# *translation*: Programma Gezonde Leefomgeving [Healthy Living Environment Program]

###### tags: `data`, `Hollandse Luchten`

:::info
*This note is the English translation of the report:*
Province North Holland (19 mei 2020). Programma Gezonde Leefomgeving [Healthy Living Environment Program].
https://www.noord-holland.nl/Actueel/Archief/2020/Mei_2020/Ruim_13_miljoen_voor_gezondere_leefomgeving_in_Noord_Holland/Programma_Gezonde_Leefomgeving
:::

## 1. Introduction

**Residents of the province of Noord-Holland consider health an important policy theme, according to the exploration carried out for the NH2050 Environmental Vision. Many parties see a clear role for an active middle board in this. Empowered citizens ask for a acting province, municipalities and GGDs ask for a partner and a binding middle government, and the government also sees decentralized opportunities to achieve health benefits. ==This has been fleshed out in the elaboration of the NH2050 Environmental Vision and the 2019-2023 coalition agreement "[Sustainable action! *(Duurzaam doorpakken!)*](https://www.noord-holland.nl/Configuratie/Publicaties/Publicaties/Coalitieakkoord_2019_2023_Duurzaam_doorpakken/Coalitieakkoord_Duurzaam_doorpakken.org)" of the province of North Holland.==**

The province believes that everyone is entitled to a healthy living environment. That is to say: an environment where the pressure on health is as low as possible and which invites a healthy lifestyle. The province wants to achieve health gains by steering from its role to maintain and where possible improve a healthy physical living environment.

The realization of this task and the advent of the ==Environmental Act *(Omgevingswet)*== require a programmatic approach, so that adjustments can be made in progress. This was also announced in the coalition agreement. This document contains the basic principles that shape that program. It is therefore both the framework and the beckoning perspective within which the program is further developed and implemented. This document is intended for the province of North Holland and its partners.

### Program under the Environmental Act

Public health plays an important role in the Environmental Act. Articles 1.3 and 2.1 state that “achieving and maintaining a safe and healthy physical living environment” is an imperative aspect of the administrative task and authority exercise under the Environmental Planning Act, in conjunction with “efficient management, use and developing the physical living environment to meet social needs ”. The fourth paragraph of Article 2.1 stipulates that the balanced allocation of functions to locations must in any case take into account the importance of protecting health.

The Environmental Act provides the province with new instruments. In addition to the Environmental Vision and Environmental Regulation, programs are also part of this. Some programs are mandatory, such as the Noise Action Plan. But the province can also develop voluntary (compulsory) programs to implement its policy. The Healthy Living Environment Program is intended to become a voluntary program under the Environmental Act in due course. This offers the possibility to link administrative agreements to it, for example. Although such a program is self-binding, it should be stated how the participation is organized. After the Environmental Act comes into effect, the program plan is therefore made available for inspection and adjusted where necessary.

### Reading Guide
Chapter 2 deals with the ambitions of the province of North Holland as formulated in the coalition agreement. In chapter 3 we translate this ambition into three partial ambitions that serve as a guideline for the elaboration of the Healthy Living Environment Program. We elaborate on the partial ambitions in chapter 4. Chapter 5 examines the four-track approach to the programmatic approach. Chapter 6 contains an overview of how the program budget is used over the duration of the program.

## 2. Sustainable progress towards health benefits

**The coalition agreement "Sustainable action!" Outlines the following wish of the province of North Holland: "We want North Holland to be a healthy living environment. Part of a healthy living environment is also supporting a healthy lifestyle, a rich cultural offer and the preservation of our cultural heritage. ” The aspects of a healthy living environment and a healthy lifestyle are fleshed out by means of the Healthy Living Environment Program, the aspects of the cultural offer and cultural heritage are tackled in a different way.**

In the coalition agreement, the aspects of a healthy living environment and a healthy lifestyle have been translated as follows within the chapter Liveability and Economy: *“Promoting a healthy living environment requires a programmatic approach and a financial impulse in the form of a quality of life fund. Our current environmental policy will be included in this program, with special attention to the problems surrounding substances of very high concern and improvement of the air quality in accordance with the Clean Air Agreement.”*

This programmatic approach takes shape in this Healthy Living Environment Program.

### Stimulating healthy behavior

In the exploratory phase of this program, discussions were held with the municipalities of Amsterdam and Zaanstad, the GGDs of Amsterdam and Kennemerland and the Environmental Services IJmond and North Sea Canal Area. ==One question that was asked more often during the exploration for this program plan is why the province is considering engaging in healthy behavior. Is this a task for a province, and is it useful?== Policy is often based on a rational view of man, man as a homo economicus who acts rationally and efficiently. It is now known from psychology that decisions, and therefore behavior, are largely driven by the environment, impulses and feelings. Behavior that influences health can be roughly divided into consumption (of food, drink and stimulants), meeting (strengthening social cohesion) and exercise. With its core tasks, the province mainly influences exercise. Think of the design of public space and regional mobility. Consuming and meeting belong more in the social domain and therefore lie more in the tasks of municipalities. There are several ways to implement behavioral insights. Which technique is effective depends on the situation, environment, target group and the underlying psychology. We look at where behavioral insights have added value and how we can give them a place in policy and in implementation.

## 3. Ambition for a healthy living environment

**The following main ambition has been defined for the Healthy Living Environment Program:**

**“The province of North Holland strives to create a physical living environment that is healthy for its inhabitants and that promotes a healthy lifestyle. We focus on the aspects of the healthy living environment that fall within or affect our current range of tasks and where the greatest health benefits can be achieved. We realize this in collaboration with our partners: municipalities, health authorities, companies and residents.”**

This main ambition has been translated into three partial ambitions:

### Maintaining a healthy living environment and improving it where possible

We strive to maintain and where possible improve the quality of the physical living environment. We focus on the environmental qualities of soil, (ground) water, air, environmental safety, noise, odor and (developments in) the subsurface. In any case, we meet the legal standards. Where possible, we actively strive to accelerate the achievement of WHO recommended exposure limits. The Clean Air Agreement (SLA), for example, is based on these values for the particulate matter components (PM10 and PM2.5) and nitrogen dioxide as of 2030, while the Environmental Vision was based on 2050. We work together with our partners and involve residents and companies as much as possible. possible in realizing improvements. We work in an area-oriented manner, with special attention to the environment-related health risks associated with the densification of the urban area.

### Current environmental quality in view and a source of knowledge for our partners

We monitor the environmental qualities. Areas with high environmental pressure on one and / or more environmental qualities (so-called 'hotspots') are mapped out in more detail in various projects, together with our partners. ==We pioneer in the use of (affordable) sensors.== We therefore develop specialist knowledge and methodologies that can be used more widely. ==Where possible, we involve residents.== We are the client for studies into the health effects of environmental pollution and nuisance. We bundle and stimulate knowledge development and exchange about which physical living environment qualities facilitate a healthy lifestyle.

### Promote health by promoting a healthy lifestyle

We promote health by communicating our ambitions, putting the subject on the agenda and bringing parties together. We support spatial planning initiatives that promote healthy behavior. Sometimes this will mean that the province is also a (co-) initiator. However, we are modest:

==Ultimately, it is the municipalities, GGDs and market parties that take the lead in this. But if we can lend a hand, we are prepared to invest money and time in this.== We shape the ambition by taking health aspects into account in provincial decision-making, for example with regard to spatial planning or mobility, but also in the granting of permits for environmentally harmful companies.

## 4. A closer look at ambition

**In order to realize a healthy living environment, we have to look at the provincial tasks through health glasses. We make a link between the themes of health and (living) environment. Our basic ambition is to realize a healthy physical living environment. We consider this to be a provincial core task. A healthy living environment is a living-working environment where you are exposed as little as possible to unhealthy substances and safety risks and that promote healthy behavior. In concrete terms, this means a living environment that is clean and safe, invites cycling and walking, for example, and has good environmental quality (noise, odor, air, soil, environmental safety). It also means a living environment that offers enough greenery, silence, nature and water to relax and escape the hustle and bustle of everyday life.**

The terms "healthy living environment" and "liveability" are regularly used interchangeably. However, liveability is a broader concept and often also includes social aspects and the perception of people. We endorse the importance of this. But from our view of the task, we focus on the qualities of the physical living environment. We act as much as possible on the basis of knowledge and agree with our partners on how we can strengthen their efforts to realize a healthy living environment.

### Put on health glasses

The province of North Holland has been working on a good living and living climate for some time. For example in our activities in the field of soil, infrastructure, nature and (drinking) water. Or in our efforts in the field of air quality or public transport. However, achieving health benefits has seldom been a major driver or identified as a primary objective. By doing this and updating existing activities and programs on this point, opportunities are created to achieve significant health gains in the province of North Holland.

The Healthy Living Environment Program focuses on aspects of a healthy living environment that are close to the core tasks of the province. Think of subjects such as air quality, odors, noise nuisance and substances of very high concern (ZZS). These arise from the environmental file of the province and focus on reducing harmful substances in the environment and nuisance. In addition, extra gains can be made by looking for connections with other core tasks and tasks. The most prominent examples of this are spatial environment and mobility. For example, we can take health aspects into account when making investment decisions for, for example, roads or the (re) development of areas. By focusing on smart mobility, we are working on concepts that contribute to both the climate and the living environment. And even to economic development, by stimulating innovations and applying them where possible. The Healthy Living Environment Program does not attract these subjects, but seeks the connection. We strive to make the healthy living environment an integral part of decision-making.

Stimulating a healthy lifestyle is somewhat further away from the core tasks of the province. However, we do not want to miss the opportunities in this area and we will explore what we can do in this area. We do not focus on individual behavior, but on collective facilities to facilitate or encourage healthy behavior. Examples are the bicycle policy, easy access to quiet areas or greenery at public transport hubs and various activities in the context of the food vision. The availability of 'attractive places' in the immediate vicinity can also contribute to reducing stress. Initially, it is up to municipalities and the GGDs. But by properly coordinating the efforts of the various parties, customization with added value can be delivered.

### Link with other policy tasks

Within almost all files that the province is dealing with, a link can be made with a healthy living environment. In the further elaboration of the program, an inventory will be made per file of the points where profit can be made. A short selection of the examples:

- Mobility
- Focusing on 'active transport' (walking, cycling) stimulates movement and reduces air pollution. By doing the daily trips to work, school or shop by bike or on foot, everyone gets enough exercise and they contribute to less air pollution. For longer distances this is possible in combination with public transport. In addition to making people fitter, it prevents obesity and stress-related complaints. Active transport also has a positive impact on the climate and the decline in car traffic for more space on the street and a more pleasant and safer living environment.
- Smart mobility: Better traffic flow costs less money and reduces air pollution.
- Public transport hubs: A combination of a good connection of public transport hubs to the bicycle network and sufficient bicycle parking facilities lowers the threshold for using the bicycle for commuting.
- Spatial planning and housing
- By taking health into account when assigning functions to an area and taking into account, for example, noise pollution when designing an area, it is avoided that expensive measures must be taken afterwards to reduce the nuisance. This is particularly important in areas where housing construction takes place in the vicinity of industry or transport. An example of this is the urbanization strategy for the Amsterdam Metropolitan Area; a balance must be found in this between space for business, housing and good spatial planning.
- Water (and soil)
- A good quality of water and soil contributes to the quality of the physical living environment and is beneficial for, for example, biodiversity.
- Green
- Easily accessible nature and quiet areas reduce stress and thus contribute to better health.
- Good biodiversity mitigates climate change by storing carbon in the soil and using soil energy.
- Energy transition
- Solar panels that simultaneously function as a noise barrier. By placing fields with solar panels in the vicinity of a sound source (think of roads, industrial installations, transformer stations, airports), it may be possible to influence the transport of sound.
- Climate adaptation
- Measures against heat stress also ensure a healthier city, for example by creating shade. This can be done by smartly designing the environment. They remain shaded with the help of green roofs or by creating walkways on the shadow side of buildings. This means that walking in the outdoor area remains possible for longer in periods of heat - which in turn stimulates a healthy lifestyle.
- Sport
- Sport is good for health and for many North Hollanders a popular form of relaxation.

### Province as principal

The province is the client for (water) roads, public transport concessions and the construction and management of nature reserves. In addition to its policy, the province can also focus on health in its tenders. The province also contributes to improving the quality of the physical living environment by carefully examining health aspects during the tenders.

### Area-oriented cooperation

Within the Healthy Living Environment Program we work together with our partners in an area-oriented manner. Together we define the tasks and the most important results, look for effective ways of working together and make agreements about the division of roles. We will continue to actively search for input from knowledge institutions, companies and residents. We also look at vulnerable groups and sensitive destinations. This is in line with the new working method of the Environmental Act. This requires that at an early stage ("at the front") we work together on a healthy living environment, in which participation and new instruments are central.

There are already examples of the collaborations we envisage. ==For example, consider the [Hollandse Luchten](https://hollandseluchten.waag.org/) project, in which three communities have been set up in the IJmond, Zaanstad and Amsterdam-Noord that measure air quality themselves.== Or the Administrative Consultation Industry & Health IJmond in which the province, municipalities, environmental services and GGD Kennemerland work together to improve the quality of the living environment. We will continue this line in the coming years.

### Authorization, Supervision and Enforcement (VTH)

The environmental services carry out most of the environmental tasks of the province. This mainly concerns licensing, supervision and enforcement (VTH) for companies in the more severe environmental categories (BRZO companies). With the movement from environment to healthy living environment, the demand for environmental services is also shifting. The basic principle remains compliance with European and national laws and regulations. However, health considerations are increasingly part of licensing and enforcement.

In this light, for example, the movement towards the recommended values of the World Health Organization (WHO) can also be seen. In the most recent data report on air quality in the IJmond, the measurements have already been set against these recommended values. And as part of the national Clean Air Agreement, we are also exploring whether it is possible to grant a sharper license (in jargon: whether it is possible to steer at the bottom of the BBT bandwidth, where BAT stands for "best available techniques"). We also consider voluntary measures by companies to improve air quality.

In addition to air quality, sound and odor, environmental safety also determines a determining aspect of a healthy living environment. When carrying out the VTH tasks, sufficient attention must be paid to nuisance and accidents that may arise because hazardous substances are stored, produced, used or transported in the area.

### National cooperation

We mentioned the Clean Air Accord in the previous section. This is one of the forms in which we cooperate with central government, municipalities and other provinces. Other examples include diffuse lead or PFAS2. We worked together with the provinces of Utrecht and South Holland to develop policy on diffuse lead. Within the PFAS file, the province of North Holland has played an important bridging role between central government and the local authorities. The demand for this type of collaboration will only increase in the coming years. On the one hand because the Environment Act places more responsibilities with decentralized authorities. That requires good coordination. On the other hand, because research into (potentially) substances of very high concern3 (ZZS) provides new insights into the distribution and harmfulness of certain substances. This makes it necessary to develop new frameworks for the way in which these substances are handled.

### Innovation

Environmental pressure is increasing, especially in the urban area. This is due to the increasing densification, including the associated increase in transport movements. Physical space is also decreasing, so that people are moving closer together and closer to emission sources (be it air quality, noise or odor). This requires innovative measures.

The province itself is partly an engine of innovation, partly through the funds it has set up and by stimulating entrepreneurs to innovate in tenders. ==The province is also the client of innovative projects such as [Hollandse Luchten](https://hollandseluchten.waag.org/), in which affordable sensors are used to set up a fine-meshed measurement network.== The province also wants to invite residents (groups), municipalities and other parties to come up with innovative solutions that contribute to improving the quality of the physical living environment. For that reason, part of the program budget is used for an implementation scheme to support third-party projects.

## 5. Four-track approach

**The Healthy Living Environment Program is a new program with a term of (provisionally) four years. It is pre-eminently intended as a development program: every year we look at the results and developments and where new opportunities lie. For this reason, only ambitions and strategic goals have been identified (see Chapters 2 to 4) and evaluations and monitoring are an essential part of the approach. In order to have some guidance on the further interpretation and implementation, we opt for an implementation along four tracks:**

- Track 1: Regulation
- Track 2: Research and monitoring
- Track 3: Measures
- Track 4: Assessment method

Reporting on the program will follow these four tracks, with most activities and projects falling within tracks 2 and 3. It is important to continue to look at track 1 and track 4 as they help determine the success of this program.

### Track 1: Regulate

Regulation forms the basis of environmental policy. First of all, through licensing and supervision of companies for which the province is competent authority. This concerns companies in the heavier risk categories, ie companies with a potentially large impact on the liveability of their immediate environment. Our ambition is to make health aspects weigh more heavily in licensing and supervision and to grant sharper licensing. We are (partly) dependent on others, especially the European Union and the national government. We ensure that additional knowledge is built up in this area and look for opportunities. Where necessary we start a lobby. We encourage companies to take voluntary measures to improve the environmental quality. We will further elaborate on this approach in the provincial Policy Document on Licensing, Supervision and Enforcement that is yet to be drawn up. What we also give to the environmental services as a point of attention from the Healthy Living Environment Program is to seek more cooperation with health authorities. Until now, we have only involved institutions such as the GGD or RIVM to a limited extent in the implementation of provincial policy.

A second instrument that the province can use is the [Environmental Ordinance *(Omgevingsverordening)*](https://www.noord-holland.nl/Onderwerpen/Ruimtelijke_inrichting/Projecten/Omgevingsvisie/Omgevingsverordening). For example, we set rules with regard to quiet areas, groundwater, provincial roads and industrial sites of provincial importance. At the industrial sites, we look at noise nuisance, odor nuisance and environmental safety. For provincial roads, we are considering developing guidelines for sensitive destinations that are close to provincial roads or that will be located in the future. Other subjects for which we set rules are regional airports, soil and subsurface, groundwater and greenery.

A third instrument is measures that the province can take under this program. For example, administrative agreements in which certain ambitions are further specified, or instruction rules in the field of odor, noise or environmental safety, for example. Exploring the possibilities in this area is part of the activity plan of the Healthy Living Environment Program.

### Track 2: Research and monitoring

The Healthy Living Environment Program is knowledge-driven and therefore aims to collect and bundle knowledge and to respond to knowledge gaps in relevant subjects. Knowledge provides a basis for making assessments and taking measures. Especially in areas where homes are or will be located close to industry or roads, it is important that a good understanding of the quality of the living environment is created.

The [Hollandse Luchten](https://hollandseluchten.waag.org/) project has initiated the first mapping of the environmental quality by means of affordable sensors. This is currently happening at three locations: IJmond, Zaanstad Kogerveld and Amsterdam Buiksloterham. We will continue this in the period 2020-2023 by expanding the number of locations and the substances / factors to be measured. In addition to air quality, noise and odor are also measured. Other possible extensions include measuring total dust emissions (CPC, including ultrafine particles), metals and other potentially harmful substances.

In the IJmond, research is currently being conducted into the health effects of emissions from, among others, Tata Steel. This investigation will probably continue until 2021. An inventory is also currently being carried out into the (potentially) substances of very high concern that companies emit for which the province is competent. This can also lead to new research or changes to permits.

In addition to our own research, we also use existing knowledge and networks to build up knowledge. Much research has already been carried out into the health effects of environmental pollution. We bundle the knowledge we gain from research and monitoring and bring this in during discussions with our partners.

A special point of attention are the substances of very high concern (ZZS). These substances can be very harmful and not only end up in the air, but can also pose risks for the soil and groundwater and drinking water. This directly affects the provincial tasks in the field of groundwater management.

Other topics eligible for research and monitoring include:

- Medicine residues and microplastics in the water;
- Pesticides in the rural area;
- Health effects of 5G masts;
- Odor nuisance from industry;
- Noise nuisance from road traffic.

We publish all data collected by the province through the investigations and monitoring as open data as much as possible.

As part of this track, we are setting up a province-wide Healthy Living Environment Monitor. With this we give substance to [motion 96-2019](https://ibabsonline.eu/LijstDetails.aspx?site=NoordHolland&ListId=84a8ac43-1424-48a9-8a1a-0c0bbcdfd8ed&ReportId=b3a7a724-8ee7-430a-bbf1-f4adbfae77a5&EntryId=91b20629-e9e3-4d35-a0f6-80cb8e27a196&searchtext=) of PvdA, D66, PvdD and SP. The monitor becomes part of the annual report on the progress of the program.

### Track 3: Measures

The ultimate goal of building up knowledge is to be able to take measures to improve the quality of the living environment. We distinguish three types of measures for the implementation of the program:

**1. Measures at the source**
Measures at the source can concern companies as well as transport. For companies, this is done via the VTH track (licensing, supervision and enforcement). For transport, it depends on who is the competent authority for the relevant form of transport. The province is in any case responsible for the noise nuisance along provincial roads. National roads and Schiphol Airport can also be a source of nuisance, but it is primarily up to the government to do so.

**2. Measures in the environment**
When taking measures in the area, the province will usually leave this to other parties, such as municipalities and residents' organizations. Partly for this reason, the province plans to set up an implementation scheme that allows third parties to apply for a subsidy for taking measures. An amount of € 7.5 million is available for this in the period from 2020 to 2023. A detailed proposal for the implementation scheme, including the criteria for eligibility for subsidy, will be ready in the second quarter of 2020.

**3. Communication and information**
To support its efforts in the field of a healthy living environment, the province is also investing in communication and information on this subject.

### Track 4: Assessment method

Traditionally, in environmental policy we look at individual sources or factors when determining the degree of nuisance or pollution. There are standards for air quality, the maximum amount of noise, etc. and as long as they are not exceeded, there is no reason to intervene. In line with the area-oriented approach, we will look at the total environmental quality from the Healthy Living Environment Program. So air pollution + noise + odor nuisance. After all, in many places there is more to play than that one source or factor and that adds up for residents. There is as yet no generally recognized criterion for determining the total environmental quality, but experiments have been conducted with it before. The program will examine whether the experiences gained with this can be converted into a measure that is applicable when making policy assessments. A distinction will be made between new developments and existing situations.

The methodology helps to weigh up different environmental factors and to identify opportunities for improvement. Often when looking for a solution, only the relevant source or factor is considered. Sometimes, however, no improvement is possible on that point, for example because the technology is still inadequate or the physical distance to the source is simply too short. In such situations, it may be worthwhile to look more broadly and explore whether improvements are possible in other areas, so that the overall environmental quality still improves. This can be done in two ways: by compensating for other environmental qualities and by compensating for other environmental aspects.

We also want to include aspects such as peak nuisance and area-specific features (for example, the presence of vulnerable / sensitive objects) in the methodology that we are developing for the total environmental quality. Peak nuisance often disappears in monthly or annual averages. But certainly with odor and noise, peak nuisance can still be health-relevant, because of the stress this causes. Think, for example, of loud noises in the middle of the night. For that reason, analyzing nuisance complaints is an important part of this track. We involve municipalities in the elaboration of the method.

### Planning year 1 (2020-2021)

Every year, a progress report is issued which indicates which results have been achieved and which contribution the program has made to improving the quality of the physical living environment in North Holland. The following milestones are provisionally planned for the first year of the program:

| Time | Item |
| -------- | -------- |
| May 2020 | • Adoption of the program plan in the Provincial Executive (GS) |
| June 2020 | • Program plan in committee Nature, Agriculture, Health (NLG) |
| September 2020 | • Publish implementation regulation<br>• Interim report health study IJmond |
| October 2020 | • Start of Hollandse Luchten phase 2 |
| April 2021 | • First report Program Healthy Living Environment to GS/PS |

## 6. Finance

The budget for the Healthy Living Environment Program consists of two parts:

1. Regular environmental budget;
2. Quality of life fund

In addition to these amounts, there are two other budget items that give substance to the ambitions of the Healthy Living Environment Program. These are:

- € 1 million (structurally) for intensifying the VTH tasks (licensing, supervision and enforcement);
- € 11 million for liveability measures N203 at Krommenie (Mobility budget).

The activities undertaken from these last two budgets are not controlled by this program. However, substantive coordination will take place.

### Regular environmental budget

[...]

### Quality of life fund

[...]