New study on physical environment and its effects on healthy behaviour, self-reliance and social relations

03/12/2015 - 10:31

It is generally known that the physical (built and spatial) environment influences the health and well-being of human beings. A new study looked at 20 international proven or promising examples of physical environment and their impact on healthy behaviour, self-reliance and social relations.

The study highlights how community gardens and urban farming, good indoor air quality, walkable neighbourhoods and indicators with stair prompts lead to improved healthy behaviour and productivity. It also shows that geographical access to tobacco stores and variety in fast food restaurants invites people to behave unhealthier.

With regard to the physical environment in relation to self-reliance it was found that older citizens who live in accessible housing, who think positively of their housing and who also think that others are not responsible for their housing but themselves behave more independently than others. Besides this, green environments lead to lower levels of cortisol (mental health), mobility (making trips and joining activities) leads to a lower risk of social exclusion, physical activity and falls prevention decreases the number of falls and a library turns out to be therapeutic as well through hospitality, quiet atmosphere and free choices.

Social relations are supported by walkable and mixed-use neighbourhoods. Feelings of outdoor safety are highly related to social inclusion/social capital and New Urbanism leads to a sense of higher involvement with community. On the other hand, high rise buildings have a negative relation with social inclusion.

The study also found that one asset of the physical environment may lead to more than one outcome: for example green environments lead to a better mental health and also support social contacts. On the other hand combined domains may lead to tensions: for example, cycling is part of healthy behaviour and self-reliance. A lot of older citizens are able to cycle in old age, because of the introduction of electronic bikes but this could also lead to a higher number of traffic accidents and hip fractures among older people. Another example is the use of sitting places next to the road. They are very useful for older people to rest when they are on the way, but in the evening they can be used as a meeting place for people hanging around.


Physical environment in relation to healthy behaviour, self-reliance and social network fits very well in the WHO-concept of age-friendly cities or environments. This concept aims to enable older people to continue to participate and to contribute to society. The study looked at the realisation of age-friendly environments in the Dutch built environment: the city centres, suburbs and a village in rural areas.

The Dutch city centres offer a lot of opportunities for healthy behaviour, self-reliance and social network. They offer a mixed land-use and shops and transportation are at a walking distance. City centres are often trying to discourage car use, which could stimulate walking. A disadvantage of most (Medieval) city centres is the limited accessibility of outdoor spaces: pave ways are small, have a lot of little stairs, which is a barrier for walking, notably with a Zimmer frame. Most housing is not suitable for people with mobility problems or impairments. On the other hand these houses could stimulate people to stay physically active, because they are forced to take the stairs or cross other physical barriers. Another disadvantage is that unhealthy provisions are easily available, like drug stores and fast food restaurants. 

Dutch suburbs have a big advantage because they possess a lot of green and blue environments. The accessibility and adaptability of housing is rather common, as are the broad ways and pave ways. Disadvantages are the concentration of provisions in bigger shopping centres or malls, which encourages the use of cars to reach them. Suburbs are mostly very suitable for cars, less for pedestrians. Short distances in these areas offer opportunities for the use of public transport, cycling and walking. Mostly the suburbs consist of single family homes, which could lead to good neighbourhood contacts and feelings of safety.

Most rural areas in the Netherlands face population decline and stronger population ageing. The villages in rural areas were used to have a shop which fits all (food, beverages, mail, clothing, bank and so on), but even if they offer home delivery, they have to be reached by car. Public transport is unfrequently scheduled there. Most inhabitants of rural areas experience a strong social network, for example stronger social relations between neighbours. Other positive effects of rural areas are the green environment, which enhances mental health.

This study shows that the twenty examples described above occur in the different Dutch built environments. Besides this, each type of environment has to deal with the relations between the physical environment and healthy behaviour, self-reliance and social relations on its own way.

The study, performed by Charelle Bottenheft and Willeke van Staalduinen from TNO on behalf of the Dutch Council for Public Health and Health Care and published in Environment and Self-reliance on 11 March 2015 was based on a scoping review in Scopus, Google Scholar and Google and the WHO Global Age-friendly Cities: a Guide and Manchester Age-friendly Neighbourhood Report. You may read the study here or download it in pdf format below. 

Additional documents: