{"id":5296,"date":"2026-01-14T10:59:38","date_gmt":"2026-01-14T09:59:38","guid":{"rendered":"https:\/\/healthy-cities.com\/?p=5296"},"modified":"2026-01-14T11:05:07","modified_gmt":"2026-01-14T10:05:07","slug":"bridging-urban-planning-and-health","status":"publish","type":"post","link":"https:\/\/healthy-cities.com\/nl\/2026\/01\/14\/bridging-urban-planning-and-health\/","title":{"rendered":"De brug slaan tussen stadsplanning en gezondheid"},"content":{"rendered":"<p class=\"wp-block-paragraph\"><em>Vrijwel alle beleidsmaatregelen en acties op het gebied van stedelijke planning hebben invloed op de gezondheid van de mens. Denk aan drukke, vervuilende wegen, onbegaanbare straten of toegang tot winkels die verse groenten en fruit verkopen. Door gezondheidsfactoren in elke fase van het planningsproces te verwerken, kan het HEALTHY CITIES-netwerk de stedelijke impact op de gezondheid in alle planningscontexten beoordelen en aanpassen.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Waarom het belangrijk is om onze steden te plannen en te ontwerpen met het oog op gezondheid<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Fietst of rijdt u naar uw werk? Maakt u contact met uw gemeenschap of reist u erdoorheen? En als u zich gestrest voelt, is het dan makkelijk om een rustgevende wandeling te maken in een groene ruimte? Als mensen gezondheidsbeleid horen, denken ze maar al te vaak aan ziekenhuizen. Maar gezondheid is holistisch, waarbij het ontwerp van onze stedelijke omgeving bijdraagt aan de vraag of en hoe vaak bevolkingsgroepen die ziekenhuizen nodig hebben. Stedenbouwkundigen selecteren locaties, ontwerpen ruimtes en plaatsen diensten, en er is voldoende&nbsp;<a href=\"https:\/\/www.isglobal.org\/evidencia-cientifica-exposiciones-ciudad\">wetenschappelijk bewijs<\/a>&nbsp;om aan te geven dat deze factoren een grote impact hebben op de gezondheid.&nbsp;<a href=\"https:\/\/www.isglobal.org\/en\/home\">ISGLOBAAL<\/a>&nbsp;heeft luchtvervuiling, lawaai, hitte en gebrek aan fysieke activiteit of natuurlijke ruimte ge\u00efdentificeerd als gezondheidsrisico&#039;s die het leven in de stad met zich meebrengt (zie figuur 1). Goed&nbsp;<strong>stedenbouw, echter,&nbsp;<\/strong>kunnen niet alleen de impact van die gevaren verminderen, maar ook&nbsp;<strong>een hulpmiddel om gezondheid te cre\u00ebren.<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Als het gaat om het ontwerp van een stedelijk plan, beleid of actie, krijgt gezondheid niet altijd de ruimte die het verdient in het gesprek. Het is veelzeggend dat&nbsp;<strong>Gezondheidsdeskundigen worden zelden betrokken bij de ontwikkeling van stadsplannen en -beleid.&nbsp;<\/strong>Artsen, verpleegkundigen en medische experts zijn over het algemeen volledig bezig met pati\u00ebnten, ziekenhuizen en het zorgsysteem. Er is weinig ruimte voor betrokkenheid bij stadsplanning. Helaas zijn onze zorgsystemen over het algemeen meer reactief dan proactief.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Om een proactieve benadering van gezondheid te hanteren, zouden stadsplanners en beleidsmakers Health Impact Assessments (HIA&#039;s) moeten gebruiken om de impact van verschillende stedelijke factoren op gezondheid beter te begrijpen. HIA&#039;s worden echter vaak gezien als een onbelangrijke aanvullende activiteit, in plaats van als een belangrijke preventieve maatregel om de algehele gezondheid te verbeteren. Aan de andere kant belemmert het gebrek aan betrokkenheid van gezondheidsexperts bij de huidige HIA-implementatie de effectiviteit van hun resultaten.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Hoe gezondheid systematisch te integreren in stadsplanning: de &#039;Healthy Cities&#039;-aanpak<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">HEALTHY CITIES, een netwerk van negen partners (lokale en planningsautoriteiten), ontwerpt ge\u00efntegreerde actieplannen die een brug slaan tussen stedelijke planning en gezondheid. Met zijn methodologie wil het netwerk stedelijke planning een generator voor gezondheid maken.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Het netwerk promoot gezondheid via een cross-sectorale en collaboratieve aanpak met de hulp van traditionele gezondheidssystemen en experts (waar mogelijk). Fysieke, sociale en milieugezondheid is een verenigend doel voor alle partners en een rode draad voor alle stedelijke beleidsmaatregelen. Elke partner heeft een multidisciplinaire lokale groep opgericht om hun stedelijke gebieden te plannen en ontwerpen. De groepen overwegen alle verschillende belangen in de ruimte en betrekken milieu-experts, architecten, gezondheidsexperts en mensen uit burgergroepen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Het netwerk gebruikt de HIA-tool als leidraad om de impact van stedelijke determinanten op gezondheidsindicatoren te begrijpen. Het ondersteunt ook de Health in all Policies (HiaP)-benadering en gebruikt zijn eigen Healthy Cities Assessment Tool voor de best mogelijke uitkomst.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Gezondheidsimpactanalyse als ge\u00efntegreerd instrument<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong><em>Wat is een gezondheidsimpactanalyse?<\/em><\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>\u201cGezondheidseffectbeoordeling is een&nbsp;<strong>combinatie van procedures, methoden en hulpmiddelen&nbsp;<\/strong>waarmee een beleid, programma of project kan worden beoordeeld op de potenti\u00eble effecten ervan op de gezondheid van een bevolking, en de verdeling van die effecten binnen die bevolking.\u201d&nbsp;<\/em>(WHO 1999).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">HIA is geen nieuw instrument. De eerste richtlijnen werden begin jaren negentig ontwikkeld en in 1999 werd de&nbsp;<a href=\"http:\/\/www.healthedpartners.org\/ceu\/hia\/hia01\/01_02_gothenburg_paper_on_hia_1999.pdf\">Gothenburg consensus paper<\/a>&nbsp;definieerde de belangrijkste concepten en benaderingen. De HIA heeft zes stappen: Screening, Scoping, Assessment, Recommendations, Reporting en Monitoring &amp; Evaluation (uitgelegd in figuur 2).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Helaas is HIA geen gangbare praktijk in stedelijke planning. Hoewel het een laag complexiteit toevoegt aan het planningsproces, is het een waardevol en flexibel hulpmiddel dat kan worden aangepast aan de behoeften en expertise van de gebruikers. Als praktijk streven HIA&#039;s ernaar om een reeks op bewijs gebaseerde aanbevelingen te produceren die positieve gezondheidseffecten maximaliseren en negatieve effecten minimaliseren. Deze worden gebruikt om besluitvormers en het publiek te informeren wanneer beleid of plannen met een aanzienlijk potentieel om de gezondheid te be\u00efnvloeden, worden overwogen.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">HIA wordt het best ge\u00efmplementeerd wanneer de gebruikers ervan ook de Health in All Policies (HiAP)-aanpak ondersteunen. HiAP houdt systematisch rekening met de gevolgen voor de gezondheid in alle sectoren en zorgt ervoor dat overheden zich inzetten voor de verbetering van gezondheid en welzijn. HiAP maakt gezondheid tot een centrale pijler binnen verschillende instanties en sectoren en bevordert samenwerking met behulp van een op bewijs gebaseerde methode. Het toepassen van het HiAP-principe kan ertoe bijdragen dat stadsplanning een motor voor gezondheid wordt.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Wat is er nieuw aan HEALTHY CITIES?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">HEALTHY CITIES ondersteunt de HiAP-praktijk en gebruikt HIA voor een ge\u00efntegreerde benadering van stedelijke planningspraktijken. Tijdens de ontwikkeling van de negen lokale ge\u00efntegreerde actieplannen worden zowel gezondheids- als stedelijke planningsinputs constant overwogen (figuur 2).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Al vanaf de allereerste stap bij het defini\u00ebren van de doelstellingen gebruikten de partners de Healthy Cities Assessment Tool om de impact van alle voorgestelde acties op de gezondheid te evalueren en visualiseren (figuur 4).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">De&nbsp;<strong>Beoordelingsinstrument voor gezonde steden&nbsp;<\/strong>maakt een snelle beoordeling van stedelijke plannen, doelstellingen en acties mogelijk op basis van hun invloed op de 16 stedelijke determinanten. Het berekent automatisch de potenti\u00eble gezondheidsimpact van acties, ondersteunt besluitvormingsprocessen en toont de gezondheidsimplicaties van beslissingen over stedelijke planning. Het geeft kennis door aan niet-gezondheidsexperts en faciliteert interdisciplinaire gesprekken. De invloed van stedelijke determinanten op de gezondheid kan direct zijn (op sommige indicatoren zoals hart- en vaatziekten, luchtwegaandoeningen, diabetes, depressie, enz.) of indirect (op sommige gezondheidsdeterminanten zoals fysieke activiteit, dieet, luchtkwaliteit of geluidsoverlast).<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">De&nbsp;<strong>Beoordelingsinstrument voor gezonde steden<\/strong>&nbsp;(2020) is gebaseerd op een systematische review die wetenschappelijke, peer-reviewed publicaties samenvoegt die een verband leggen tussen stedelijke determinanten en hun impact op de stedelijke gezondheid\u00b9. De tool maakt gebruik van een matrix van 16 stedelijke determinanten en hun impact op 21 gezondheidsindicatoren. De tool is ontwikkeld door de co\u00f6rdinator van HEALTHY CITIES, Marta Rofin Serra, stedenbouwkundige en architect.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">De HEALTHY CITIES-methodologie integreert een systematische analyse waarbij elke gedefinieerde stap van HIA drie iteratieve elementen ondersteunt: analyse, planning en ontwerp en governance (figuur 4)<sup>2<\/sup>.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Deze aanpak&nbsp;<strong>combineert de HIA met het Framework for Collaborative Planning<\/strong>. De drie elementen zijn nodig om op een gepaste en ordelijke manier stedelijke planningsgerelateerde kwesties aan te pakken en van een uitdaging naar een ontwerpresultaat te gaan via een collaboratieve aanpak. In essentie organiseert deze aanpak de HIA om beter aan te sluiten bij het doel van stedelijke planning.<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table class=\"has-fixed-layout\"><tbody><tr><td><strong>Analyse<\/strong><\/td><td><strong>Het doel is om feiten vast te stellen en problemen te analyseren, defini\u00ebren of herformuleren en aan te pakken.<\/strong><\/td><\/tr><tr><td><strong>Planning en ontwerp<\/strong><strong><\/strong><\/td><td>Het doel is om beelden te cre\u00ebren en om oplossingen en strategie\u00ebn te ontwikkelen, analyseren, bespreken en voorstellen.<\/td><\/tr><tr><td><strong>Bestuur<\/strong><\/td><td>Het houdt in dat deelnemers hun ambities bespreken en defini\u00ebren om sociaal geconstrueerde kennis te cre\u00ebren en de ambities en rollen van de belanghebbenden met betrekking tot het ontwikkelingsproject en het beleid in het algemeen te benadrukken.<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\"><strong>Wat volgt er?<\/strong><\/p>\n\n\n\n<p class=\"wp-block-paragraph\">De ge\u00efntegreerde aanpak die HEALTHY CITIES voorstelt, is niet bedoeld om te bepalen, maar om betere besluitvorming te ondersteunen bij de ontwikkeling van ge\u00efntegreerde actieplannen. Alle tools en benaderingen worden verder besproken en getest door de negen partners. Naarmate het project vordert, worden er meer resultaten gepubliceerd met betrekking tot de ge\u00efntegreerde aanpak en de effectiviteit ervan voor het plannen en ontwerpen voor een gezondere stad. Het doel van het netwerk is om stadsplanning een generator voor gezondheid te maken.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Bij Bax &amp; Company hebben we het HEALTHY CITIES-netwerk ondersteund op hun weg naar een gezondere stadsplanning. Als u ge\u00efnteresseerd bent in manieren om de leefbaarheid en duurzaamheid van uw stad te verbeteren, neem dan contact op met een van onze teamleden hieronder voor meer informatie.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Referenties:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">\u00b9&nbsp;<em>Puig-Ribera A, Bort-Roig J, Rofin M, Garcia-Cuy\u00e1s F, Geli M, Chamorro C, Perona-Ribes L, Cervantes P, Torrent\u00f3 J, del Val R, Palmero F. (2018). Lokale stedelijke omgevingen plannen om de gezondheid in Vic (Barcelona) te bevorderen: een alomvattende aanpak. Europees tijdschrift voor volksgezondheid; 28 (suppl. 4): 208.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em><sup>2&nbsp;<\/sup><\/em><em>van Herk S., Zevenbergen C., Ashley R., Rijke J., Learning and Action Alliances voor de integratie van overstromingsrisicobeheer in stedelijke planning: een nieuw raamwerk op basis van empirisch bewijs uit Nederland, Environmental Science &amp; Policy, Volume 14, Issue 5, 2011.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><em>Dit bericht is oorspronkelijk geschreven door Sebastiaan van Herk (Lead Expert), Sofia Aivalioti en Marta Rofin Serra (HEALTHY CITIES co\u00f6rdinator) voor de\u00a0<\/em><a href=\"https:\/\/urbact.eu\/networks\/healthy-cities\"><em>URBACT Netwerk voor Gezonde Steden<\/em><\/a><em>.<\/em><\/p>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>","protected":false},"excerpt":{"rendered":"<p>Almost all urban planning policies and actions have an impact on human health. Think busy, polluting roads, unwalkable streets, or access to shops selling fresh fruit and vegetables. 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