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The European Environmental Noise Directive opens the door for the public to participate in the development and review of noise action plans. Regarding health inequities related to environmental noise exposure, we aimed to identify determinants that influence residents' civic engagement against transportation noise exposure. We defined four variable groups representing either environmental quality with indicators of (1) noise exposure and (2) environmental resources or behavioural cognitions with indicators related to (3) civic engagement and (4) generalised emotions and cognitions. We used data collected from 3,743 participants in the population-based KORA study in the Augsburg region, Germany, and employed Conditional Inference Trees (CIT) to identify variable sets within these four groups that are most likely to classify civic engagement intentions. A final CIT model encompassed all variables. Participants' social characteristics were included in each of our CIT models. Results suggest interactions between environmental quality (related to sound/atmosphere in the sleeping room) and income and between income and emotions (positive affectivity) with respect to engagement intentions. When considered simultaneously, engagement-specific cognitions appeared as more relevant for engagement intentions than environmental quality. This finding indicates that noise action planning should take behavioural cognitions into account when designing participation processes.

ZusammenfassungStädte werden durch verschiedene Merkmale charakterisiert, von denen Dichte ein aus gesundheitlicher Sicht besonders bedeutendes ist. Am Beispiel der Gesundheitsdeterminanten Lärm, Grün- und Freiflächen sowie gesundheitliche Versorgung wird dargestellt, dass Stadt als sich stetig verändernder Raum zu verstehen ist, der nur unter Beachtung der Wechselwirkungen seiner baulichen und sozialräumlichen Gestalt sowie gesellschaftlichen Gestaltung verstanden werden kann. Es werden verschiedene Stadttypen aufgezeigt und Leitbilder der Raum- und Stadtentwicklung aus gesundheitlicher Perspektive beschrieben. Eine Auseinandersetzung mit Instrumenten der Stadtentwicklung und des planerischen Umweltschutzes zeigt die Möglichkeiten zur Beeinflussung von Gesundheitsdeterminanten auf kommunaler Ebene auf. Partizipation von Öffentlichkeit und Stakeholdern spielt in lokalen Lebenswelten eine besondere Rolle. Der Beitrag zeigt auf, dass die Potenziale für eine gesundheitsfördernde Stadtentwicklung gegeben, aber vielfach noch nicht ausgeschöpft sind.

Background Municipal health promotion provides the opportunity to promote health equity and to design health-promoting living environments by developing individual strategies. The Place Standard tool is a participatory instrument to identify needs by asking citizens to evaluate their living environment. It is increasingly being implemented and recommended on an international level. The aim of the study was to identify the potential of the Place Standard tool for the development of strategies in a municipal context as well as to identify facilitators and barriers when designing these. Methods Within a qualitative study design, nine guided interviews were conducted with international experts who have applied the tool at a municipal level in Europe. The interviews were recorded, subsequently transcribed and analysed using MAXQDA software. The analysis was based on a qualitative content analysis according to Mayring, using a deductively developed category system. Results A total of 355 statements were analysed. Some refer to the fact that a comprehensive needs analysis is enabled by the Place Standard tool, empowerment can be promoted and that the development of strategies can only be carried out with follow-up work. Furthermore, some facilitating factors, e.g. participation and intersectoral cooperation, were described. Mentioned inhibiting factors are e.g. lack of support from political decision-makers and the Covid 19 pandemic. Conclusions The results of the research indicate that the Place Standard tool can be used to identify priorities for action regarding the needs of the population at a municipal level. They show that a successful strategy development for municipal health promotion strongly relies on the application of the tool in an overall process. Key messages The Place Standard tool can be used to analyse needs at a municipal level. In order to develop sustainable strategies for municipal health promotion, it should be applied in an integrated process.

Cities are increasingly confronted with multiple environmental and climatic stressors. Especially during heatwaves, street canyons are both producers and sufferers of air pollution and urban heat island (UHI) effects, with severe risks on public health. To better design mitigation measures, it is important to consider both the microclimate behaviors as well as the perceptions of the local population. Therefore, this study examined pedestrian perceptions and microclimate modelings to understand outdoor thermal comfort conditions and air pollution dispersion in the case study neighborhood of Dortmund Marten, Germany. A field survey with measurement points at two street canyons for climatic variables and questionnaires on subjective thermal comfort and air pollution was conducted on a hot day during the heatwave period in August 2020. As a cost-effective method for modeling input generation, we extracted spatial and spectral data like albedo, roof materials and tree locations out of remote sensing imageries. Finally, we compared the modeling results of the physiological equivalent temperature (PET) index, particulate matter concentrations and air temperatures with empirical field measurement data and the questionnaire responses. Results indicate that during hot summer days with light winds from the east, the north-south orientated street canyon with tree arrangements tends to act as a tunnel for particulate matter accumulation. Coincidently, pedestrians show less thermal discomfort than calculated PET values in that particular area during morning and daytime, which underlines the dichotomy of such places. On the other hand, the low rise east-west orientated street canyon shows higher PET votes than predicted by the model. However, particulate matter concentrations were considerably underestimated by the model, while air temperature predictions provided meaningful results. The proposed workflow shows the potential to accelerate future preparations of input data for microclimate modelings, while the results can enhance wind-sensitive planning procedures and heat stress resilience in mid-latitude urban neighborhoods.

Cities can be described by different factors. From a health perspective, density is a factor of great importance. Cities are seen as dynamic places with interaction between built and social environments as well as design by societal stakeholders. This is illustrated through the example of noise and greenspaces as determinants of health and the provision of health services. Different city types and guiding principles of spatial and urban development are explained through the health lens. The potential to influence health determinants through local interventions is illustrated by planning instruments of urban development and environmental protection. Participation of the public and other stakeholders plays a crucial role in local settings. This paper shows the great potential of healthy urban development, which is not utilized in many cases.Städte werden durch verschiedene Merkmale charakterisiert, von denen Dichte ein aus gesundheitlicher Sicht besonders bedeutendes ist. Am Beispiel der Gesundheitsdeterminanten Lärm, Grün- und Freiflächen sowie gesundheitliche Versorgung wird dargestellt, dass Stadt als sich stetig verändernder Raum zu verstehen ist, der nur unter Beachtung der Wechselwirkungen seiner baulichen und sozialräumlichen Gestalt sowie gesellschaftlichen Gestaltung verstanden werden kann. Es werden verschiedene Stadttypen aufgezeigt und Leitbilder der Raum- und Stadtentwicklung aus gesundheitlicher Perspektive beschrieben. Eine Auseinandersetzung mit Instrumenten der Stadtentwicklung und des planerischen Umweltschutzes zeigt die Möglichkeiten zur Beeinflussung von Gesundheitsdeterminanten auf kommunaler Ebene auf. Partizipation von Öffentlichkeit und Stakeholdern spielt in lokalen Lebenswelten eine besondere Rolle. Der Beitrag zeigt auf, dass die Potenziale für eine gesundheitsfördernde Stadtentwicklung gegeben, aber vielfach noch nicht ausgeschöpft sind.

Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

Health in All Policies ist eine Strategie, die vielfaltige Herangehensweisen zur Berucksichtigung von gesundheitlichen Aspekten umfasst. Diese unterscheiden sich erheblich zwischen den Politikfeldern und -ebenen. Trotz der Vielfalt der Perspektiven und der zwangslaufig unvollstandigen Inhalte dieses Sammelbandes lassen die Beitrage einige Gemeinsamkeiten erkennen, die auf Politikfelder und -ebenen ubergreifende Charakteristika, hinderliche und forderliche Faktoren der Umsetzung von HiAP sowie deren Chancen und Risiken hindeuten.

The link between health, socio-economic status and the living environment is increasingly moving into the focus of public health research and policy. The aim of the European Union&rsquo, s Project &ldquo, Joint Action Health Equity Europe (JAHEE)&rdquo, is to enable countries to identify and implement needs-based measures to promote health equity. In one of JAHEE&rsquo, s work packages, focusing on healthy living environments as a strategy to tackle health inequities, a Policy Framework for Action (PFA) has been developed. This article gives an insight into the core contents of the PFA, which are valid beyond the project boundaries for all actors that work at the intersection of community health promotion. The PFA was developed as a consensus document in a participatory process between the members of the work package and an interdisciplinary German team of public health experts. Results from project meetings of the partner countries as well as research findings and recommendations from field experts were incorporated. Reducing health inequalities in public health is a cross-sectional issue that needs to be addressed across all policy areas. The municipality setting is of particular importance in this context, as it offers many starting points and can coordinate between all relevant actors with an overarching strategy.

Die Bedeutung von Sozialraumen als Lebenswelten und Planungsraume wird in den Gesundheitswissenschaften zunehmend erkannt. Sowohl auf theoretischer als auch empirischer Ebene sind Zusammenhange bekannt und konnen mit verschiedenen quantitativen und qualitativen Methoden beschrieben werden. Der Beitrag stellt einleitend Zusammenhange zwischen Sozialraum und Gesundheit dar, behandelt relevante Methoden der Sozialraumanalyse und erlautert die Bedeutung von Umweltfaktoren als Ursache fur Morbiditat und Mortalitat sowie Unterschiede in der Gesundheitsversorgung zwischen Stadt und Land. Abschliesend werden verhaltnispraventive Strategien thematisiert, bei denen Partizipation und Empowerment eine bedeutende Rolle zukommen. Auf dieser Grundlage konnen unter Nutzung verschiedener Politikfelder Verhaltnisse geschaffen werden, in denen ein gesundes Leben fur alle moglich ist.

Noise annoyance may reflect a pro-participatory attitude towards public information and consultation according to the European Environmental Noise Directive. However, noise annoyance is also indicative of a stress response to perceived uncontrollable noise exposure. Using cross-sectional data on a sample of elderly citizens (n = 1772), we investigated whether the value residents ascribed to being able to control noise exposure at home moderated the potential indirect effect of road traffic noise on annoyance through perceived noise control. Our results confirmed the presence of such a moderated mediation, which may justify studying the impact of residents' valuing perceived noise control on participation readiness.

Urban residents’ need to be in control of their home environment can be constrained by perceived uncontrollability of exposure to road traffic noise. Noise annoyance may indicate a psychological stress reaction due to this uncontrollability perception, thereby undermining the restoration process. Environmental resources, such as having access to a quiet side at home and dwelling-related green, may reduce noise annoyance both directly by shielding acoustically and indirectly by enhancing residents’ perceived noise control. We assessed the potential mediating role of perceived noise control in independent and joint associations of road traffic noise exposure (>65 dB Lden) and of an absent dwelling-related environmental resource (three indicators concerning quiet sides and one indicator concerning dwelling-related green) with noise annoyance. In our cross-sectional, questionnaire-based study on elderly urban citizens (N = 1812), we observed a statistically significant indirect effect of noise exposure on noise annoyance through perceived noise control (39%, 95%CI 26–55%). Statistical mediation between indicators of absent environmental resources and noise annoyance was weaker. The potential indirect effect was confirmed for combinations of noise exposure with each of the four indicators of an absent environmental resource. Our findings may call for mitigating noise levels while fostering quietness and green at residents’ homes.

Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

Environmental justice is increasingly becoming a subject of academic debate in Germany. However, the realisation that environmental goods and hazards as well as the impacts of environmental policies are unequally distributed among social groups has not had many practical consequences yet. There are scattered initiatives and pilot projects aiming to address issues of environmental justice. Nevertheless, in the design and implementation of environmental policies there is no systematic consideration of their social dimension. In this paper, we outline the perspective of employees in German local environmental agencies on environmental justice. For this purpose, we conducted six qualitative interviews, which focused on the example of low emission zones. We identified three crucial aspects in these interviews: problem perception, motivation to act and perceived scope of action. Our main finding is that environmental justice is hardly an issue for environmental agencies and that this is the case because...

Borrowing from concepts of socio-environmental epidemiology and psychology, we conceived self-rated health as a function of multiple physical and psychosocial stressors and resources at the residential neighbourhood and individual level. In this model of multiple stressors, objective exposure to road traffic noise was specified as a physical stressor whose effect on health may be mediated and modified by residents’ subjective response to noise (serious noise annoyance). Self-reported hearing disability, recreational coping in green areas and residential neighbourhood satisfaction were examined as additional psychosocial stressors or resources, independently of socio-demographic and -economic factors. Results from our empirical analysis based on two studies and multivariable logistic regressions might support the idea that environmental planning should overcome sectoral boundaries and adopt an integrative approach including objective exposures, residents’ subjective responses, and perceived resources.

Noise action planning according to the EU Environmental Noise Directive aims to improve people's health. Although health inequalities exist, the Directive does not address social inequalities in residential exposure to road traffic noise. In multivariate regression analyses based on two urban study populations, we assess the relationship between objective and subjective indicators of residential exposure to road traffic noise as an issue of environmental justice. Residential neighbourhood satisfaction, socio-demographic and -economic, health-related and noise-related attitudinal factors were included as covariates additionally explaining the subjective response to road traffic noise (noise annoyance). Our results underline the need to select, operationalise and examine noise-related indicators very carefully, as objective noise exposure predicts noise annoyance insufficiently. Otherwise, urban environmental planning might miss environmentally unjust situations and fail to initiate distributive and procedu...

The transformation of cities towards healthy urban living environments for all is a challenge that needs to be addressed through collaboration of all relevant sectors in a transdisciplinary research processes. This paper reports on the design and showcase implementation of a methodological approach, named Interactive Spatial Understanding Support System (ISUSS), that is intended to support interactive knowledge co-production and integration among practitioners and researcher in a specific local context. The approach involves the combined use of interactive maps on a MapTable and a rich picture. The goal is to stimulate, articulate and map stakeholders’ knowledge on environmental health issues to come to a shared problem understanding. Drawing on the rich seam of data gathered over the reflexive engagement with the participants in Dortmund, Germany, we explored incidences of a transdisciplinary process. Findings suggest that the approach has the potential to encourage communication and social learning geared towards a shared understanding of the holistic problem situation. Whilst locally embedded spatial knowledge was shared using interactive maps on the MapTable, the rich picture elicited issues linked to wider geographical scale as well as non-spatial drivers. The paper concludes discussing research needs to further explore the approach among various other groups, including citizens.

Spatial differences in urban environmental conditions contribute to health inequalities within cities. The purpose of the paper is to map environmental inequalities relevant for health in the City of Dortmund, Germany, in order to identify needs for planning interventions. We develop suitable indicators for mapping socioeconomically-driven environmental inequalities at the neighborhood level based on published scientific evidence and inputs from local stakeholders. Relationships between socioeconomic and environmental indicators at the level of 170 neighborhoods were analyzed continuously with Spearman rank correlation coefficients and categorically applying chi-squared tests. Reclassified socioeconomic and environmental indicators were then mapped at the neighborhood level in order to determine multiple environmental burdens and hotspots of environmental inequalities related to health. Results show that the majority of environmental indicators correlate significantly, leading to multiple environmental burdens in specific neighborhoods. Some of these neighborhoods also have significantly larger proportions of inhabitants of a lower socioeconomic position indicating hotspots of environmental inequalities. Suitable planning interventions mainly comprise transport planning and green space management. In the conclusions, we discuss how the analysis can be used to improve state of the art planning instruments, such as clean air action planning or noise reduction planning towards the consideration of the vulnerability of the population.