Positive Health and Living Environment

Our living environment has a great impact on our health as demonstrated by many scientific studies. For example, the Blue zones are geographic areas in the world in which people have low rates of chronic diseases and live longer than anywhere else. This could be due to their healthier lifestyle and positive traits of their physical and social living environment. The Louis Bolk Institute has developed the model of Positive Health that is used as individual conversation tool by care provides. This is further developed into a model for Positive Health and Living Environment. 

The Louis Bolk model for Positive Health and Living Environment 

This is an expansion of the Positive Health model, which is an individual conversation tool, towards a more holistic approach for health in relation to the living environment, like a neighbourhood (see Figure). For bodily functions, this could be cycling lanes and sports facilities. For mental functions and perception, this could be a reduction of noise and more connection with the neighbourhood. Moreover, for daily functioning this could be information and shopping amenities. We have expanded this model from application at the individual level to the collective level. Many people are familiar with the spider web as instrument to map the Positive Health for an individual and its use as conversation tool. With this expansion, the model can also provide support for improvements of the living environment in such a way that it can improve health of residents of neighbourhoods. 

Integraal model Positieve Gezondheid en Leefomgeving - raamwerk

Integraal model Positieve Gezondheid en Leefomgeving - voorbeeldinvuilling


New laws for environment with health components

This is very relevant as the new law for environment in the Netherlands demands that municipalities should consider health when developing local policies and the execution of subsequent projects. We support municipalities and other organisations in trajectories involving development of and establishing the living environment with the Bolk-model. We develop this together with municipalities and other stakeholders to gain insight in the processes and activities that occur at the neighbourhood level. The National note on Heath Policy 2020-2024 also recommends this instrument.

Together building consensus

With this model, conversations on health and environment are held with the residents of neighbourhoods, other stakeholders and the researchers. Together, they complete information on the six domains of Positive Health of the Bolk-model for Positive Health and Living Environment (see Figure). This approach has numerous advantages. Therefore, the model is already widely accepted, as it based on health from a broad perspective based on the six domains. Moreover, during this process of dialogue, a better sense of consensus and ownership is created. Often we see that municipalities and residents have different ideas what should happen in their neighbourhood. Collaboration and working together can be difficult then. We help to find synergy and activities that meet the residents’ needs. In addition, we regularly perform a scan of the living environment, based on the model Positive Health and Living Environment. Together with residents, we walk around in neighbourhoods to complete a case-specific questionnaire. Moreover, we interview people to get a better understanding of the different perspectives and possibilities for improvement in the living environment. With our guidance and the Bolk-model the different stakeholders can come to common plans and implementation.  

More coherence in policy

The Bolk-model of Positive Health and Living Environment also leads to more coherence in policy. Often there are different policies for public health, environment, spatial planning, economy and social affairs, whilst often there is a need for an integrated approach. Many policy workers are directed to focus on their own organisational structures, while there is a dire need for an integrated approach. As soon as policy workers complete the provided framework together, they experience more coherence in the different policy domains. Then they experience the integrated approach naturally: they see that they need each other to achieve more. 


During the past years, the Louis Bolk Institute has completed several projects on Positive Health and Living Environment, for example in Amsterdam Southeast, Oss, Arnhem, and the province Flevoland. In addition, we are currently working on several projects, including the new construction of a neighbourhood in Texel, in situations where residents experience substantial burden of intensive livestock farming in North Brabant, and a project on finding the balance between People, Planet and Profit on Saint Eustace. The preliminary results from the Texel project demonstrate a list of smart initiatives that contribute to health and quality of living environment, for example a common vegetable garden and shared space for DIY for residents. 

In addition, we often give workshops on Positive Health and Living Environment for healthcare organisations or policy workers.