and actions and start implementing these.

This has resulted in, among other things:

  • an improvement in the indoor environment at approximately 4,300 schools;
  • a website (Healthy Design Guide [GezondOntwerpWijzer]) in which the existing knowledge and information from the various fields of expertise were combined on a theme basis;
  • this website, the 'Atlas of the Living Environment', which provides access to government maps and information about the living environment and health in one location.
     

Many of the activities by the NAMG will continue in the coming years, with state involvement. The letter to parliament entitled 'Completion of the National Approach to the Environment and Health' contains more details on this issue.

edited January 19th 2018

Tips for the improving the health of your living environment

Do you want more greenery or play facilities in the neighbourhood? If so, you should check out the Healthy Design Guide [GezondOntwerpWijzer] for fun examples and tips on how you can start up a greenery or play project. If you have any questions about health and a healthy living environment, you can always contact your local Municipal Public Health Services.

Resources which can be used to assess health effects

Various instruments exist which can be used to assess and evaluate the positive and negative health consequences of policy or (spatial) plans.

A qualitative estimate can be made using questionnaires and checklists. A quantitative estimate involves calculating the expected number of (extra or reduced) illnesses or fatalities. Other effect criteria are, for example, the number of gained (or lost) years of life or the total disease burden or health costs in euros. Under the 'products' tab above the 'Find Out More' column on the right-hand side you will find all kinds of applications, manuals and instruments which may be useful to professionals.

edited January 19th 2018