1. Transport and
health: pioneer of
Health in All Policies
Make way for healthy
transport: experiences in the
Netherlands and Europe
Brigit Staatsen
RIVM, the Netherlands | 13 June 20131

2. Why integrated approach transport and health?
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108,000108,000
deaths anddeaths and
2.4 million2.4 million
injuries/yearinjuries/year
Exposure to PM10 decreasesExposure to PM10 decreases
life expectancy of everylife expectancy of every
person by 9 monthsperson by 9 months
PhysicalPhysical
inactivity : oneinactivity : one
millionmillion
deaths/yeardeaths/year
(WHO-European region)(WHO-European region)
More than 20% ofMore than 20% of
the EU populationthe EU population
exposed to noiseexposed to noise
levels > 65 dB(A)levels > 65 dB(A) Promotion walking, cycling and public transportPromotion walking, cycling and public transport
: significant reduction CO: significant reduction CO22 emissionsemissions

3. History of cycling in the Netherlands:
Safe infrastructure due to pressure citizens
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4. Transport policy Netherlands
Safeguard mobility, limit negative impacts on environment and health,
and create conditions for active transport (biking, walking).
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What has been done:
•Nota mobility (2004)
•National Policy letter promotion measures
biking
•Project bike-highways
•Promotion campaign ‘Everybody bikes’
•Action programme Traffic Safety
•Contribution Transport, Health and
Environment Pan-European Programme of
WHO and UNECE (THE-PEP)

5. Implementation transport policies the
Netherlands
• Collaboration transport & environment sectors & companies
• Financial stimuli municipalities
• Awareness raising , e.g.energy-efficient driving, bike to work
• Sharing of knowledge, best practices and tools for impact
assessment outsourced via a.o. Bicycle Council
• Very active Cyclist Association: benchmarking
Recent negative developments:
• Expansion highways and higher speed limits
• Less attention for active transport policy-makers
RIVM, the Netherlands | 12 June 20135

6. Some key facts
• Biking is fun and relaxing, cheap and you are always
on time. 84% of Dutch people positive about biking.
• Everybody bikes: young and old, men and women,
poor and rich.
• One-third of all transport up to 7.5 km by bike.
• Almost half of Dutch adults <30 min. physical active.
• Replacement of short car-trips: considerable
environment and health gains.
• NL highest number of cyclists in EU and high bicycle
safety, followed by Denmark and Germany.
• Large inter- and international differences in cycling,
linked to spatial and transport policies (cars, public
transport), culture (bike is for lower classes).
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7. Example Alkmaar: 10% increase biking – 2-6%
reduction emissions and 3% decrease physical
inactive
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Source: Fietsberaad, 2012

8. Inspiring example: Biking network Houten
• Starshaped network of biking routes.
• Cars have to make use of a ring road.
• Number of trips to school by car are much lower than average (5-10%).
• Young children (>6 yrs) bike or walk to school on their own.
• Retail research shows that business profits.
RIVM, the Netherlands | 12 June 20138

9. Aims and workplan THE-PEP
Making THE link:
(a) Stimulate integration of policies on transport, health and
environment
(b) Exchange knowledge and promising practices
(c) Strengthen (inter)national and regional cooperation
(d) Capacity-building
(e) User-friendly overview of main relevant initiatives in European
Region
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Source: Amsterdam Declaration, 2010

10. Netherlands and Denmark as inspirators?
• Contributions NL THE-PEP:
> Evidence briefings transport and health
> Experts sent to several EU countries
> Contribution relay estafette
> Toolbox healthy transport
• Ministerial High-level Meeting in Amsterdam 2009
• Since start THE-PEP more and more cities in Europe are starting with
biking projects, e.g. Russia, Georgia, Macedonia, etc.
• Embassy and Bicycle Council share experiences in eg USA, Brasil, UK
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“Biking is easy
for you, but not
for us.”

11. Which approaches are effective?
√ High % cycling in European cities with continuous and integral
policy, linked to local objectives. Mix of creation safe infrastructure
combined with legal measures (speed and emission limits),
financial incentives and awareness raising.
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• For example: safe routes to school or work, speed reduction limits
urban areas, in combination with education and financial incentives
(eg for employees)
• Intersectoral collaboration and knowledge sharing: e.g.
Switserland, NL: bike knowledge-broker
• Limited evidence base: Only few longitudinal investigations of
impacts of healthy transport measures on health.

12. Integral approach
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Source: Fietsberaad
Integral approach
Smart internal
organization
Smart external
organization
Sharp problem
analysis
Involve the users
Connect finances Support of the
public
Support of
politics
Regional
cooperation
Project approach

13. The benefits of walking and cycling:
helping other sectors achieve their own goals
• Most people can do it
• It is cheap and relaxing
• Avoids dependence on facilities for physical activity
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In Europe, many car trips are short - Shifting some of these
trips to walking and cycling can help…
• Improve road safety, air quality and noise
• Improve accessibility and quality of urban life
• Reduce congestion, energy consumption and CO2 emissions
• Complement technological improvements to vehicles and fuels
• Create extra jobs (tourism, bike-sharing, etc.)
Source: THE PEP, 2012

14. Conclusions
• Cycling improves traffic flow, is sustainable and healthy
• Cycling is cheap (purchase and infrastrcuture): NL 3-26 Euro/citizen
• Benefits outweigh investments (e.g. Barcelona).
• Most succesful policies: integrated & continuous approach.
• Biking more than sports is new for most countries
• Sharing experiences and knowledge, presenting benefits in informal
and practical settings helps.
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1 Euro spent on
pedestrian crossings
saves 14 Euro’s
1 Euro spent on
pedestrian crossings
saves 14 Euro’s

15. Challenges for the future
• Continue awareness raising: Keep healthy transport on agenda
health, transport and environment sector. Raise awareness for
safety (e.g. Rome).
• Make biking attractive and integral part of daily activity (easy)
• Monitor and evaluate interventions, share effective ones, but keep
aware of local situation (no ‘one size fits all’)
• How to get physically inactive people more active (e.g. AVENUE)
• Sustainable mobility is healthy mobility (chance at EU level)
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16. More information
www.thepep.org
http://www.fietsberaad.nl 
Publicaties 
Cycling+in+the+Netherlands
http://www.bicyclecouncil.org
www.healthytransport.com
www.heatwalkingcycling.org
‘health economic assessment tool’
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17. Choice between unlimited car mobility…
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18. Or more space for bicycles and pedestrians…
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