'The most important environment is your fellow human being'

If you have to walk a small distance in order to get to your car, you will meet more neighbors and thus greet them. Social relationships help al lot with your mental ánd physical health. Machiel van Dorst and Anna Petra Nieboer examine how the physical and social environment can advance well-being and health. .

This double interview is one of seven double interviews with fourteen scientists of Zuid-Holland in the white paper 'Towards a healthy society for all'. Publisher is Healthy Society, a collaboration between Leiden-Delft-Erasmus Universities and Medical Delta. The whitepaper can be downloaded here.

What does our physical environment, for example the neighborhood, do for our health?

Machiel van Dorst, professor of Environmental Behavior and Design at Delft University of Technology: "The most important environment are your fellow human beings. Social interaction promotes mental health. The built environment can promote or hinder social interaction. Front gardens help, for example: if you sit in them or if your gardening, you meet your neighbors. 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 program 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 help a lot with our health and well-being. In addition to smoking and exercise, you should also see social activity as health behavior. Social relationships not only improve your well-being. Socially active people actually live longer."

So a neighborhood 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 have to have the choice to meet people or not meet people. You don't solve that with a meeting room in a big apartment. If you walk in there, you immediately have a sticker with "lonely" on your forehead. Or that one neighbor 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 it can prevent problems. It also makes it easier to speak to each other about loud music, for example. 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 behavior, such as putting your trash in the elevator and not taking it all the way to the basement."

Beyond front yards and wide galleries, how can you encourage the solidarity needed in a neighborhood?

Nieboer: "It's difficult. Together with the municipality of Rotterdam, we did the ‘Even Buurten‘ study to identify and solve health and welfare problems in the elderly in a timely manner. Care and welfare professionals tried to strengthen the social networks around vulnerable elderly people living at home. Cooperation between home care and the general practitioner proved difficult. Cooperation with the informal network of the elderly, such as their informal caregivers or neighbors, was also difficult. One solution could be a long-term investment by the municipality in an enterprising pivot in the neighborhood: someone who knows many residents and professionals, makes small talk and establishes connections."

Van Dorst: "Living on a busy road makes it more difficult to tell if a passerby is a neighbor or not. Knowing who your neighbors are is already very important. Even in existing neighborhoods, some roads can be transformed, for example with a small park in the middle. These encourage encounters and walks in a pleasant temperature. Green contributes to well-being, prevents the urban heat island effect 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're 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 specialized, within SPRING I want to bring all this knowledge together. In living labs we want to carry out interventions in neighborhoods together with the people concerned. Like preventing lack of exercise among the elderly, or obesity among children. Health scientists, behavioral experts, sociologists and urban designers must learn from this. We also make data accessible. This data also facilitates future researchers, the municipality and most importantly: the residents themselves."

Each care provider has its own checklist that often just doesn't fit

Nieboer: "Together with colleagues, I am researching within SPRING the neighborhood prevention chain that the municipality is now developing. That chain of primary care - such as general practitioners, the municipal demand counter and other professionals in the neighborhood - 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 health care provider has their 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 neighborhood. And whether people aren't too stressed by debt. That awareness is beginning to emerge, and the neighborhood prevention chain offers an opportunity to reduce socioeconomic health disparities in disadvantaged neighborhoods."

Do conditions for optimal well-being differ by population group?

Nieboer: "In Rotterdam, with its great diversity, we study the needs of elderly people with and without a migration background. People seek out people with similar cultural backgrounds. On the other hand, Moroccan and Turkish elderly prefer not to live isolated, then they feel set apart. We also found that older migrants who don't feel safe and valued in their neighborhoods get out and exercise less. We are looking for how to set up age friendly communities, without sharp boundaries and conflicts. If there is little contact in a neighborhood, there is little sharing and mutual solidarity does not come naturally. In neighborhoods where that 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 a million more 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, sometimes you only see cars and experience the lack of play space. In larger cities, still maintaining the smaller scale can work well. The metropolis of Tokyo, for example, is very safe partly because of the small scale of its neighborhoods. In every neighborhood part, people feel that it really belongs to them."

Nieboer: "However, Tokyo is very homogeneous. In more diverse neighborhoods, more is needed to promote interaction. And we must guard against excessive social control. Because the village to which some elderly people long to return also has a downside."

By Rianne Lindhout

Machiel van Dorst (1963) studied architecture and environmental psychology and is professor of Environmental Behaviour and Design at TU Delft. He is one of the leaders of the SPRING research program. In it, a broad group of researchers works with the municipality of Rotterdam on health and well-being in residential neighborhoods.

Anna Petra Nieboer (1966) studied sociology and is Professor of Social and Medical Sciences at Erasmus University Rotterdam. She investigates innovation of care and support of vulnerable citizens from a multidisciplinary perspective. She works together with involved people and parties to achieve better interventions and solutions.