This Annex contains detailed information on the 15 INHERIT case studies, available by clicking the … symbol in each box.
The Food Garden
Community garden providing organic food for low-income families, staffed by volunteers from vulnerable groups. Provides healthy and sustainable food, work activation and garden education opportunities for vulnerable populations, and increased green space in an urban area.
The Food Garden (De Voedseltuin), The Netherlands
The Food Garden is located at a former industrial harbour area in Rotterdam. The aim of the Food Garden is, through the help of volunteers (n=59 in 2018), to produce organic vegetables and fruit for lower income families that are connected to the Dutch Food bank. The Food Garden offers work for volunteers, amongst others through participation ‘spots’ to reactivate unemployed people with a large distance to the job market. The Food Garden covers 7,000 m² of land and produces organic fruit and vegetables using permaculture principles. It has gradually developed from a food garden with a social function, to a food park with multiple functions (production garden, learn/work garden, urban garden and breeding ground for innovation and development).
The target groups of the Food Garden initiative are disadvantaged families who receive food packages from the Rotterdam Food Bank, and other vulnerable population groups, including volunteers who are disconnected from the job market.
What inspired the creation of The Food Garden?
It was initiated in 2010, as a way to grow vegetables to supplement food packages (which were short on vegetables at the time) for the local food bank in Rotterdam. At the same time, many users of the food bank were unemployed at home, and could work as volunteers in the food garden.
The high availability of volunteers, the support from the municipality and the location near the Food Bank have all been important factors for the successful operation of this initiative. Another central facilitator has been the availability of a green space area that could be allotted for the Food Garden. Having a hybrid business model, with funding from different (private, collective and public) sources, meant less dependency on the municipality (who could be a more equal cooperation partner). Municipality stakeholders went into the city and looked across sectors and facilitated small initiatives. Setting the agenda, so being active in reaching and engaging policymakers instead of merely reacting on policy (and also being policy resistant, for example by having enough resources to continue when subsidies stop or decrease). Involved cooperation stakeholders were motivated, driven and like-minded, and actively sought cooperation (they formed a chain of green-social initiatives). They also knew each other’s worlds, trusted and respected each other, and were willing to share ideas.
Outcomes and Impact
No quantitative or cost-benefit evaluation was conducted. However, the Food Garden has a societal impact through multiple routes: healthy and sustainable food, work activation and garden education opportunities for vulnerable populations, and increased green space in an urban area.
The (societal) value and impact of the cooperation chain must be made more visible, better acknowledged and rewarded financially. Financing should change from fragmented small sources to integral funding. Also needed is a pilot experiment to test, develop and grow the business model and cooperation chain, with time, energy and space for the municipality to support the initiatives and develop the hybrid business model further. Finally, development of green social work as a new transdisciplinary education.
The Food Garden demonstrates the importance of chain cooperation between small-scale initiatives (e.g. a food garden, catering organization, work activation centre) and the importance of municipality support. In the future, there should be more time and space for these type of initiatives to test, develop and grow.
Small-scale farmers sell healthy products directly to consumers through an online platform, highlighting the benefits of an alternative economic model that focuses on a short circuit of food production and consumption. The farmers’ wellbeing and individual empowerment is positively affected. PROVE is aiming to expand to distribute its products to schools
PROVE is a national programme that provides tools, training and partnerships to empower small-scale farmers in organised local networks (or PROVE groups) to directly sell their seasonal fruits and vegetables locally, through collaborative work and an online platform. Citizens, associations or municipalities can approach PROVE partners to trigger the implementation of new PROVE groups. It was created by a consortium of partners led by ADREPES (Association for Rural Development of the Península de Setúbal) in 2004. In 2018 there were 108 active PROVE groups across Portugal.
Small-scale farmers, local consumers, local promotors (municipalities, non-governmental organisations, groups of citizens).
What inspired the creation of PROVE?
PROVE was triggered at a social forum on local sustainable development in which the local agriculture sector was discussed. The programme was inspired by international experiences in short food chains and was created with EU funding (through the EQUAL and PRODER programs) by an intersectoral team led by ADREPES.
According to stakeholders’ perceptions, the PROVE methodology allows farmers to self-manage their own unit and create an income source that is valid in contexts of economic downturn and disinvestment in the agricultural sector. Its success is based on building relations of proximity and trust and reinforced by investments in the brand identity and group activities (visits, national meetings).
Outcomes and impact
Farmers perceived their life circumstances to be improved by PROVE, and reported higher levels of personal empowerment and wellbeing when compared with a matched national sample that were not part of PROVE. For consumers, having a PROVE subscription appears to enable higher consumption of fruits and vegetables by making them more readily available in the household.
PROVE implementers argue that PROVE needs to restructure its funding to ensure brand consolidation and further technical support to farmers. The project could grow if strategies are put in place to attract more people to work in sustainable agriculture and to diversify PROVE access points. The evaluation suggests that in the future, the triple-win (improving health, equity and environmental sustainability) can be fostered by reaching out to consumers from lower socioeconomic groups and by promoting more alternatives to animal protein.
PROVE illustrates the importance of citizens’ participation and network collaboration to foster the empowerment of consumers and farmers in local food production. The promotion of local production and consumption networks can help consumers to make choices that contribute simultaneously to health, environmental sustainability and social equity.
An integrated city approach to ensure healthy sustainable food to low-income populations. Demonstrates how different sectors and organisations can work synergistically together to implement actions towards healthy eating.
Gent en Garde: The STOEMP initiative, Belgium
STOEMP is a network that brings together initiatives around good food – food that is healthy, nutritious, local, and good for the environment. It was launched in 2017, as part of the Gent en Garde food policy of the city of Ghent. INHERIT helped to gain insight in how different policy domains (environment, health, social welfare) and sectors work together in relation to STOEMP’s objective of connecting and strengthening initiatives to make good, sustainable food available to everyone, in particular to the most disadvantaged groups.
STOEMP is a collaboration of stakeholders from education, civil society, research, social welfare and city administration. It aims to reach all parts of society but with special focus on the most disadvantaged.
What inspired the creation of STOEMP?
In addition to being anchored in the Milan Food Policy Pact and the United Nations Sustainable Development Goals, the initiative’s two key partners had complementary objectives: first, the food council of Gent en Garde wanted to work more on one of its five strategic goals: “Creation of more social added value for food initiatives”. Second, community health centres wanted to work towards making healthy food accessible for everyone.
The most important success factors in implementing the STOEMP initiative, according to the participants, were the enthusiasm and motivation of the different partners as well as the shared values and perspectives on how to combat the problem despite varying goals of the involved organisations. In addition, the feeling of ownership of the partners by being actively involved in the creation and revision of the project’s goals and actions was highly important. Political support for the facilitation of a moderator and coordinator at the municipal level was also seen as vital for the initiation and functioning of this initiative.
Outcomes and impact
INHERIT has found STOEMP to be a promising implementation model in the context of a city-wide strategy. The case study demonstrates how different sectors and organisations work synergistically together to implement actions towards healthy eating, with a particular focus on those facing socioeconomic disadvantage. Research on the impact of the initiative on healthy eating among different social groups is planned but has not yet been conducted.
According to INHERIT’s qualitative evaluation, a strong basis and framework for STOEMP exists. In the future, the focus could lie on enhancing the visibility of STOEMP, creating even more support from stakeholders from different sectors, further increasing the exchange of good ideas and even organising shared actions, and attracting new target groups and organisations.
STOEMP demonstrates how policy domains and partners from different sectors can successfully work together with the goal of reaching a more sustainable, healthy and fair food system for everyone in the city.
Training programme for teachers to bring children outdoors and educate them about food production. Grew from 1 pilot to over 400 programmes across 3 countries.
The GemüseAckerdemie is a training and support programme for school teachers established in 2013 that enables them to give lessons to children on the theory and practice of growing food. More than 400 schools and kindergartens participated in 2019. Building on this, the INHERIT case study aimed to increase the number of volunteers supporting the GemüseAckerdemie PLUS programme, which is dedicated to schools and kindergartens that are situated in deprived areas and that have a strong focus on integration, and/or are attended by children with some form of disability. The case study was conducted over the 12 months from February 2018 to January 2019.
One target group were the volunteers, who were contacted and engaged to support the GemüseAckerdemie PLUS to work in the vegetable fields. The other target group were the school or kindergarten children from institutions situated in deprived areas that have a strong focus on integration, and/or that children with some form of disability attend.
What inspired the creation of GemüseAckerdemie?
The GemüseAckerdemie programme was started as a social enterprise with the aims of re-establishing children’s contact with nature and increasing their knowledge about how to grow food and eat healthily, as the funder felt the need to address this challenge. The case study was created to improve the quality of experience for the children participating in GemüseAckerdemie PLUS.
Having started as a pilot with one school in 2013, the number of schools and kindergartens in the overall GemüseAckerdemie programme has since increased to 400 in Germany, Austria and Switzerland, which shows the interest in the approach. From the feedback from the qualitative evaluation within the interviewed schools, it was apparent that the support of Ackerdemia, the organisation behind the programme and that brought in all the materials and advice, was an important and appreciated facilitating factor. Other important factors were the personal commitment and enthusiasm of all those involved, easy and fast communication, and meeting in person.
Outcomes and impact
No quantitative or cost benefit evaluation was conducted. However, other studies on GemüseAckerdemie conducted every year show that the initiative has a significant impact on both children’s and teachers’ way of thinking and acting; the children feel more involved with nature and value their food more after they have experienced how much work it can be to grow vegetables. Teachers and volunteers in the case study reported similar experiences.
Both GemüseAckerdemie in general and the case study programme could be scaled up. An interesting way to do this would be to integrate the programme with the standard school curriculum and to anchor it within regional and national policy. This way, teachers could implement the programme as part of the regular curriculum, not on top of it, and more time could be allocated to the collaboration with the other actors involved.
The programme successfully brings together environment, health and equity aspects by giving children the chance to be outside and to grow and eat their own vegetables. The GemüseAckerdemie PLUS programme specifically supports children from deprived areas or with need for special care.
Gardening with Green Gyms and Meat Free Mondays
Initiative providing children with opportunities to connect to nature and consume healthy foods. Benefited in particular children with learning difficulties/autism and children who struggle with work in the classroom.
Gardening with Green Gym and Meat Free Monday, United Kingdom
Gardening with Green Gym (GG) and Meat Free Monday (MFM) is a collaboration between University College London, the Conservation Volunteers (TCV), the Meat Free Monday campaign and a primary school in London. The intervention designed within the INHERIT project aims at improving children’s diet, physical activity and mental wellbeing through gardening activities in the school grounds along with provision of a meat-free school meal at least once a week. The intervention was designed for one school year, September 2018 to July 2019. This evaluation is based on analysis of data up to February 2019.
The target group was a group of children aged 9 to 10 years old from a socioeconomically and ethnically diverse neighbourhood in London. The target group also included children with disabilities.
What inspired the creation of Gardening with GG and MFM?
The creation of the intervention was triggered by the INHERIT aim of achieving a triple-win (of improving health, equity and environmental sustainability) and based on evidence about the benefits of complex interventions (environmental and educational) for improving children’s diet, physical activity and wellbeing.
Actively seeking involvement of the stakeholders and bringing the key actors on board, particularly finding and engaging an interested school, contributed to the successful implementation of the intervention. The mutual interest of the stakeholders and their common goals and values, and demonstration of the benefits of outdoor learning through existing evidence, were also key motivating factors.
Outcomes and impact
The mixed methods evaluation indicated some positive impact of the intervention on children’s attitudes to and preferences for eating vegetables and fruit, and their physical activity levels and wellbeing.. Further data analysis will be carried out until the end of the INHERIT initiative (December 2019). Longitudinal studies with a larger sample size in future would yield stronger evidence.
More time and resources for planning with key actors ahead of time, improved communication between the stakeholders, and training of teachers can further improve the intervention. Interdisciplinary research in close collaboration with the sectors involved would also be of benefit. Integration of outdoor learning within the curriculum is crucial for scale-up and transferability across England and Europe.
Enabling children during the school day to take part in gardening activities and access plant-based foods in the school environment has the potential to contribute to a triple-win for health, equity and the environment. Successful implementation and scaling up require integration into the school curriculum. Co-design and planning of the intervention with children, teachers and all key actors is also important.
Sustainable Food in Public Schools
Initiative under which nursery schools in Madrid provide healthy sustainable food to children. Assessed as economically beneficial (the potential benefits exceed the costs in a ratio of approximately six to one).
Sustainable Food in Public Schools, Spain
This case study introduces change in the menus in 56 public municipal nursery schools in Madrid to children aged 0-3. The intervention includes reduction in meat consumption, increased consumption of fruits and vegetables, introduction of organic food, total avoidance of processed foods, and reduction of intermediates in the food procurement, among others. The municipality started the project in 2017 in 2 schools and it was expanded in 2018 to the rest of the schools with the contribution of INHERIT project and other parallel funding sources. Other key aspects of the case study included supporting the entire school community during the process of change, including training the kitchen staff to develop healthier menus without sacrificing the good taste of the dishes. To facilitate this, stakeholders created ‘motor change groups’ in each school including families, educators, management and kitchen staff, where the new menus were discussed with a nutritionist.
Children 0-3 years old and the whole school community, to encourage acceptance of the new approach, and participation in the process of change. The target schools are public and some of them are located in particularly disadvantaged areas in Madrid.
What inspired the creation of Sustainable food in public schools?
The project arose as a response of the municipality of Madrid to the Milan Urban Food Policy Pact.
The project was immediately appropriated by the educational community and in particular by the group of cooks. So much so, that a very high percentage of the school cooks participate voluntarily in parallel related initiatives (i.e. a learning community that emerged from the project community). The empowerment of the school cooks proved to be a very important engine of change. The change could not have been achieved without their support, since the intervention includes a significant amount of additional work for them (such as cutting and cooking fresh vegetables, making homemade sponge cakes without sugar except for fruit, peeling fruits or squeezing juices) and new training.
Outcomes and Impacts
The main achievements have been the change of children’s menus with little confrontation, with a high level of acceptance by children and the whole school community. The economic evaluation of the intervention has showed that the potential benefits exceed the costs in a ratio of approximately six to one, so the intervention is highly beneficial in the long run.
Further development One of the challenges of the project has been the difficulties in procuring organic products from the local area, since the local production is not enough to supply the increased demand created by the initiative. To promote this type of initiative at a larger scale, it must be accompanied by public policies that support the production side. Otherwise, the environmental cost of transport may be high (in the assessment of the pilot, an increase in CO2 emissions has been reported).
This case study demonstrates that investing in an initiative to provide healthy food for children aged 0-3 in nursery schools has the potential to create benefits that outweigh costs at the ratio of 6 to 1. In addition, the initiative was welcomed by catering staff in the nursery schools who were motivated by the initiative to adopt and develop healthy menus. Engagement with catering staff and families is important in changing perceptions and encouraging behavioural changes among those responsible for healthy infant feeding.
Over the long term, if diets high in plant–based foods encouraged in nursery school become embedded in families and later school environments this is likely to encourage healthy eating, with consequent health benefits, and to reduce the carbon footprint of diets, provided the supply chain and distance from the farm are short enough to reduce transport costs.
Three-kilometer path created from a disused railway. Increasingly used since opening, by lower socio-economic groups. Assessed as economically beneficial, after only a year of use.
Malvik Path, Norway
The Malvik Path is a green space area with a three-kilometre-long path along the coast in the municipality of Malvik, outside the city of Trondheim. Built along a disused railway track, it was opened to the public in June 2016. The activities carried out as part of the INHERIT project have been related to evaluation of the use of the path and the potential positive effects on health, wellbeing and the environment from this use.
The path has been designed according to the principles for universal design so that it can be accessed and used by all people, regardless of their age, size, ability or disability.
What inspired the creation of Malvik Path?
The population of Malvik expressed in a population survey that they wanted to have accessible areas free of cost for physical activities and social interaction in the community. They also wanted to gain better access to the coast. This inspired the idea of a path, which was further developed through a type of brainstorming session, called Search Conference, in which several local stakeholders participated, including citizens from various age and social groups.
Data from the municipality on population health and wellbeing, and feedback from inhabitants on what needed improvement in the municipality, were important factors facilitating the development of the path. Involvement of citizens in the planning and implementation of the initiative led to a quick realisation of the path and a strong sense of ownership and commitment across all stakeholders, turning it into a whole-community initiative. It was also an important success factor that the municipal project group upgraded their project management skills (Anthun et al., 2019).
Outcomes and impact
The evaluations show a significant increase in use of the path from 2015 (just before the official opening) to 2018. People are satisfied with the path. Contextual matters such as location and design were identified as important determinants for using the path. The path is used by all socioeconomic groups and thus is perceived as inclusive. The estimations of costs and benefits show that the path is economically feasible and profitable from a societal perspective.
Community planners and policy-makers should improve opportunities for participation and community involvement in public health initiatives and find ways to include all groups. The Malvik Path is an example of how an abandoned area, if recovered and transformed into an accessible open/green space, can be beneficial for health, social inclusion and physical activity for all citizens in a community.
The Malvik Path is used by a broad range of local residents, including people facing socioeconomic disadvantage, and might thereby contribute to closing the gap in health between different socioeconomic groups by offering a fitting, easy opportunity for physical activity, social interaction and contact with nature.
Restructuring Residential Outdoor Areas
Initiative to restructure a courtyard in a low-income neighbourhood in Stockholm, which could have benefited from the closer involvement of local authorities.
Restructuring Residential Outdoor Areas, Sweden
Restructuring residential outdoor areas (RRO) aimed to create attractive and functional environments in deprived areas for social cohesion. The initiative included the redevelopment of a courtyard in a residential area in one of the most deprived areas of Stockholm by redesigning the playground, adding more seating and activity areas to stimulate social interaction, improving the lighting and making the area more pedestrian-friendly by reducing vehicle access. The aim of the INHERIT evaluation was to understand the impacts and benefits of restructuring an outdoor area in a deprived neighbourhood.
The intervention was targeted at the residents living in the apartments surrounding the restructured courtyard and in the neighbourhood more widely. The development was a collaboration between the public and private sector. Specific stakeholders included property owners, urban planners, architects, district administrators of the municipality, and residents living in deprived areas.
What inspired the creation of RRO?
Growing awareness of and the political will and desire to act on issues like integration, social inclusion and equity facilitated the process. Half of the financial support coming from the National Board of Housing, Building and Planning, and consultation with an urban development company, were also important factors.
Many of the stakeholders involved had experiences of collaborative projects. The residents were consulted in a dialogue in a trusted environment where they felt safe and encouraged to participate. The dialogue with residents was also of great value for building trust and creating a sense of ownership.
Outcomes and impact
The outdoor area was improved taking into account the views of residents, although residents felt there should have been opportunities for commenting on the design before it was finalised. The property owner felt encouraged to continue working with the residents and other stakeholders.
The INHERIT evaluation (based on data collected in summer and winter 2018) of impacts and benefits of RRO on residents’ physical activity and wellbeing is inconclusive but it does indicate some improvement in residents’ perception of safety in the area. A follow-up evaluation in summer 2020 may be needed to ascertain measurable outcomes.
Meaningful participation of residents at all stages of design and development and more frequent consultations with residents during the design development phase are important for the success of the intervention and also for managing residents’ expectations. Evaluation of the project should be planned early on and integrated well with the conception and implementation of the project. Use of qualitative methods at follow-up one year on can provide insights on the quality of the design and whether any changes are necessary.
The act of regenerating residential outdoor spaces in more deprived areas aims to reduce environmental inequalities in the built environment. It has the potential to improve the living conditions of more disadvantaged groups through the design of more attractive and accessible areas that can encourage use, more physical activity and social interaction among residents of different ethnic backgrounds, gender and ages. The initiative has the potential to contribute to social inclusion.
Restructuring Green Space
Restructured communal outdoor space in a low-income urban neighbourhood in Breda, carried out through a long-term collaborative approach between different stakeholders, including citizens. The restructuring led to an increase in the use of the space.
Restructuring Green Space, Breda, The Netherlands
The Breda case study uses a co-production approach to planning and executing the restructuring of green space in a residential area. Its original main aim was to improve the quality of a neighbourhood in the municipality of Breda and to encourage residents to make more use of the green space into the future. The initiative also aimed to promote sustainable lifestyles by creating the infrastructure to support physical activity, social interaction, relaxation and community cohesion. The restructuring took place between spring 2015 and spring 2017 and efforts to establish a variety of uses for the space are ongoing. The professionals first worked on empowering people in the neighbourhood, before restructuring the park area.
The main target group of this intervention is the residents of the neighbourhood, who are a culturally diverse group with a large proportion from relatively poor socioeconomic backgrounds; many are unemployed.
What inspired the creation of Restructuring Green Space?
The initiative can be linked to (but is not part of) a broader national integrated ‘health-in-all-policies’ approach for disadvantaged neighbourhoods in the Netherlands. It is also consistent with a desire by the municipality of Breda to involve residents in the development of neighbourhood plans. Moreover, the case study supports several health and social programmes in the neighbourhood and the national ‘JOGG’ programme, which encourages young people to take more physical exercise.
The key determinants of success for this initiative lie in its use of a co-production approach and the enthusiasm and continued long-term engagement and collaboration of the different partners. A sense of shared vision among participants and the openness and flexibility of the facilitators have also been important. Investing first in empowerment of the residential community before investing in restructuring of the park was also crucial to success.
Outcomes and impact
Data gathered to date indicate that the initiative is already fulfilling a key objective: to increase the ways in which people use the green space. The neighbourhood health and environmental professionals were also satisfied with the design of the park and the possibilities it provides for the users and have indicated that the park is now used by a range of residents. Observational data show a wide variety of people using the area in terms of age, gender and ethnicity, but the main users are children of Western, Moroccan or Turkish background. Restructuring Green Space Breda is already delivering on of INHERIT’s triple-win goals. First, it is opening up the area to a variety of people, consistent with increasing equity. Second, observed increases in overall use and higher activity levels among users imply wider adoption of a healthy lifestyle. Third, the provision of green space contributes to climate change adaptation and resilience, although the biodiversity of the park could be further enhanced.
Restructuring green spaces could be scaled up to represent part of EU-funded nature-based programmes, as a dimension of integrated national or local policies targeting health inequalities and as a contribution to climate change adaptation and resilience measures.
This case study has shown that restructuring urban green space can increase community involvement in making environmental improvements, enhance disadvantaged neighbourhoods and increase social cohesion, in turn creating more ownership and empowering people within their own local areas. It can increase people’s activity levels in a neighbourhood as well as the perceived attractiveness of the neighbourhood. By encouraging healthy outdoor use by a variety of people, restructuring green space can enhance opportunities for positive neighbourhood social interactions and the inclusion of ethnic or other minorities. It also offers a place for relaxation. In all of these ways it has a positive impact on people’s physical and mental health. The action might also contribute to environmental sustainability through climate change adaptation and potentially increased biodiversity.
Previously a fee-only green space, now open to the general public. Increasingly used since opening, with lower socio-economic groups standing to benefit most. Assessed as economically beneficial (net present value of around €1.2 million).
Thinking Fadura, Spain
The Thinking Fadura initiative provides the general public with free access to an area of green space in the town of Getxo, in the Basque country. It will open up the green areas of Fadura’s Municipal Sports Center (FMSC), which in the past were only accessible to people who were registered and paid an annual fee. FMSC’s facilities occupy around 20 hectares along the Gobela River, and include green spaces. The initiative will not only allow the general public to access and enjoy the green areas surrounding Fadura, but also opens a way to cross and connect the city, like a green belt.
Target group The initiative is inclusive of all population groups. However, low-income groups will gain a greater benefit because for them the annual fee represented a greater economic barrier than for the rest of the population.
What inspired the creation of Thinking Fadura?
The initiative is the result of a consultation process based on a participatory design methodology carried out in 2017 with participants including Getxo citizens and members of different departments of the municipality, such as social welfare, equality, multiculturalism, development cooperation, environment, urban planning, housing, civil protection, economic promotion and health, and the Fadura sporting area.
The success of Thinking Fadura can be measured through the number of new visitors in the green spaces. The participatory process in the design of Thinking Fadura was very successful, increasing people’s awareness of the green spaces available to the general public. The financial support from the municipality was also very important. Social media was used to inform and engage citizens.
Outcomes and impact
Findings from INHERIT’s cost benefit analysis (CBA) demonstrate that Thinking Fadura was economically beneficial from a societal perspective. The CBA showed a net profitability of around €1.2 million. The greatest benefits come from the increased property value (around €1.5 million) and recreation value (around €1.1 million). These benefits are classified as economic and social benefits, respectively. The highest cost was for land adjustment (building and landscaping costs), including parking (around €0.8 million). The internal rate of return, which indicates the discount rate at which the total present value of costs equals the total present value of the benefits, was 11.7 per cent, the payback period 10.6 years and the benefit to cost ratio around 1.63, which indicates that for every Euro spent, about €1.63 accrues in benefits. Most scenarios show a positive net present value (52 of the 54 scenarios produced), a benefit to cost ratio greater than 1, and an internal rate of return greater than 4 per cent.
Further development The economic evaluation of Thinking Fadura could serve as a reference in the decision-making process in numerous European case studies. Firstly, there are numerous green urban areas in Europe where use is restricted to some sections of the population, as was the case in the sporting area of Fadura. Furthermore, the Fadura case study exemplifies how public sporting clubs can remove their fences and become accessible to the general public in order to increase societal use of urban green areas. Thus the CBA presented here could be used to show the feasibility and profitability from a societal perspective of opening up restricted green areas to the general public.
INHERIT highlights Thinking Fadura has covered the INHERIT triple-win goals of health, equity and environmental sustainability by providing possibilities for outdoor physical activities and social interaction in an area that formerly was open only to paying visitors. It also has demonstrated that the pilot implementation is clearly beneficial for society from an economic perspective. One key learning point could be the fact that the usage of green areas strongly depends on their accessibility: better access will increase the likelihood of people visiting. This could have a positive impact on equity; in the case of Fadura, the economic cost of entering the green space before the intervention was a barrier for many people living in poor socioeconomic circumstances. Another key learning point is the fact that green paths and corridors are usually preferred by visitors over relatively small green areas.
Development of peer-to-peer training about household energy saving and waste disposal strategies among refugees in the city of Pforzheim, Germany. Evaluation results highlight the need for sensitivity to take into account educational and language barriers, and the necessity for innovative evaluation methods taking into account the specific characteristics of the target group (such as unstable residency status).
Eco Inclusion, Germany
Eco Inclusion consists of a peer-based training programme for around 200 refugees in the city of Pforzheim, on responsible, environmentally-friendly and health-friendly behaviours associated with housing. Implemented between August 2018 and March 2019, it involved recruiting and training a pool of nine refugees as peer trainers. With support from the city’s Integration Management the trainers then organised and conducted awareness-raising meetings for their peers in various settings and languages. Eco Inclusion aims to decrease the costs of energy use while promoting healthy lifestyles by reducing exposure to health risks related to poor heating and ventilation use in refugee communities. It also supports integration of refugees by reducing potential social conflicts linked to some groups using a lot of energy and disposing of waste inappropriately.
Eco Inclusion targets the population of registered refugees living in the city of Pforzheim in the frame of a collaboration between stakeholders from the local public administration, and the non-profit and private sectors.
What inspired the creation of Eco Inclusion?
Local decision-makers decided to implement the intervention in recognition of specific challenges generated by the housing situation of refugees who had made their home in Pforzheim: these challenges included in particular: high energy consumption not adapted to local housing standards, inadequate heating and ventilation causing high humidity levels and mould growth, and inappropriate waste disposal, which was leading to an unclean environment and conflicts with neighbours and landlords.
A major success factor was the existence of previous and trustful relationships between involved stakeholders, based on past joint cooperation involving other target groups. This was critical in ensuring a common understanding and in establishing both ownership of and availability 77
of support for the intervention. The peer-based approach that allocated a key role to refugees and the pre-existence of structures that could be used by Integration Management, the body responsible for social integration of refugees in the city, also facilitated access to refugee communities.
Outcomes and impact
Findings from the quantitative evaluation of the knowledge transfer seem to indicate that peer-to-peer training is a promising approach for raising awareness about energy-efficient and responsible housing among refugees. Further research is needed, however, to measure the effects of such interventions and adapt evaluation methods to the specificities of the target group.
Assuming the availability of time and financial resources, Eco Inclusion would benefit from involvement of a wider network of stakeholders, including, for example, landlords’ associations, job centres, welfare associations and religious/faith communities, and from potential cooperation with local schools to better reach children and young people. Further exchange with similar peer-based interventions from other sectors (e.g. the health sector) targeting migrants might prove beneficial for transfer and scale-up.
The Eco Inclusion initiative, with its emphasis on peer learning, provides an example of how strong commitment from municipal decision-makers, together with involvement of experienced stakeholders and active participation of the resident community, can take steps to create a more energy-efficient and healthier housing environment for refugee populations.
Retrospective analysis of Energy Efficiency Investments
Considered the costs and benefits of four energy efficiency measures (loft insulation, double glazing, draught-proofing and boiler replacement) targeting low-income households in the UK, with a focus on their link to health. Results highlight that although the impacts on the environment are likely to be unambiguously positive, due to energy and carbon savings, the picture for health is more mixed, potentially contributing to increased health inequalities.
Retrospective analysis of energy efficiency measures, United Kingdom
Energy efficiency improvements may offer potential ‘triple-wins’ (in terms of environment, health and health equity) – in part because measures put in place to encourage them have often been targeted at those in poorer groups or living in social housing. They may also offer ‘quadruple wins’ – in terms of being economically viable and yielding net social or financial benefits – as energy and carbon savings may offset the financial cost of the measures put in place. In this case a retrospective cost benefit analysis was conducted of several different measures: double glazing, new boilers, draught proofing and loft insulation. We combined information around health impacts from previous analysis of health data and energy efficiency actions at a large scale.
Many actions to improve energy efficiency have been targeted towards those with lower socioeconomic status, including those in social housing.
What inspired the investment in energy efficiency?
Many investments have been based around the energy companies’ obligations to reduce greenhouse gas emissions (arising from policies including those under the UK Climate Change Act of 2008).
Most investments show a positive net present value, suggesting that the options are economically viable. However, the impact when including health is mixed, as some show negative health impacts (in terms of asthma, Chronic Obstructive Pulmonary Disease [COPD] and cardiovascular disease) due to sealing affecting air quality. In terms of the environment, the benefit through mitigating carbon emissions is clear. Funding availability through energy company obligations reduces the cost burden for lower socioeconomic groups.
Outcomes and impact
Reductions in carbon and energy use are significant over time – so the environmental effects are unambiguously positive. The health impacts are mixed – for draught proofing and loft insulation these are negative (see above), whereas for double glazing and replacement boilers, hospital admissions are reduced. The need for energy efficiency actions to consider whole-house solutions is clear, taking into account ventilation needs.
Considering the wider health impacts of energy efficiency, such as the impacts on mortality (the potential to decrease the number of excess winter deaths), may change the picture somewhat. Measurement of indoor environmental quality in houses with different energy efficiency measures may also yield interesting insights.
Overall, the cost benefit analysis shows that investments in energy efficiency yield economic benefits – with internal rates of return of between 4 per cent (for boilers) and 26 per cent (for loft insulation). However, our analysis shows that it is by no means certain that energy efficiency investments lead to a ‘triple-win’: in terms of the environment the impact is likely to be unambiguously positive due to energy and carbon savings, though we do not consider lifecycle impacts, including construction and disposal. For health, the picture shown here is mixed. In terms of health equity, the targeting of lower socioeconomic groups and those in social housing for energy efficiency investments may lead to health inequalities unless the measures put in place are appropriately designed to avoid the sealing of properties and the negative health impacts associated with this.
Motivates users of a lifestyle app to engage in physical activity. Targets disadvantaged populations, and is particularly effective in those with low-levels of initial activity.
Lifestyle e-coaching, Greece and the Netherlands
This INHERIT case study, conducted in the Netherlands and Greece, investigated the effectiveness of a lifestyle e-coaching application in encouraging people facing socioeconomic disadvantages (low SES), to engage in healthier and more active lifestyles over the course of a 19- week period. Based on recording and analysis of daily activities, the app prompted users to become more physically active.
The direct target group were people facing socioeconomic disadvantages who engaged in an estimated amount of less than 210 minutes of light activity per week.
What inspired the creation of the lifestyle e-coaching case study?
The case study was triggered by the parallel facts that no information is currently available on the impact of lifestyle e-coaching on people facing socioeconomic disadvantages and being unable to buy such devices, as well as, that they may also be less health conscious. Whilst it is true that previous studies mostly targeted at (motivated) people in the general public show that social, economic and environmental factors shape health and wellbeing, lifestyle e-coaching applications have the potential to successfully change people’s lifestyles, behaviour and improve their health, with different effects on different groups of people.
Lifestyle e-coaching applications can have a personalized approach by giving insights into users’ behaviours and can trigger changes in behaviour, while they also motivate users by comparing activity patterns with others and showing improvement over time. In addition to that, the wearable technology by tracking behaviours unobtrusively and continuously, helps people to better monitor their health status for self-health tracking at a daily basis.
Outcomes and Impact
This lifestyle e-coaching application can be considered as a triple-win given the identifiable effects on health, equity and the environment. Starting with health, over the course of 19 weeks, both the people become more physically active, and their well-being significantly improved, with the first one being more evident among people with sedentary lifestyles. In addition, the system proved to be effective for people facing socioeconomic disadvantages. This highlights that access to such devices and applications improving lifestyle factors detrimental to health, is especially relevant given that other similar services may be less accessible for these individuals. Finally, because of the increased levels of physical activity, it is possible to speculate that users were stimulated to use active transport instead of motorized options, benefiting the environment.
Based on the present findings, and in order to reduce health inequalities, local/national governments and/or insurance companies could consider providing lifestyle e-coaching systems to those who cannot afford them. It would be important to carefully consider the ethics of such initiatives, particularly if lifestyle e-coaching applications are part of insurance schemes and jeopardize access to personal data.
Lifestyle e-coaching applications can improve health, wellbeing and foster environmental benefits, while they are also effective promoting behaviour change of people in lower SES.
Aims to promote regular cycling, through a combination of cycling maps, route planner, turn-by-turn navigation, smart gamification features and financial rewards. Suggests that investing in technological devices can encourage active transport. Ideally, it should be paired with changes in infrastructure.
UrbanCyclers, Czech Republic
UrbanCyclers (recently shortened to ‘Cyclers’) is a smartphone app that combines cycling maps, a route planner and turn-by-turn navigation, with smart gamification features. UrbanCyclers aims to promote urban cycling as a regular transport mode by supporting and motivating self-regulated behavioural change. This case study aimed to improve effectiveness of the UrbanCyclers app by evaluating various motivational features in a pilot study conducted in Prague and other Czech cities during summer/autumn 2018 and spring/summer 2019.
The UrbanCyclers app is freely available for download from Google Play and Apple AppStore. Participants in the experiment were recruited among those who installed the Czech version of the app from Google Play (new users of the app). Each participant who agreed to participate was randomly assigned to either one of four different motivational treatments (smart gamification, two different schemes of financial rewards, and smart gamification and financial rewards combined) or a control group (no specific motivation).
What inspired the creation of the UrbanCyclers experiment?
The inspiration for this experiment came from an earlier idea of intersectoral collaboration with UrbanCyclers’ developers to combine knowledge of IT and social sciences to nudge users into regular commuter cycling in Prague and other Czech cities. In the Czech Republic, commuter cycling accounts for only 1 to 2 per cent of intra-city daily journeys, in spite of the huge popularity of cycling for leisure.
A well-designed and functioning state-of-the-art smartphone app that helps to overcome barriers for less-experienced cyclers and provides motivation/entertainment for experienced ones was the key success factor of the experiment. It allowed for a seamless integration of the experiment into the app’s features and spurred a stimulating collaboration between the private sector and academia.
Outcomes and impact
The preliminary analysis using data from around 400 participants suggests that people can be effectively motivated to cycle for their commute more frequently with the help of the smartphone app. Offering small financial rewards seems to be more effective than smart gamification. A combination of both, smart gamification and financial rewards, may work to the same extent or slightly better than financial rewards.
If these preliminary results are confirmed by further analysis, it would be appropriate to devise a tool for municipalities wishing to promote commuter cycling that can be put in place easily and quickly, even before cycling infrastructure is fully developed. Data collected by the app from real behaviour can help urban planners in improving overall cyclability of their city.
We demonstrate that small financial rewards embedded in smartphone apps like UrbanCyclers can be effective in nudging people to commute by bike more often. Thanks to the ubiquity of, and people’s attachment to, smartphones (particularly among younger people), it is easy to transfer and scale-up such apps to other cities and countries. Thus, smart solutions can effectively help to redesign urban transport systems into healthy, carbon-free and affordable ones by exploiting behavioural responses to tailored incentives.
A simple framework to enable people to think about and discuss, in a methodical way, the place in which they live. The Mayor’s support was crucial in Skopje.
Place Standard Tool, Latvia
The Place Standard Tool was tested in work developed and conducted by Riga City Council in Grizinkalns. The Place Standard Tool brings public health and place-making theory into a simple-to-use tool that can assist professionals and communities in identifying what works well and what needs improving in a local community. On average it took two to three months to plan and one month to recruit respondents, conduct citizen focus groups and interviews, prepare the research report, conduct a qualitative evaluation group, translate focus group transcripts and summarise the results.
Target group Participants were of different genders, ages and employment status (including those in work, unemployed and retired people), and included parents and people with disabilities.
What inspired the creation of the Place Standard Tool?
The tool has been popularised in international meetings and workshops, and representatives from Riga were inspired to implement this tool for the first time in Latvia. Another crucial factor was interest in the tool and its outcomes from other project partners.
The main facilitator was the communication and collaboration between partners from research and from the municipal administration.
Outcomes and impact
In this study, a participatory governance method has been tested in a novel context. It is too early to assess the impact of this on practice in Riga, but the engagement of people in the process was encouraging.
The findings of the results provide a good basis for implementing the tool on a wider scale, involving and activating citizens. Adequate financial resources would need to be put in place to enable this to happen.
It is very important to involve local people in expressing their opinion and to give them a platform to influence decision-making. The Place Standard Tool is a good way to garner public opinion about the locality in which they live. During the discussion time citizens have a chance to meet with neighbours and discuss common problems. There may be co-benefits in terms of fostering social cohesion and providing a space for social engagement.
- Anthun K.S., Lillefjell M., Espnes, G.A., et al., (2019) INHERIT: Implementing triple-win case studies for living, moving and consuming that encourage behavioural change, protect the environment, and promote health and health equity.
- Report: Bell, R., Khan, M., Romeo-Velilla, M., et al. (2019) Creating triple-wins for health, equity and environmental sustainability: Elements of good practice based on learning from the INHERIT case studies
- Article: Bell, R., Khan, M., Romeo-Velilla, M., et al. (2019) Ten lessons for good practice for the INHERIT triple-win: Health, Equity, and Environmental Sustainability. Int. J. Environ. Res. Public Health, 16(22), 4546.