Special Issue "A More Sustainable and Healthier Future for All: What Works?"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601).

Deadline for manuscript submissions: closed (30 June 2020).

Special Issue Editors

Ms. Ingrid Stegeman
Website
Guest Editor
EuroHealthNet, Brussels, Belgium
Interests: Health inequalities; social determinants of health; HiAP; sustainable development; early child development; capacity building for health promotion
Dr. Tim Taylor
Website
Guest Editor
European Centre for Environment and Human Health, University of Exeter Medical School, Truro Campus, UK
Interests: Ecological public health, Cost-benefit analysis, Environmental economics, Housing and health, Climate change
Prof. Patrick Saunders
Website
Guest Editor
Visiting Professor of Public Health University of Staffordshire, Director carolan57 Ltd, Associate Director WHO Collaborating Centre for the Public Health Management of Chemical Exposures
Interests: Inequalities, air quality, epidemiology, toxicology, contaminated land

Special Issue Information

Dear Colleagues

Our societies appear to be locked into patterns of human behaviour that damage the environment, undermine health and wellbeing and fuel health inequalities. In addition, lower socio-economic groups, who suffer the most from the consequences of pollution and environmental change, benefit least from measures being taken to address these problems.

Despite concerns about the effects of how people are currently living, there has been insufficient attention paid to exploring the potential of behaviour change when seeking solutions in environment and health. People’s lifestyles and behaviours are firmly rooted in social, economic and physical contexts. Changing these contexts, to ensure they sustain rather than undermine health and well-being, can only be achieved through more coherent approaches across policy and practice. Such approaches are also needed to address common challenges like environmental degradation, the rise in chronic diseases and the growth of inequalities.

INHERIT is an ambitious translational research project (Jan 2016 –Dec 2019) funded under the EU Horizon 2020 Programme. 18 partners are investigating effective inter-sectoral policies, interventions and innovations that enable and empower citizens to behave in ways that simultaneously improve the environment, health and contribute to reducing health inequalities - the INHERIT ‘triple-win’ (www.inherit.eu). INHERIT covers the areas of living (green space, energy efficient housing), moving (active transport) and consuming (food).

How can we implement more cross-cutting initiatives in a variety of contexts and help Europe pave the path to a more sustainable and healthier future for all? This special edition will showcase outcomes from different strands of INHERIT’s work to advance knowledge in relation to: 1) the role of lifestyles and behaviours; 2) strengthening governance and inter-sectoral collaboration; and 3) ensuring that initiatives reach disadvantaged socioeconomic groups. We also invite contributions from other relevant research initiatives that focus on what works to ensure more sustainable and healthier futures for all, with a specific focus on any of these cross-cutting themes.

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Ms. Ingrid Stegeman
Dr. Tim Taylor
Prof. Patrick Saunders
Guest Editors

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • Health promotion and prevention
  • Environment
  • Social determinants of health
  • Lifestyle and behaviour change
  • Inter-sectoral collaboration
  • Health inequalities
  • Active travel
  • Energy efficient housing
  • Green space
  • Food production and consumption

Published Papers (22 papers)

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Open AccessArticle
Social Acceptance of Aquaculture in Spain: An Instrument to Achieve Sustainability for Society
Int. J. Environ. Res. Public Health 2020, 17(18), 6628; https://doi.org/10.3390/ijerph17186628 - 11 Sep 2020
Abstract
Aquaculture is a technique to produce food that is under debate, due to its possible consequences for altering the economy, traditional fishing included, or the environment, even with doubts about the health of consumers. This document studies its social acceptance from the point [...] Read more.
Aquaculture is a technique to produce food that is under debate, due to its possible consequences for altering the economy, traditional fishing included, or the environment, even with doubts about the health of consumers. This document studies its social acceptance from the point of view of carrying capacity. This term is defined as the level at which this activity begins to be disproportionate and poses important disadvantages for society. In this context, we conducted 803 surveys in six coastal provinces in Spain. The results show that the acceptance of these products is good, implying that aquaculture is far from reaching its saturation point in society. Additionally, the respondents gave a higher priority to socio-economic objectives than to environmental ones. We can conclude that the further development of this sector is advisable in these provinces. The general perception of aquaculture is better among men, and also among higher-income consumers. Informative activities should be organized to target these more hesitant groups. Production structures should be revised to overcome biases in the population about the idea that the food obtained from aquaculture harms the environment or is less natural or healthy. The possible abuse of feed and chemicals spreads this idea, and this could affect the taste and quality adversely. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
Open AccessArticle
Cross-Sector Collaboration for a Healthy Living Environment—Which Strategies to Implement, Why, and in Which Context?
Int. J. Environ. Res. Public Health 2020, 17(17), 6250; https://doi.org/10.3390/ijerph17176250 - 27 Aug 2020
Abstract
Background: Working toward a healthy living environment requires organizations from different policy domains and nongovernment partners involved in public health and the living environment to collaborate across sectors. The aim of this study is to understand how this cross-sector collaboration for a healthy [...] Read more.
Background: Working toward a healthy living environment requires organizations from different policy domains and nongovernment partners involved in public health and the living environment to collaborate across sectors. The aim of this study is to understand how this cross-sector collaboration for a healthy living environment can be achieved. Methods: The realist evaluation approach was used to investigate what strategies can be used in which contexts to achieve cross-sector collaboration. The “Collaborative Adaptive Health Networks” framework was used as a theoretical framework. Seventeen partners of three Dutch projects collaborating for a healthy living environment in different regions were interviewed about their experiences during the initiating phase of their projects. Results: Seven themes for achieving cross-sector collaboration were identified, namely creating a feeling of equivalence, building trust, bridging different perspectives, providing clarity regarding roles and tasks, creating commitment, creating active engagement, and understanding whom to engage and when. For each theme, the strategies that were used, and why, were specified. Conclusion: This study provides new insights in how cross-sector collaboration for a healthy living environment can be achieved in different contexts. Whether the start of a cross-sectoral collaboration is successful is largely influenced by the choice of leadership and the interorganizational relations. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
How to Achieve a Healthier and More Sustainable Europe by 2040 According to the Public? Results of a Five-Country Questionnaire Survey
Int. J. Environ. Res. Public Health 2020, 17(17), 6071; https://doi.org/10.3390/ijerph17176071 - 20 Aug 2020
Cited by 2
Abstract
The aim of this paper is to understand public preferences for several future scenarios of achieving a healthier, more equitable and sustainable Europe, which differ in the way the society is organized (individualistically vs. collectively) and in the driving sector (public vs. private). [...] Read more.
The aim of this paper is to understand public preferences for several future scenarios of achieving a healthier, more equitable and sustainable Europe, which differ in the way the society is organized (individualistically vs. collectively) and in the driving sector (public vs. private). To achieve this aim, we conducted a questionnaire survey using representative samples for five European countries in 2018. About three thousand respondents chose among the four scenarios presented within four different contexts (green spaces, active mobility, energy-efficient housing, food consumption) or none of them. A majority of people in the five European countries were ready to accept one of the scenarios. We found significant differences in preferences according to socioeconomic backgrounds and values of respondents. People above 35 years old, those who were less educated, and those in the lowest household income tertile were less supportive of all scenarios. The heterogeneity in preferences associated with differences in socioeconomic backgrounds was larger for the scenario in which society is organized individualistically and driven by the private sector. Smaller distinctions were found in case of the scenario in which society is organized collectively and is driven by the public sector. Departing from social psychological theories, we examine the role of altruistic, biospheric, egoistic, hedonic, and security values. People with stronger biospheric values were more likely to accept scenarios, particularly those which are driven by the public sector and where there is more collective organisation. Those with a more egoistic value orientation were more likely to have higher preferences for scenarios where the private sector had a dominant role. The policy implications, in terms of the selection and framing of policy measures to enhance public support, are discussed. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Incentivizing Commuter Cycling by Financial and Non-Financial Rewards
Int. J. Environ. Res. Public Health 2020, 17(17), 6033; https://doi.org/10.3390/ijerph17176033 - 19 Aug 2020
Abstract
Current mobility patterns over-rely on transport modes that do not benefit sustainable and healthy lifestyles. To explore the potential for active mobility, we conducted a randomized experiment aimed at increasing regular commuter cycling in cities. In designing the experiment, we teamed up with [...] Read more.
Current mobility patterns over-rely on transport modes that do not benefit sustainable and healthy lifestyles. To explore the potential for active mobility, we conducted a randomized experiment aimed at increasing regular commuter cycling in cities. In designing the experiment, we teamed up with developers of the “Cyclers” smartphone app to improve the effectiveness of the app by evaluating financial and non-financial motivational features. Participants in the experiment were recruited among new users of the app, and were randomly assigned to one of four different motivational treatments (smart gamification, two variants of a financial reward, and a combination of smart gamification and a financial reward) or a control group (no specific motivation). Our analysis suggests that people can be effectively motivated to engage in more frequent commuter cycling with incentives via a smartphone app. Offering small financial rewards seems to be more effective than smart gamification. A combination of both motivational treatments—smart gamification and financial rewards—may work the same or slightly better than financial rewards alone. We demonstrate that small financial rewards embedded in smartphone apps such as “Cyclers” can be effective in nudging people to commute by bike more often. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Qualitative Evaluation of the STOEMP Network in Ghent: An Intersectoral Approach to Make Healthy and Sustainable Food Available to All
Int. J. Environ. Res. Public Health 2020, 17(9), 3073; https://doi.org/10.3390/ijerph17093073 - 28 Apr 2020
Cited by 1
Abstract
The STOEMP network is, to our knowledge, one of the first initiatives to bring different sectors together in a municipality so as to increase accessibility to healthy and sustainable foods for all, with particular attention for the disadvantaged population. This qualitative study aimed [...] Read more.
The STOEMP network is, to our knowledge, one of the first initiatives to bring different sectors together in a municipality so as to increase accessibility to healthy and sustainable foods for all, with particular attention for the disadvantaged population. This qualitative study aimed to gain an in-depth insight into how the STOEMP network aims to reach its goal of making healthy, sustainable food available to everyone, through an intersectoral, collaborative process, exploring the facilitators and challenges of taking a systems-oriented approach to achieving this. Interviews were conducted among 15 stakeholders of the STOEMP network between March–July 2019 in Ghent (Belgium). Factors that facilitated the development and work of the network are reported, including having an external, neutral process manager, shared values, multisector engagement, enthusiasm, resources, and sense of ownership, as well as the barriers that were faced, such as time issues, uncertainty regarding continuation and funding, and discrepancy in visions. These issues reflect the strengths and challenges of taking a systems approach that aims to formulate solutions to widening access to healthy and sustainable foods. STOEMP would like to influence policy and thereby strengthen its impact, but needs further discussions to collectively formulate exact needs. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
Open AccessArticle
Providing Access to Urban Green Spaces: A Participatory Benefit-Cost Analysis in Spain
Int. J. Environ. Res. Public Health 2020, 17(8), 2818; https://doi.org/10.3390/ijerph17082818 - 19 Apr 2020
Cited by 2
Abstract
The opening up of green spaces could provide significant benefits to society. This study develops a framework to assess the economic benefits and costs of public interventions providing citizen access to urban green spaces. The Thinking Fadura project in Getxo (Spain) was used [...] Read more.
The opening up of green spaces could provide significant benefits to society. This study develops a framework to assess the economic benefits and costs of public interventions providing citizen access to urban green spaces. The Thinking Fadura project in Getxo (Spain) was used as a case study. A method for participatory benefit-cost analysis is developed, where a stakeholder-participatory evaluation is combined with a standard cost-benefit analysis. The participatory evaluation followed a bottom-up approach in a sequential evaluation including three main focal points: key stakeholders and experts, visitors and the general public. The assessment demonstrates that the Thinking Fadura project’s benefits outweigh the costs. The results suggest that projects designed with the purpose of improving green space accessibility to the general public can be beneficial from a societal perspective. The highest economic benefits were an increase in the amenity and recreational value and an increase in people’s physical activity. The participatory evaluation indicates that giving access to people of lower socio-economic status and vulnerable groups and improving recreational use were perceived as the most beneficial. An increase in noise, dirt, and risk of criminal activities as well as potential conflicts between green space users were perceived as the most negative impacts of opening a previously restricted area to the general public. The economic assessment of Thinking Fadura project could serve as a model in the decision-making process in locations where the use of greenspaces is restricted. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Ranking Preventive Interventions from Different Policy Domains: What Are the Most Cost-Effective Ways to Improve Public Health?
Int. J. Environ. Res. Public Health 2020, 17(6), 2160; https://doi.org/10.3390/ijerph17062160 - 24 Mar 2020
Abstract
It is widely acknowledged that in order to promote public health and prevent diseases, a wide range of scientific disciplines and sectors beyond the health sector need to be involved. Evidence-based interventions, beyond preventive health interventions targeting disease risk factors and interventions from [...] Read more.
It is widely acknowledged that in order to promote public health and prevent diseases, a wide range of scientific disciplines and sectors beyond the health sector need to be involved. Evidence-based interventions, beyond preventive health interventions targeting disease risk factors and interventions from other sectors, should be developed and implemented. Investing in these preventive health policies is challenging as budgets have to compete with other governmental expenditures. The current study aimed to identify, compare and rank cost-effective preventive interventions targeting metabolic, environmental, occupational and behavioral risk factors. To identify these interventions, a literature search was performed including original full economic evaluations of Western country interventions that had not yet been implemented in the Netherlands. Several workshops were held with experts from different disciplines. In total, 51 different interventions (including 13 cost saving interventions) were identified and ranked based on their incremental cost-effectiveness ratio (ICER) and potential averted disability-adjusted life years (DALYs), resulting in two rankings of the most cost-effective interventions and one ranking of the 13 cost saving interventions. This approach, resulting in an intersectoral ranking, can assist policy makers in implementing cost-effective preventive action that considers not only the health sector, but also other sectors. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
The Role of Cohesion Policy Funds in Decreasing the Health Gaps Measured by the EURO-HEALTHY Population Health Index
Int. J. Environ. Res. Public Health 2020, 17(5), 1567; https://doi.org/10.3390/ijerph17051567 - 29 Feb 2020
Cited by 2
Abstract
Social, economic, and environmental differences across the European Union significantly affect opportunities to move forward in achieving greater equity in health. Cohesion Policy (CP) funds can contribute positively through investments in the main determinants of health. The aim of this study is to [...] Read more.
Social, economic, and environmental differences across the European Union significantly affect opportunities to move forward in achieving greater equity in health. Cohesion Policy (CP) funds can contribute positively through investments in the main determinants of health. The aim of this study is to analyze to what extent the planned investments for 2014–2020 are addressing the regional health gaps, in light of the population health index (PHI), a multidimensional measure developed by the EURO-HEALTHY project. The operational programs of all regions were analyzed, namely, the CP planned investments by field of intervention. Analysis of variance was performed to examine whether the regional scores in the PHI dimensions were statistically different across regions with different levels of development (measured by gross domestic product (GDP)). Results show that 98% of regions with worse performances on the PHI are less developed regions. Overall, all regions present planned investments in intervention fields linked to dimensions appraised within the PHI (e.g., employment, income, education, pollution). Yet, more needs to be done to focus regional investments in health determinants where regions still lag behind. The PHI has the potential to inform future CP restructuring, providing evidence to extend the current eligibility criteria to other dimensions beyond the GDP. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
The Role of Health in Households’ Balancing Act for Lifestyles Compatible with the Paris Agreement—Qualitative Results from Mannheim, Germany
Int. J. Environ. Res. Public Health 2020, 17(4), 1297; https://doi.org/10.3390/ijerph17041297 - 18 Feb 2020
Cited by 3
Abstract
Household lifestyles are the main drivers of climate change. Climate change mitigation measures directed to households often have substantial health co-benefits. The European mixed-methods study HOPE (HOuseholds’ Preferences for reducing greenhouse gas emissions in four European high-income countries) investigates households’ preferences for reducing [...] Read more.
Household lifestyles are the main drivers of climate change. Climate change mitigation measures directed to households often have substantial health co-benefits. The European mixed-methods study HOPE (HOuseholds’ Preferences for reducing greenhouse gas emissions in four European high-income countries) investigates households’ preferences for reducing greenhouse gas emissions and particularly researches the role of information on health co-benefits in households’ decision making. The results presented in this study are derived from 18 qualitative interviews, conducted with a subsample of households from Mannheim, Germany. The in-depth interviews were transcribed verbatim, analyzed with a qualitative content analysis, supported by NVivo software. They showed that, in order to reduce their greenhouse gas emission in a way compatible with the 1.5 °C goal, households have to undertake a difficult balancing act, considering factors from the individual sphere, such as health co-benefits, as well as from the public sphere, such as (climate) policies. Shared responsibility and equity are important aspects of households. In conclusion, health is an important factor in households’ decision making. However, information policies about health co-benefits need to go along with structural policy measures, in order to support households effectively in the implementation of healthy and climate-friendly lifestyles, especially in sectors where behavior change is difficult, like the mobility sector. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
A Technological Scenario for a Healthier, More Equitable and Sustainable Europe in 2040: Citizen Perceptions and Policy Implications
Int. J. Environ. Res. Public Health 2020, 17(1), 231; https://doi.org/10.3390/ijerph17010231 - 28 Dec 2019
Cited by 3
Abstract
This article aims at exploring, understanding and comparing European citizens’ insights and perceptions towards “My life between realities”, a positive future scenario which depicts a narrative of reaching healthier, more equitable and sustainable societies by 2040 with the support of technology and technological [...] Read more.
This article aims at exploring, understanding and comparing European citizens’ insights and perceptions towards “My life between realities”, a positive future scenario which depicts a narrative of reaching healthier, more equitable and sustainable societies by 2040 with the support of technology and technological solutions. It responds to the need for gathering and incorporating more citizen insights into future policy developments and strategic actions to tackle the global challenge of unsustainable development. Citizens of five European countries—the Czech Republic, Germany, North Macedonia, Spain and the United Kingdom—have been consulted through focus groups. The exercise has uncovered citizens’ preferences and attitudes towards four main lifestyle areas; namely, green spaces, energy efficient housing, active mobility and (food) consumption. The technological attributes of the scenario led to citizens expressing diametrically opposed and critical perceptions and attitudes. Given the prospects of technology in driving sustainable development, based on these insights, policy recommendations for the better integration and acceptance of technological advances by the public are discussed herein. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
How Good Is our Place—Implementation of the Place Standard Tool in North Macedonia
Int. J. Environ. Res. Public Health 2020, 17(1), 194; https://doi.org/10.3390/ijerph17010194 - 27 Dec 2019
Cited by 1
Abstract
This study describes the implementation, in North Macedonia, of a “tool”, initially devised in Scotland, to generate community and stakeholder discussion about the places in which they live and notably a place’s capacity to generate health wellbeing and greater equity among citizens. In [...] Read more.
This study describes the implementation, in North Macedonia, of a “tool”, initially devised in Scotland, to generate community and stakeholder discussion about the places in which they live and notably a place’s capacity to generate health wellbeing and greater equity among citizens. In this study, the “place standard tool” (PST) is viewed from the perspective of creating places which can deliver a triple win of health and wellbeing, equity, and environmental sustainability. Skopje, North Macedonia’s capital, inevitably differs economically, culturally, and politically from Scotland, thus providing an opportunity to augment existing knowledge on adaptability of the tool in shaping agendas for policy and action. Тhe PST was tested through seminars with selected focus groups and an online questionnaire. Over 350 respondents were included. Information on priorities enabled the distillation of suggestions for improvement and was shared with the Mayor and municipal administration. Skopje citizens valued an approach which solicited their views in a meaningful way. Specific concerns were expressed relating to heavy traffic and related air and noise pollution, and care and maintenance of places and care services. Responses varied by geographic location. Application of the PST increased knowledge and confidence levels among citizens and enthusiasm for active involvement in decision making. Effective implementation relies heavily on: good governance and top-level support; excellent organization and good timing; careful training of interviewers and focus group moderators; and on prior knowledge of the participants/respondents. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Equity, Health, and Sustainability with PROVE: The Evaluation of a Portuguese Program for a Short Distance Supply Chain of Fruits and Vegetables
Int. J. Environ. Res. Public Health 2019, 16(24), 5083; https://doi.org/10.3390/ijerph16245083 - 12 Dec 2019
Cited by 2
Abstract
PROVE is a Portuguese program that empowers small-scale farmers organized into local networks to directly commercialize baskets of locally produced fruits and vegetables to consumers. This study applied a post-test-only non-equivalent group design to evaluate the resulting influence on the social empowerment of [...] Read more.
PROVE is a Portuguese program that empowers small-scale farmers organized into local networks to directly commercialize baskets of locally produced fruits and vegetables to consumers. This study applied a post-test-only non-equivalent group design to evaluate the resulting influence on the social empowerment of farmers and on consumer diets. The method included conducting a survey of PROVE farmers (n = 36) and a survey of PROVE consumers (n = 294) that were compared against matched samples of Portuguese respondents of international surveys (European Social Survey, n = 36 and the INHERIT Five-Country Survey, n = 571, respectively). PROVE farmers reported higher scores for perceived influence on the work environment than the national sample. PROVE consumers were more likely to eat five or more portions of fruits and vegetables a day in comparison to the matched sample of Portuguese citizens (average odds ratio: 3.05, p < 0.05). Being a PROVE consumer also generated an impact on the likelihood of consuming no more than two portions of red meat a week (average odds ratio: 1.56, p < 0.05). The evaluation study suggests that the promotion of short supply chains of fruits and vegetables can make a positive contribution to a healthier, more sustainable, and fairer future in food consumption. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
Open AccessArticle
Addressing Inequity: Evaluation of an Intervention to Improve Accessibility and Quality of a Green Space
Int. J. Environ. Res. Public Health 2019, 16(24), 5015; https://doi.org/10.3390/ijerph16245015 - 10 Dec 2019
Cited by 2
Abstract
Green space areas offer several benefits that support our physical, psychological, and social health. However, the level of engagement with green space areas may not be the same across population groups. Using a mixed-method research design, we investigated the use of a green [...] Read more.
Green space areas offer several benefits that support our physical, psychological, and social health. However, the level of engagement with green space areas may not be the same across population groups. Using a mixed-method research design, we investigated the use of a green space area and whether and how the area was beneficial for health, social inclusion, and physical activity for all socioeconomic groups in a suburban area in Norway. The study showed significantly increased use of the area from 2015–2018 and that users belonged to different socioeconomic groups. The motivation for using the area was the opportunity to experience nature and to interact socially. While no significant changes in self-rated health, life satisfaction, or levels of physical activity were found, the study indicates that factors such as location, availability, and designated places for social interaction are important motivating factors for use. Users from the lower socioeconomic groups were among the frequent users but were also the least satisfied with the quality and availability of the path. Our findings call for closer consideration of the location and availability of green spaces and that including places for social interaction and relaxation can contribute to increased use of green spaces. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
Open AccessArticle
Ten Lessons for Good Practice for the INHERIT Triple Win: Health, Equity, and Environmental Sustainability
Int. J. Environ. Res. Public Health 2019, 16(22), 4546; https://doi.org/10.3390/ijerph16224546 - 17 Nov 2019
Cited by 7
Abstract
The world’s challenges of climate change, damage to ecosystems, and social and health inequalities require changes in human behaviours at every level of organisation, among governments, business, communities, and individuals. An important question is how behaviour change can be enabled and supported at [...] Read more.
The world’s challenges of climate change, damage to ecosystems, and social and health inequalities require changes in human behaviours at every level of organisation, among governments, business, communities, and individuals. An important question is how behaviour change can be enabled and supported at the scale and speed required. The research reported in this paper describes important lessons for good practice in changing contexts to modify behaviours for a triple win for health, equity and environmental sustainability. Authors synthesised learning from qualitative, quantitative and cost benefit evaluations of 15 case studies conducted in 12 countries in Europe. The case studies address ways of living (green spaces and energy efficient housing), moving (active transport) and consuming (healthy and sustainable diets) that support the triple win. Ten lessons for good practice were identified. These include bringing a triple win mindset to policy and practice in planning interventions, with potential to improve environmental sustainability, health and equity at the same time. The lessons for good practice are intended to support governmental and non-governmental actors, practitioners and researchers planning to work across sectors to achieve mutual benefits for health and environmental sustainability and in particular to benefit poorer and more socio-economically disadvantaged groups. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Lifestyle E-Coaching for Physical Activity Level Improvement: Short-Term and Long-Term Effectivity in Low Socioeconomic Status Groups
Int. J. Environ. Res. Public Health 2019, 16(22), 4427; https://doi.org/10.3390/ijerph16224427 - 12 Nov 2019
Cited by 1
Abstract
E-coaching applications can improve people’s lifestyles; however, their impact on people from a lower socioeconomic status (low SES) is unknown. This study investigated the effectiveness of a lifestyle e-coaching application in encouraging people facing low SES disadvantages to engage in a more active [...] Read more.
E-coaching applications can improve people’s lifestyles; however, their impact on people from a lower socioeconomic status (low SES) is unknown. This study investigated the effectiveness of a lifestyle e-coaching application in encouraging people facing low SES disadvantages to engage in a more active lifestyle over a course of 19 weeks. In this bicountry study, 95 people with low activity level (GR: 50, NL: 45) used a mobile application linked to a wearable activity tracker. At the start and after 6 and 19 weeks, self-reported physical activity levels, attitudes, and intention towards increasing activity levels, perceived behavioral control, and wellbeing were measured. Results indicated that participants using the lifestyle e-coaching application reported significantly more often an increase in activity levels than a parallel control group. Additionally, the people using the application also more often reported increased levels of wellbeing and perceived behavioral control. Therefore, lifestyle e-coaching applications could be a cost-effective solution for promoting healthier lifestyles in low-SES populations. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
An Empirical Study of the Impact of Social Interaction on Public Pro-Environmental Behavior
Int. J. Environ. Res. Public Health 2019, 16(22), 4405; https://doi.org/10.3390/ijerph16224405 - 11 Nov 2019
Cited by 3
Abstract
Public pro-environmental behavior plays a positive role in solving environmental pollution problems. In a real socioeconomic system, because public pro-environmental behavior has characteristics of externality and interactivity, a number of factors, such as external information and the behavior of others, could affect the [...] Read more.
Public pro-environmental behavior plays a positive role in solving environmental pollution problems. In a real socioeconomic system, because public pro-environmental behavior has characteristics of externality and interactivity, a number of factors, such as external information and the behavior of others, could affect the pro-environmental behavior of individuals who optimize their own strategies by interacting with the outside world; thus, public pro-environmental behavior and social interaction are very closely related. In order to study the impact of social interaction on public pro-environmental behavior and its mechanisms, the authors of this paper conducted an empirical study based on an Ordinary Least Square (OLS) regression model and data from the Chinese General Social Survey (CGSS). The empirical results show that: (1) social interaction has a promoting effect on public environmental protection behavior, and social interaction has a more significant impact on private environmental protection behavior; (2) the public will not only adjust their own environmental protection behavior by directly observing the behavior of others, they will also obtain environmental protection knowledge through social interactions which thus have a positive impact on their behavior. It is of great practical significance to study the impact of social interactions on public pro-environmental behavior. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Analysis of Small Area Environmental, Socioeconomic and Health Data in Collaboration with Local Communities to Target and Evaluate ‘Triple Win’ Interventions in a Deprived Community in Birmingham UK
Int. J. Environ. Res. Public Health 2019, 16(22), 4331; https://doi.org/10.3390/ijerph16224331 - 06 Nov 2019
Cited by 2
Abstract
The contemporary environment is a complex of interactions between physical, biological and socioeconomic systems with major impacts on public health. It is well understood that deprived communities are more exposed to negative environmental and social factors, more susceptible to the effects of those [...] Read more.
The contemporary environment is a complex of interactions between physical, biological and socioeconomic systems with major impacts on public health. It is well understood that deprived communities are more exposed to negative environmental and social factors, more susceptible to the effects of those exposures, more excluded from access to positive factors, less able to change their circumstances and consequently experience worse health, economic and social outcomes compared to the more affluent. Welsh House Farm estate in Birmingham is one of the most deprived areas in Europe. An alliance between a local charity, City Council Public Health and a University in collaboration with the local community has accessed, analysed and mapped a range of health, social and economic factors at small area level, identifying areas where the community experience is unacceptably worse than other parts of Birmingham and therefore requiring targeted interventions. We make specific recommendations for coordinated action addressing the living, moving and consuming domains of residents’ lives and have also identified positive aspects of life on the estate to celebrate. This pilot demonstrates the utility and cost-effectiveness of local collaboration to identify and target health, environmental and social inequalities informed by local concerns. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
Effects of a School Based Intervention on Children’s Physical Activity and Healthy Eating: A Mixed-Methods Study
Int. J. Environ. Res. Public Health 2019, 16(22), 4320; https://doi.org/10.3390/ijerph16224320 - 06 Nov 2019
Abstract
Combined diet and physical activity school-based interventions (rather than only diet or physical activity interventions) are more likely to help prevent children from becoming overweight in the long term. However, such interventions are less prevalent, and therefore, this pilot study aimed to assess [...] Read more.
Combined diet and physical activity school-based interventions (rather than only diet or physical activity interventions) are more likely to help prevent children from becoming overweight in the long term. However, such interventions are less prevalent, and therefore, this pilot study aimed to assess the feasibility of a gardening intervention coupled with awareness about plant-based meals among 9−10 year old children in a London primary school. We recruited 60 children from two Year 5 classes, one class participated as an intervention group, and results were compared against another class who acted as the control group. Children’s physical activity (PA) was measured using GENEActiv wrist-worn accelerometers. Their fruit and vegetable intake and attitudes to and preferences in eating fruits and vegetables were measured using a self-report questionnaire. Furthermore, three focus groups were held with children in the intervention group to understand the reasons behind any change as a result of the intervention. Results are inconclusive; however, they indicate some impact on reduction of sedentary behaviour, increase of moderate to vigorous PA, knowledge of nutrition and some level of acceptance in trying new vegetables. School-based interventions involving gardening show some promise to increase children’s PA and improve their attitudes to eating fruits and vegetables. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
European Rural Development Policy Approaching Health Issues: An Exploration of Programming Schemes
Int. J. Environ. Res. Public Health 2019, 16(16), 2973; https://doi.org/10.3390/ijerph16162973 - 18 Aug 2019
Abstract
Malnutrition, obesity, type 2 diabetes, micronutrient deficiencies, and the increase in non-communicable diseases are among the future European key challenges in health and welfare. Agriculture and rural development policies can positively contribute to a healthier and nutritious supply of food. The objective of [...] Read more.
Malnutrition, obesity, type 2 diabetes, micronutrient deficiencies, and the increase in non-communicable diseases are among the future European key challenges in health and welfare. Agriculture and rural development policies can positively contribute to a healthier and nutritious supply of food. The objective of the research is to analyze to what extent European 2007–2013 and 2014–2020 rural development programmes address the nexus between agriculture, food, health, and nutrition to respond to the evolving dietary needs. The research carries out a quali-quantitative content analysis on all 210 European rural development programmes. Results show that the interconnection between agriculture, food, health, and nutrition is present, with differences in the European agricultural and rural policy programming periods. The main interlinking issues of the nexus are food safety, food quality, diseases, nutritional aspect, animal health and welfare, plant health, and environmental health. Healthier and nutritious food-related issues are emerging, addressing dietary needs, and sustaining consumer food trends. Healthy and nutritious food is pursued by combating foodborne communicable diseases and non-communicable diseases. The future Common Agricultural Policy, including its rural dimensions, should support the consumption of healthy foods produced in ways that are environmentally and economically sustainable. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessArticle
The INHERIT Model: A Tool to Jointly Improve Health, Environmental Sustainability and Health Equity through Behavior and Lifestyle Change
Int. J. Environ. Res. Public Health 2018, 15(7), 1435; https://doi.org/10.3390/ijerph15071435 - 07 Jul 2018
Cited by 11
Abstract
The need for analysis and action across the interrelated domains of human behaviors and lifestyles, environmental sustainability, health and inequality is increasingly apparent. Currently, these areas are often not considered in conjunction when developing policies or interventions, introducing the potential for suboptimal or [...] Read more.
The need for analysis and action across the interrelated domains of human behaviors and lifestyles, environmental sustainability, health and inequality is increasingly apparent. Currently, these areas are often not considered in conjunction when developing policies or interventions, introducing the potential for suboptimal or conflicting outcomes. The INHERIT model has been developed within the EU-funded project INHERIT as a tool to guide thinking and intersectoral action towards changing the behaviors and lifestyles that play such an important role in today’s multidisciplinary challenges. The model integrates ecological public health and behavioral change models, emphasizing inequalities and those parts of the causal process that are influenced by human behaviors and lifestyles. The model was developed through web-based and live discussions with experts and policy stakeholders. To test the model’s usability, the model was applied to aspects of food consumption. This paper shows that the INHERIT model can serve as a tool to identify opportunities for change in important −food-related behaviors and lifestyles and to examine how they impact on health, health inequalities, and the environment in Europe and beyond. The INHERIT model helps clarify these interrelated domains, creating new opportunities to improve environmental health and health inequality, while taking our planetary boundaries into consideration. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Review

Jump to: Research

Open AccessReview
Encouraging and Enabling Lifestyles and Behaviours to Simultaneously Promote Environmental Sustainability, Health and Equity: Key Policy Messages from INHERIT
Int. J. Environ. Res. Public Health 2020, 17(19), 7166; https://doi.org/10.3390/ijerph17197166 - 30 Sep 2020
Abstract
Human consumption and activity are damaging the global ecosystem and the resources on which we rely for health, well-being and survival. The COVID-19 crisis is yet another manifestation of the urgent need to transition to more sustainable societies, further exposing the weaknesses in [...] Read more.
Human consumption and activity are damaging the global ecosystem and the resources on which we rely for health, well-being and survival. The COVID-19 crisis is yet another manifestation of the urgent need to transition to more sustainable societies, further exposing the weaknesses in health systems and the injustice in our societies. It also underlines that many of the factors leading to environmental degradation, ill health and social and health inequities are interlinked. The current situation provides an unprecedented opportunity to invest in initiatives that address these common factors and encourage people to live more healthily and sustainably. Such initiatives can generate the positive feedback loops needed to change the systems and structures that shape our lives. INHERIT (January 2016–December 2019), an ambitious, multisectoral and transnational research project that involved 18 organisations across Europe, funded by the European Commission, explored such solutions. It identified, defined and analysed promising inter-sectoral policies, practices and approaches to simultaneously promote environmental sustainability, protect and promote health and contribute to health equity (the INHERIT “triple-win”) and that can encourage and enable people to live, move and consume more healthfully and sustainably. It also explored the facilitators and barriers to working across sectors and in public private cooperation. The insights were brought together in guidelines setting out how policy makers can help instigate and support local “triple-win” initiatives that influence behaviours as an approach to contributing to the change that is so urgently needed to stem environmental degradation and the interlinked threats to health and wellbeing. This article sets out this guidance, providing timely insights on how to “build back better” in the post pandemic era. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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Open AccessReview
Urban Green Space: Creating a Triple Win for Environmental Sustainability, Health, and Health Equity through Behavior Change
Int. J. Environ. Res. Public Health 2019, 16(22), 4403; https://doi.org/10.3390/ijerph16224403 - 11 Nov 2019
Cited by 9
Abstract
Urbanization, costs of green space maintenance, and diminishing connection between people and nature all exert pressures on urban green space. This is regrettable as green space has the potential to create wins for environmental sustainability, health, and health equity. This paper explores this [...] Read more.
Urbanization, costs of green space maintenance, and diminishing connection between people and nature all exert pressures on urban green space. This is regrettable as green space has the potential to create wins for environmental sustainability, health, and health equity. This paper explores this potential triple win and investigates how to increase the use of urban green space through behavior change. A narrative literature review was conducted and was supplemented with literature suggested by experts. Results show that creating well-designed green spaces and stimulating people to use them can indeed deliver this triple win. Providing accessible, attractive, well-maintained green space with room for socialization, and where people feel safe, may increase the opportunity and motivation of people to use it more often. Informing and educating people and organizing activities may increase capability (and motivation) to use green space. Since the use of green space depends on life stage, lifestyle factors and individual values, it is important to involve potential users in its design. We recommend a specific focus on those groups who may benefit most from the use of green space. More evaluation is needed to inform effective green space interventions and to assess related economic, social, and environmental benefits. Full article
(This article belongs to the Special Issue A More Sustainable and Healthier Future for All: What Works?)
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