The healthy city

How can environmental and planning policies for urban areas be designed to achieve health benefits? What should the national government and subnational authorities do to enable this?
Photo: children playing in a park

Background and request for advice

One of the stated aims of the Environment and Planning Act is to establish and maintain a healthy built and natural environment. How that goal should take shape in policy remains unclear to many public authorities. How will this affect the balancing of interests when drawing up environmental strategies and plans? How will it affect sustainable urban development projects? In this advisory report, the Council for Environment and Infrastructure (Rli) offers its suggestions.

The Healthy City seeks to answer the following question:

How can environmental and planning policies for urban areas be designed to achieve health benefits? What should the national government and subnational authorities do to enable this?

Main recommendations

The Council feels that public authorities can achieve extra health benefits if they go beyond health protection (traditional environmental policy) and strive towards health promotion. Health is more than the absence of illness. People’s environment should reduce stress, encourage exercise and stimulate social engagement. The Council proposes new options for environmental policy and instruments, research and design, and finance and governance.

Bolstering policy and employing instruments

The Council believes that protecting human health is and will remain an important policy ingredient for a healthy built and natural environment – the Netherlands must, at the very least, comply with the environmental standards in force. Additional health benefits will however require efforts to create an environment that promotes health by enabling and encouraging exercise, social engagement and relaxation. Public authorities should cooperate more effectively,  seek synergies and make full use of the instruments offered by the Environment and Planning Act.

Fostering research and design

Promoting health through the environment will require a more solid evidence base. The effects of health-promoting measures should be better understood, and the results of local interventions better communicated. The Council recommends developing new tools, such as health maps and environmental health stress tests. Design studios can help to bring together parties from diverse backgrounds, help them learn each other’s language and help them to work together towards creative solutions for improving health.

Strengthening the financial base and improving governance

When making investments in the physical environment, consideration should be given not only to health risks, but especially to the health benefits. The 2018 evaluation of the Housing Act should consider whether or not housing associations should be allowed to invest more towards a healthy environment, liveability and public property. To overcome the split-incentive issue, municipalities, healthcare providers and the national government could create local prevention coalitions for the promotion of a healthy environment. In addition, public authorities should work more in interdisciplinary teams to bring together the often-separate worlds of environment and healthcare and to take a more holistic approach to fostering a healthy environment.

Publication date

On 18 April 2018 the Council presented its advisory report The Healthy City to Minister Ollongren of the Ministry of the Interior and Kingdom Relations (BZK).

de overhandiging

Program Director General Erik Jan van Kempen receiving the advisory report on behalf of Minister Ollongren (BZK). Rli Chair Jan Jaap de Graeff (m) and council member Ellen Peper (l) (Photo by Fred Ernst)

See the photos of the presentation of the advisory report The healthy city

Urban design workshops

In September 2017, the Council held two urban design workshops on environmental health using three Dutch cities as case studies. The results of these studios are presented in the Dutch-language version of the advisory report. For more detailed information, please see:

These reports were drawn up at the request of the Rli, but their contents remain the responsibility of the design practices.

More information

For more information, please contact Lianne van Duinen (project leader):