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Better health begins close to home (and not in the doctor’s surgery)

Should we ban snack bars from neighbourhoods where residents are overweight or have diabetes? At the Common Sense about Health knowledge festival, scientists, civil servants and other professionals discussed how South Holland can become healthier. The Healthy Society Map makes it clear where there are urgent problems, as the workshop by Leiden psychologists showed.

If you place information maps of The Hague side by side, you will see something remarkable. ‘Take a look at the neighbourhoods where there are a lot of health problems,’ says psychologist David de Buisonjé, pointing to a series of topographical health maps. In neighbourhoods that have the most snack bars, a relatively high proportion of the residents suffer from obesity and diabetes. The new Healthy Society Map online platform shows this kind of relevant data very clearly, says De Buisonjé. The website will be made available to the general public later this year and is an initiative of Healthy Society (a collaboration of Leiden-Delft-Erasmus Universities and Medical Delta), the South Holland province and the municipal health service.

‘We hope the Healthy Society Map will help government staff and scientists find the right way through the warren of data,’ says Andrea Evers, Medical Delta professor of Healthy Society. ‘The maps can be used to get scientists and policymakers talking to one another.’

Some residents are discouraged from moving around by the concrete environment, broken paving stones and unsafe streets.

No snack bars close to schools

In the workshop, De Buisonjé explained the concept to staff at universities, municipalities and knowledge institutes such as RIVM. ‘Will there also be a map with information about low frequency noise?’ someone wants to know. Another participant suggests a map about the radiation levels in The Hague. Evers believes these are good suggestions, provided the data is scientifically grounded. De Buisonjé got the participants to work together in groups deciding which health problems they want to deal with and which experts they need to be able to do that. Wiktar, a Rotterdam student who is doing an internship at the municipality of Rotterdam, gave some examples from his city. ‘In Rotterdam, we are banning mobile snack bars near to schools and we’re using the five main food groups for a healthy diet for different culinary cultures. Could that be something for The Hague?’

Frank den Hertog from RIVM questioned whether snack bars are the real problem. People also buy a lot of unhealthy food in supermarkets, so wouldn’t it be better for snack bars and supermarkets to sell healthier food? Besides the scientists, you should ask the local residents as experts, suggested psychologist Lennart: if you ask them for advice on healthy lifestyles, that will build more support for lifestyle changes

Isa van Rijswijk, neighbourhood sports coach at Bewegen Werkt. ‘My area is the Loosduinen part of The Hague where almost half the residents are 50 or older. I encourage older people to move more and I look at what’s needed to make that happen. Older people often want different things from younger people. They’re not interested in having a football pitch, for example, but they do want good public transport or other ways of getting to the woods or a park. The Healthy Society Map can give me access to valuable research data that I can use in practice.’

Sugar tax needed

 The brainstorming session of the other groups produced a lot of good ideas for a local and national approach. A sugar tax and lower VAT on fruit and vegetables will make it more attractive to eat healthy food. And as well as eating healthily, people also need primarily to be encouraged to be more active. Some residents feel inhibited by their concrete surroundings, narrow and broken pavements and the feeling of being unsafe on the streets, one participant noted. This is an indication that the currently low-scoring neighbourhoods need to become greener and safer. De Buisonjé was happy with all the suggestions: 'The advice makes it clear that we should also explicitly involve residents as experts in order to improve the neighbourhood together. And snack bars are not necessarily bad, as long as the food they offer is healthier.’

Frank den Hertog, scientific officer at RIVM. ‘I came here to get inspiration. Municipalities and provinces ask RIVM for guidance for a healthier environment. That’s why I’m working on a national online knowledge bank that makes all the fragmented information on the living environment more accessible. For South Holland I can now refer to the Healthy Society Map. Knowledge and awareness of the consequences of how a neighbourhood is organised Everyone should understand and be aware of the consequences of neighbourhood planning. This applies, for example, to employees of municipal land development agencies. They need to guard against selling land to any party that won’t help the area flourish.’

Consequences of demolition

As well as the different workshops, there were also lectures, including by psychologist Semiha Denktaş from Erasmus University Rotterdam. She pointed out the importance of smartly designed public spaces that encourage contacts and movement almost automatically. 'Good health starts primarily in the neighbourhood and not in the doctor's consulting room.' For instance, a life-sized chess board on a neighbourhood square can prove a useful meeting place and people are more likely to take the stairs if there are signs on the steps telling them how many calories they will burn. Journalist and social geographer Floor Milikowski pointed out the disturbing consequences of the demolition hammer, as in Rotterdam's Tweebos area.

The residents were a close-knit group but after the area was demolished, not everyone was able to return, and Rotterdam’s wealthier residents moved in. ‘The sledgehammer destroys more than you might want,’ one participant commented quietly.

During this festival on 16 February in the provincial government building in The Hague, the app Momo BedSense app won the regional round of the Healthcare Innovation prize. The app is linked to a bed sensor under the matrass. Healthcare workers can then see straight away which residents need assistance.

Banner photo: Province of South Holland/Remco Zwinkels

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