If you have to walk a bit to your car, you can meet more neighbours and thus greet them. Social relationships do a lot for your mental and physical health. The Medical Delta newsletter features a double interview (Dutch) with Prof. Anna Nieboer and Prof. Machiel van Dorst, on how the physical and social environment can advance wellbeing and health. The whole interview is written by Rianne Lindhout.
How does our physical environment, for example the neighbourhood, affect our health?
Machiel van Dorst, professor of Environmental Behaviour and Design at TU Delft: "The most important environment is your fellow human beings. Social interaction promotes mental health. The built environment can promote or hinder social interaction. Front gardens, for example, help: if you sit in them or weed, you meet your neighbours. A row of cars in front of houses, on the other hand, does not help."
Anna Petra Nieboer, one of the Scientific Leaders of the scientific programme Healthy Society in Medical Delta: lifestyle & prevention and professor of social-medical sciences at Erasmus University Rotterdam: "Our research shows that greenery, safety, good housing quality and mutual solidarity do a lot for health and well-being. Besides smoking and exercise, you should also see social activity as health behaviour. Social relationships not only promote your well-being. Socially active people also actually live longer."
So a neighbourhood should promote as much social interaction as possible?
Van Dorst: "Again, not that. The definition of privacy is that people have control over how they interact with others and the information they share. So you should have the choice to meet people or not. You don't solve that with a meeting room in a big flat. When you walk in there, you immediately have a sticker with 'lonely' on your forehead. Or that one neighbour you don't want to meet is just sitting there. A wide gallery is much better. There you can walk past each other or stay for a chat. Details like that do the trick."
Nieboer: "Knowing each other does help. It contributes to our well-being and can prevent problems. It also makes it easier to speak to each other about loud music, for instance. And if you fall down in the street, will someone come to help you?" Van Dorst: "Complete anonymity also makes it easier to engage in inappropriate behaviour, like putting your rubbish in the lift and not taking it all the way to the basement."
Beyond front gardens and wide galleries, how can you encourage the solidarity needed in a neighbourhood?
Nieboer: "It's difficult. With the municipality of Rotterdam, we did the Even Buurten study to identify and solve health and well-being problems in the elderly in good time. Care and welfare professionals tried to strengthen the social networks around vulnerable elderly people living at home. Cooperation between, for instance, home care and GP proved difficult. Cooperation with the informal network of the elderly, such as their informal carers or neighbours, was also difficult. A solution could be a long-term investment by the municipality in an enterprising pivot in the neighbourhood: someone who knows many residents and professionals, who talks and makes connections."
Van Dorst: "Living on a through road makes it difficult to tell whether a passer-by is a neighbour or not. Knowing who your neighbours are is already very important. Even in existing neighbourhoods, some through roads can be transformed, for instance with a small park in the middle. These encourage encounters and walks at a pleasant temperature. Greenery contributes to wellbeing, prevents warming of the city and can temporarily store water during heavy rainfall."
"Also involve residents in the infill and then really take them seriously. Most people notice very well when participation is actually a sham. In Rotterdam Noordereiland, residents were given a large bridge in front of their door. At the end of a participation evening, someone from the municipality came in with a model: this is how we are going to do it!"
Where does your research come together?
Van Dorst: "We work together in SPRING, a transdisciplinary research project with the municipality of Rotterdam. Scientists often think very specialised, I want to bring all the knowledge together in SPRING. In living labs we want to carry out interventions in neighbourhoods together with the people concerned. Like preventing exercise poverty among the elderly, or obesity among children. Health scientists, behavioural experts, sociologists and urban designers must learn lessons from this. We also make data accessible. That also facilitates future researchers, the municipality and, above all: the residents themselves."
Nieboer: "Together with colleagues, I am researching within SPRING the neighbourhood prevention chain that the municipality is currently developing. That chain of primary care - such as GPs, the municipal demand counter and other professionals in the neighbourhood - should help and refer Rotterdammers with an unhealthy lifestyle or health problems earlier. We know from previous research that it is difficult to connect well with what people need."
"We are too stuck in certain disciplines. Each healthcare provider has its own checklist, which often doesn't fit. If we want to get someone with heart problems moving, it is relevant whether there are difficult stairs at home and in the neighbourhood. And whether people are not too stressed by debt. That awareness is beginning to emerge and the neighbourhood prevention chain offers an opportunity to reduce socio-economic health inequalities in deprived neighbourhoods."
Do conditions for optimal well-being differ by population group?
Nieboer: "In Rotterdam, with its great diversity, we investigate the needs of elderly people with and without a migration background. People seek out people with a similar cultural background. On the other hand, Moroccan and Turkish elderly prefer not to live secluded, then they feel set apart. We also found that older migrants who do not feel safe and valued in their neighbourhood get out and move around less. We are looking for how to set up age-friendly communities, without sharp boundaries and conflicts. If there is little contact in a neighbourhood, there is little sharing and mutual solidarity does not come naturally. In neighbourhoods where this is difficult, substantial investment is needed."
Van Dorst: "In the Brazilian city of Curitiba, it worked very well to put up a Japanese temple, a German farmhouse or an Arab library. That brought populations self-respect and that in turn created the will to participate. They felt seen. On Rotterdam's Noordplein, a Moroccan fountain also made young people proud and sparked conversations."
The government wants to add a million houses, what should it pay particular attention to? Van Dorst: "Don't fall into mass production, but start on the small and human scale. Know who you are building for. I sometimes have my students walk through the city in groups, with one of them blindfolded. Then you hear and smell the city, feel the quality of the pavement. From the lower perspective of children, you sometimes only see cars and experience the lack of play space. In larger cities, still keeping the smaller scale can work well. The metropolis Tokyo, for instance, is very safe, partly because of the small scale of its neighbourhoods. In each neighbourhood area, people feel that it really belongs to them."
Nieboer: "However, Tokyo is very homogeneous. In more diverse neighbourhoods, more is needed to promote interaction. And we have to guard against excessive social control. Because the village that some elderly people long for back also had a downside."
- Professor
- More information
This double interview is one of seven double interviews with 14 South Holland scientists in the white paper 'Towards a healthy society for all'. Sender is Healthy Society, a collaboration of Leiden-Delft-Erasmus Universities and Medical Delta. The whitepaper can be downloaded here (Dutch).