“A living environment should encourage health, not hinder it”
At the heart of Resilient Delta lies the belief that by converging science, policy, industry, and society, adaptations for complex urban deltas can be created and shared. In the interview series “Voices of Generation Delta,” we talk to those who share our mission of addressing societal challenges through teamwork that transcends traditional boundaries. Second in the series is Mariëlle Beenackers, assistant professor at Erasmus MC, who focuses on healthy urban living environments and health inequalities. “A living environment should stimulate health, not hinder it.”
From the imposing Havenkwartier in Katendrecht to the lofty Zalmhaven residential tower. Rotterdam is growing. What does this urban expansion mean for its residents?
The Netherlands has a shortage of nearly 279,000 housing units. Starters are missing out and prices in both the rental and owner-occupied sectors continue to rise. The government wants to accelerate housing construction to 100,000 homes per year. An obvious solution, but how will this affect people who see their familiar neighborhoods flooded with new residents?
“Both the social element and mental health are often still understudied in urban densification,” states public health researcher Mariëlle Beenackers. While a compact city brings many benefits, think greater support for urban amenities, there are also caveats. “The number of stimuli increases while at the same time there are fewer places to recover from these stimuli. That reinforces each other.” For Beenackers, it’s not just about densification; we must look at the total picture. “Not only should people be seen as a whole, but so does the city. Everything is interrelated. ”
The desire to connect research, education, policy, and practice brought Beenackers to both her role as Program Leader of the Academic Collaborative Centre CEPHIR and the Resilient Delta Initiative. The Convergence, the partnership between Erasmus University, Erasmus MC and TU Delft gives her the opportunity to combine her health perspective with more technical aspects. Beenackers: “There is a lot of knowledge in Delft about how a city is designed, for example about heat stress and urban planning. The Erasmus University offers insight from a governance perspective, among other things. If we combine this knowledge with our insights into health and health inequalities from Erasmus MC, we can do even more for the city.”
People know what is healthy but can't afford it, healthy choices have become a luxury for some
Health is a collective problem
Beenackers not only looks at the effects of urban design on the mental health of residents, but also examines the overall health of the city. She emphasizes that healthy choices depend on a stable social foundation. “The basics have to be in order first, think especially about livelihood security and poverty,” she says.
Beenackers wants to get rid of the idea that health is an individual responsibility. Research by CEPHIR has shown that food in the city of Rotterdam has become much unhealthier in recent years. The health differences by neighborhood were striking. In less affluent neighborhoods, the increase in the number of fast-food outlets was the greatest; overweight and obesity were also much more common there. “People know what is healthy but can’t afford it, healthy choices have become a luxury for some,” she says.
“There needs to be more focus on prevention. Make the system work for people rather than against them.” Beenackers refers to an analogy by Albert Jan Kruiter. “When you knock on the government’s door for support you stand there as a whole person. But as soon as you stand at the counter an egg slice goes over you. One slice goes to the benefits department, another slice to housing, and so on.”
Beenackers: “Provide people with the basic necessities, such as a meaningful day job and a decent income.” Livelihood security not only removes financial stress, but also provides the space to make healthier choices both inside and outside the home.
People live in a context: in a family, in a neighborhood, in a financial environment. When someone comes to the doctor with sleep problems, the environmental factors matter.
More than a collection of organs
The core of Beenackers’ research revolves around looking at the whole and putting things in context. To achieve this, collaboration between different fields is essential. While you need specialists who know everything about an egg slice, you also need someone who analyzes the whole egg.
Beenackers sees that this collective approach in health care is insufficient, often looking at each individual or organ. It is important that doctors also see the total picture. “People live in a context: in a family, in a neighborhood, in a financial environment. When someone comes to the doctor with sleep problems, the environmental factors matter. You ask different questions to someone with a detached house in Nesselanden than to a father with three young children in a flat in Rotterdam South.”
Beenackers notices that this is changing. For example, she sees that the new generation of doctors is learning to identify the context of the patient in addition to the physical symptoms. “With education, we are investing in socially engaged doctors.” Collectivity is ultimately the common thread running through Beenackers’ work, both in urban planning and public health. For her, the whole is always more than the sum of its parts, and more attention may be paid to that. Ultimately, she has only one goal: to make health accessible to all.
Mariëlle Beenackers Mariëlle Beenackers is an assistant professor at the Erasmus Medical Centre, who focuses on healthy urban living environments and health inequalities. | She is connected to the Resilient Delta City Theme through her work for the SPRING consortium and is also linked to Resilient Delta Methodology Theme through her extensive experience with transdisciplinary research. | Additionally Beenackers is the Program Leader of the Academic Collaborative Centre CEPHIR.