Exploring Triple-Win Solutions for Living, Moving and Consuming That Encourage Behavioural
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Exploring t riple-win solutions for living, m oving and consuming that encourage b ehavioural c hange, protect the e nvironment, p romote health and health e quity WWW.INHERIT.EU AUTHORS Brigit Staatsen, Nina van der Vliet, Hanneke Kruize Lisbeth Hall (National Institute for Public Health and the Environment (RIVM), the Netherlands), George Morris (University of Exeter, UK), Ruth Bell (UCL, Institute of Health Equity, UK), Ingrid Stege- man (EuroHealthNet, Brussels) ACKNOWLEDGEMENTS The authors would like to thank the following experts for their contributions to the review: Pablo Martinez Juarez, Sonia Quiroga (Universidad de Alcala, ES) Georgina Guillen-Hanson, Kristina Modee, Rosa Strube (Collaborating Centre on Sustainable Production and Anne-Sophie Meritt, Marita Friberg Consumption, DE) (Public Health Agency of Sweden) Monica Aberg Yngwe, Caroline Costongs, Wendy van Lippevelde, Bruno Buytaert Masja Schmidt (EuroHealthNet) (Flemish Institute for HP and DP) Vojtech Maca Nikola Tilgale-Platace, Andris Izinkevics (Charles University Environment Centre, CZ) (Riga City council) Angela Donkin Yvette Shajanian Zarneh (UCL, Institute of Health Equity, UK) (Federal Centre for Health Education, DE) Geir Arild Esnes, Monica Lillefjell, Kirsti Anthun, Jantine Schuit, Irene van Kamp Siw Tone (Norwegian University of Science and (RIVM, NL) Technology) Cover design and lay-out: REVOLVE MEDIA Joyce Westerink, Hanne Spelt (Philips Research, NL) Dragan Gjorgjev, Fimka Tozija, M Dimovska (Institute of Public Health, Republic of Macedonia) Timothy Taylor, Sahran Higgins The contents of this review do not reflect the of- (University of Exeter, UK) ficial opinion of the European Union. Responsibil- ity for the information and views expressed in the Pania Karnaki, Fotis Tsichlas review lie entirely with the authors. No particular (PROLEPSIS, GR) commercial entity, service or product that may be involved in, or be a result of, the INHERIT Project is Aline Chiabai endorsed by public or non-profit project partners. (Basque Centre for Climate Change) Reproduction is authorised provided the source is acknowledged. Sibila Marques, Gabriel Muinos (Lisbon University Institute) February 2017 INHERIT | Horizon 2020 Research Project Baseline review 2 TABLE OF CONTENTS HIGHLIGHTS 4 CHAPTER 1 OBJECTIVES AND METHODS 8 1.1 INHERIT and this baseline review 8 1.2 Methodology 10 1.3 Contents of this review 11 CHAPTER 2 SETTING THE SCENE 12 2.1 Introduction 12 2.2 Key drivers, trends and main impacts 13 2.3 Government, private sector and civil society responses 20 CHAPTER 3 CONCEPTUAL FRAMEWORK 27 3.1 Conceptual Framework 27 3.2 Behaviour 30 CHAPTER 4 LIVING – GREEN SPACE 4.1 Introduction 35 4.2 Drivers, trends and policies in Europe regarding green spaces 36 4.3 Environmental and health impacts 43 4.4 Differences between subpopulations and inequalities 50 4.5 The role of behaviour 52 4.6 Opportunities to stimulate use of green space 56 4.7 Discussion and conclusion 61 CHAPTER 5 LIVING - ENERGY EFFICIENT HOUSING 63 5.1 Introduction 63 5.2 Drivers, trends and policies regarding household energy consumption and efficiency 64 5.3 Environmental and health impacts 70 5.4 Differences between subpopulations and inequalities 75 5.5 The role of behaviour 76 5.6 Opportunities for healthy energy efficient housing 78 5.7 Discussion and conclusions 86 CHAPTER 6 MOVING - ACTIVE TRANSPORT 6.1 Introduction 87 6.2 Drivers, trends and policies regarding (active) transport 88 6.3 Environmental and health impacts of transport 94 6.4 Differences between subpopulations and inequalities 100 6.5 The role of behaviour 102 6.6 Opportunities to stimulate active transport 104 6.7 Discussion and conclusions 113 CHAPTER 7 CONSUMING (FOOD AND BEVERAGES) 116 7.1 Introduction 116 7.2 Trends, drivers and policies regarding European food consumption and waste 117 7.3 Environmental and health impacts 121 7.4 Differences between subpopulations and inequalities 125 7.5 The role of behaviour 126 7.6 Opportunities to stimulate healthy and sustainable food consumption 129 7.7 Discussion and conclusions 138 CHAPTER 8 TOWARDS HEALTHIER, EQUITABLE AND SUSTAINABLE LIFESTYLES 140 Appendix 1 Glossary 149 References 155 INHERIT | Horizon 2020 Research Project Baseline review 3 HIGHLIGHTS HIGHLIGHTS Human activity is now damaging the global ecosystems tunities for beneficial change across Europe which can and depleting finite resources at an unprecedented rate, facilitate progress towards the triple win. The review in- the very resources and systems on which we rely as a vestigates the links between behaviour, environmental species for health, wellbeing and survival. On a daily sustainability, health and health equity for three areas: liv- basis, we are reminded of the urgency of this challenge ing (green space, housing), moving (active transport) and and its global and societal implications. This challenge consuming (food). These three areas are chosen, in part calls for a drastic rethink of human society, the econ- because they are so central to the lived experience of, par- omy and our relationship to the natural world. Europe ticularly, urban dwellers in the Europe of the 21st Century. will need to fundamentally transform its systems of pro- Each area, in a different way, has a profound bearing on duction, transport and consumption if it is to achieve Europe’s capacity to deliver the triple win. Nested with- its 2050 vision of ‘living well, within the limits of our in each topic are key behavioural and lifestyle levers of planet’. change which might be operated to considerable effect by carefully crafted policies based on sound theoretical The EU funded Horizon 2020 “INHERIT” project seeks and empirical knowledge. Below, the highlights of this ex- to identify effective inter-sectoral policies, interventions ploration are presented. and innovations that enable a ‘triple win’ by reducing environmental impacts, improving health and wellbe- Current transport, food and energy production, con- ing, and generating greater health equity. INHERIT will sumption patterns and lifestyles in Europe are unhealthy inform policies and the actions which flow from them. and unsustainable. They generate the pollutants that INHERIT’s contribution comes from its specific aim to most significantly affect human health, such as particu- improve understanding of how lifestyle and behaviour late matter, nitrogen dioxide, ground-level ozone, green- creates and shapes the contemporary challenge, the house gases and noise. The burden of cardiovascular and determinants of these behaviours and how behaviour- respiratory diseases attributed to these pollutants in Eu- al change may be practicably harnessed to deliver the rope is considerable. Air pollution, for example, contrib- triple win. utes to the premature death of about 600,000 people every year in the WHO European Region, with an asso- In this review, the INHERIT team explores the oppor- ciated cost of USD 1.6 trillion in 2010, and a dispropor- INHERIT | Horizon 2020 Research Project Baseline review 4 HIGHLIGHTS tionate disease burden in certain regions and less afflu- ability, the price of food in stores and food waste in the ent parts of society, increasing inequalities. Furthermore, whole supply chain must be changed, highlighting the overconsumption, lack of green space and limited phys- role producers and retailers play and the need for sys- ical activity contribute to the increase in people being tem change to stimulate the development of healthy overweight and obese observed in Europe. Globally, two sustainable behaviours and lifestyles. billion people are suffering from the consequences of overconsumption and obesity, in the form of non-com- To be effective, interventions targeting behavioural municable diseases (NCDs) such as heart diseases, can- change need to take into consideration the characteris- cer, diabetes and chronic respiratory diseases. tics of specific populations. For most people, but espe- cially low-income groups, economic measures, such as Moreover, current transport, energy and food production, financial incentives (e.g. for using the bicycle for work) consumption patterns and lifestyles damage our ecosys- and fiscal policies, e.g. taxing unhealthy foods and dis- tems at a global scale, and lead to depletion of natural counts on healthy foods, are attractive. It is effective resources, global warming and climate change with po- to lower the costs of healthy foods, to emphasise the tential disastrous consequences in the long term. If the money saved from being energy efficient at home and world population in 2050 - estimated to be ten billion taking the bike instead of the car. Targeted awareness people - were seeking a European lifestyle, this would raising, education and training initiatives are essential require, under present production and consumption pat- to change individual behaviours (e.g. Bikeability pro- terns, the natural resources of at least two Planet Earths. grammes in the UK and Netherlands), but only if ac- Furthermore, climate change, caused mainly by highly companied with changes in the environment (e.g. at- developed economies, will undermine the livelihoods of tractive and safe cycling and walking routes). millions of people in northern Africa, and lead to even larger numbers of social and economic refugees than the Fortunately, there are signs of progress and change. The numbers generated by the current political crises. This Sustainable Development Goals, for example, are sup- will have grave political and social consequences,