What is a healthy city? How can we make cities healthier? From which angles should health be assessed? These are only a few of the intricate yet vital questions discussed during the Healthy City Conference that took place on 18 April, in Rotterdam.
Physical, mental, and social health inequalities are prevalent in most – if not all – European cities, especially amongst unprivileged and vulnerable members of society. The Rotterdam-Zuid neighbourhood, in particular, is home to many citizens facing daily challenges, not only in terms of health, but also housing, income, schooling and more. To address societal problems in the city, Resilient Delta has set up a dedicated research theme.
Spearheaded by Resilient Delta and Health & Technology, initiatives under the Convergence partnership, the Conference gathered health professionals, architects and city planners, policymakers, and researchers from several disciplines, with two overarching goals: sharing ideas, findings, and experience, and fostering long-term cooperation transcending disciplinary boundaries in order to transform Rotterdam into a healthy city - for all.
Sounds good on paper, but why is it worthwhile attending such an event?
1. To gain new perspectives
Seeing your work from a different lens.
A very thought-provoking presentation was given by René Cuperus, co-author of the Atlas van afgehaakt Nederland and Senior Research Fellow at the Clingendael Institute. Cuperus explained that a growing part of the Dutch population no longer feels represented or respected by the politicians in charge, and that experiencing poor(er) health appears to have a strong correlation with the political disengagement detected. Cuperus warned that “if we are not careful, we’ll have a democracy just for healthy people”, adding that "the huge offensive being rolled out in the field of health (...) is accompanied by insufficient empathy and antenna for the groups it is actually about." With higher educated individuals imposing their lifestyle e.g., cafeteria bans, alcohol taxes, on lower educated groups, health could become a culture war.
While the picture looks gloomy, Cuperus also shared positive news. Although many green areas in the Netherlands house citizens with a lower socioeconomic status, there is still a high perception of health and happiness in those areas, such as Friesland; this is also related with a feeling of ‘community’ and people watching over each other. In fact, lifestyle and the social and physical environment determine almost 70% of a person's health, whereas the impact of medical care accounts for only 11%.
"I’m seeing policymakers much more focused on the scientific approach to policy, than the societal approach. And I’d like to see both."
The presentation ended on a critical note “I’m seeing policymakers much more focused on the scientific approach to policy, than the societal approach. And I’d like to see both.” According to Cuperus, while terms like ‘Resilient Delta’ are catchy, the gap between policymakers and citizens shouldn’t widen even more, and it’s important to reassess – “are people a statistical research object, or are they fellow citizens"?
2. To get inspired
An opportunity to gather inspiration and inspire others.
Experts of various disciplines sat together and reflected on the relationship between residents and urban trees during the RoffaLab presentation. This Resilient Delta project, introduced by René van der Velde, Associate Professor Landscape Architecture & Urban Forestry at TU Delft, seeks to deploy movable trees as a living lab throughout the city and investigate the following aspects: climate change and heat stress, vegetation and health, placemaking and identity, and citizen engagement. With 40 trees, split into two locations, one of the discussion points was “how can we use this mobile, dynamic green space initiative – a physical set of green assets - to study, understand and conceptualise the future of healthy urban green spaces?”. Indeed, with urban trees, there are many aspects playing a role – social, health, environmental, special, and reflection is needed on “what kinds of configurations of urban green spaces are needed for future cities?”.
During the afternoon panel, Jacqueline Jonkhart, Director of the Giovanni Van Bronkhorst Foundation and one of the Erasmus University Rotterdam faces of International Women’s Day, and Lieke Oldenhof, Associate Professor at ESHPM and co-founder of the CARE Lab Rotterdam, shared their inspiring work and advice.
The Giovanni Van Bronkhorst Foundation seeks to “make children captain of their own future”, giving perspective to those “who live in poverty and don’t have many chances in life if we don’t do anything about it”. The foundation provides an education programme to improve school performance, but is equally focused on prevention and resilience, including health. When approaching citizens, Jonkhart wants researchers to tell them what they can gain from it, and to consider their interests.
The CARE Lab seeks to get policymakers, scientists and citizens together to think about how to improve fragmented support systems in order to prevent people in vulnerable situations from falling between the cracks. Oldenhof stated that we should invest more in creating basic security for people by ensuring adequate housing and sufficient income. Otherwise, people do not have “the mental space to work on their own health and well-being”. The EUR professor advised researchers to diversify how they arrange participation, as certain methods, such as sticking memos on a whiteboard, might not resonate or even be uncomfortable for citizens.
"A healthy city is not a status quo; a healthy city is a city that is continuously doing better."
3. To be challenged in your work
Have others think with you and be critical.
“A healthy city is not a status quo; a healthy city is a city that is continuously doing better”, claimed John Boon, Head of ARCADIS Landscape Architecture, who pitched his company’s greening strategy for an area in the southeast of Amsterdam. Boon stated that high density areas should become greener to benefit all residents, “not just the happy few”. The Amsterdamse Poort will therefore see the introduction of green in public spaces, such as walking areas and squares, the construction of pocket parks in neighbourhoods, and the green transformation of parking facility rooftops. By changing this environment, the intention is to reduce heat stress, improve safety and wellbeing in this area and stimulate interaction between residents, as well as activeness and exercise.
Whilst there was consensus on the benefits of such a project, researchers questioned Boon on potential negative effects such as increased rent costs, locals being driven away, and gentrification. Asking each other difficult questions from the outlook of different disciplines is crucial for societal impact.
4. To connect and possibly collaborate
Together, we are stronger!
Machiel van Dorst, Professor of Environmental Behaviour and Design at TU Delft, and Renske Keizer, professor in Family Sociology at Erasmus University Rotterdam, are the academic leads of the SPRING consortium, presented in a breakout room. This long-term research project digs into why an individual’s place of birth within the city of Rotterdam determines health and well-being as well as life expectancy, in order to address these differences. Looking back at the event, Keizer revealed that “the inspiring talks underscored the complexity of health inequalities and the necessity of a transdisciplinary approach to tackle them”, adding she found it “really valuable to receive input on the developmental path” of the project.
In another breakout room, the action research on Wijkpreventieketen was introduced by Anniek Bosdijk. The Erasmus School of Health Policy & Management PhD candidate shared that “an integrated neighbourhood approach not only requires cross-domain collaboration between professionals in the neighbourhood, but also more cohesion and coordination at the municipal/policy level", confirming that the Conference was a great opportunity to “meet new people working on similar topics” and “exchange ideas”.
What are some of this Conference’s takeaways?
Transdisciplinary is the future - health cannot be viewed in isolation: Health cannot be defined from a single angle and requires a multi-discipline lens. Moreover, many health issues arise due to external factors and it’s time we tackle the root of the problem, and not merely treat the symptoms. A particular behaviour might impact health in both positive and negative ways and be, for instance, damaging to one’s physical health yet beneficial for one’s social health e.g., the infamous snackbar, where individuals can gather and socialise but consume arguably not-so-nutritious dishes. Simultaneously, the health of citizens has a much wider impact than one might think, for instance, it affects participation in democracy and voting behaviour.
There is a positive correlation between green and healthy: Let’s harness this knowledge and redesign cities accordingly, with the engagement of citizens.
The involvement of citizens needs to be rethought: It is important to carefully consider the rhetoric and methods used to spark interest and engagement by citizens – especially those who need concrete solutions for daily problems.
Collaboration is not desirable, it is necessary: Working alone is archaic and doesn’t yield the same impact, even when you have a phenomenal idea. If you’re aware that others are working on something similar, include them from the very beginning; seek to learn and connect. Conferences, such as this one, are a good place to start!