EDITORIAL
During a local political campaign in a small village, residents spoke not of abstract policies but of the conditions of their everyday surroundings: cracked pavements, speeding cars, disappearing bus stops, limited green spaces, and few places for young people to gather. These frustrations, while seemingly minor, can have a profound impact on wellbeing. Healthy living environments shape daily choices, from walking and cycling to access to fresh food and clean air, and play a crucial role in addressing social inequalities in health. Framing streets, parks, and housing as public health infrastructure can make the healthy choice the easiest choice for all, and attract financial investments, writes Caroline Costongs, Director of EuroHealthNet.
In support of a local political campaign in my village, I joined the door-to-door visits to ask residents about their lives in the village and how the municipal authorities could do more to improve the community. To my surprise, most concerns centred not on abstract political debates but on people’s immediate living environments. There was a lot of frustration, ranging from loose tiles in the pavement, a lack of parking spaces in front of their home, and cars speeding, to complaints about the lack of bicycle paths and bus stops that have been moved or disappeared. A few mentioned the lack of trees in their street or the limited spaces for young people to hang out. Most of these concerns can be addressed through simple, cost-effective measures to improve living areas and bring more wellbeing to the community. I find it imperative that politicians listen to what their citizens have to say and act on it through appropriate investments. In that sense, living environments are a potential hot topic to get politicians' attention, and we, as a public health community, can do better to leverage this concept.
Enabling healthy choices
Healthy living environments enable people to live healthily. They offer a clear counterargument to politicians who claim that health is solely a matter of personal responsibility. We can make them see that there is simply nothing healthy to choose from for people living in a community with low-quality green spaces that don’t invite outdoor activities or living in neighbourhoods with a high density of fast-food outlets. Healthy food deserts, or fast-food swamps, sports and playground deserts, or high-traffic areas clearly don’t encourage healthy, active lives. People also cannot easily escape environments with high levels of air pollution or with constant exposure to the marketing of unhealthy products. Public policies that create enabling environments for health, shape healthy living conditions proportionate to the highest needs, and make the healthy choices the easiest choices should be advocated to all politicians across the political spectrum. They are key to improving health and tackling the growing burden of chronic diseases and inequalities in health.
Healthy homes and the built environment
Buildings and the built environment are also strongly linked to health and wellbeing. Indoor air pollution, injury risks, noise, humidity, mould, inadequate indoor temperature, and mental health problems can all be influenced by building conditions. People spend on average 90% of their time indoors, either at home, work, or elsewhere. However, as most buildings in the EU were built before 2000, 75% of them have poor energy performance. And poor building quality disproportionately affects vulnerable groups, leading to energy poverty and making it a clear health inequity issue. But, there is hope. I look forward to the newly developed European Affordable Housing Plan of the European Commission in 2026, which aims to contribute to better housing for all. In order to contribute to these debates, EuroHealthNet developed a videos series exploring the intersections between health, climate and the built environment in Bulgaria, Spain, Austria and Ireland.
Bankable public health infrastructure projects
Health begins in the environments of people’s everyday lives. From affordable, energy-efficient housing, adequate public transport accessible to vulnerable people, to nutritious food environments, clean air, and quality green and blue spaces, the conditions that shape daily life are the foundation of both health and equity.
By reframing healthy living environments as essential economic and social infrastructure, or public health infrastructure, we can move decisively from managing illness to building wellbeing. Public health initiatives and interventions should team up with major social infrastructure projects, in order to make them ''bankable'' and more attractive to impact investors. We, as the public health community, need to be smart and explore such scalable investment opportunities, recognising that secure and sustainable infrastructure (housing, transport, living environments) is not only a social good but also a strategic investment in public health and resilience.
Increasingly, investors are seeking large-scale projects that are green or have a social or health impact. Various types of financial instruments can be used, such as loans, social impact bonds, or social outcome contracting, to finance combinations of 'hard' infrastructures and 'soft' public health measures. The returns on these investments could be substantial if they are calculated in terms of healthcare costs saved, improved productivity, and stronger communities.
Investors and banks are ready — It is our responsibility to be ready with a steady pipeline of large-scale investable projects for health promotion and prevention. Healthy living environments — public health infrastructures — offer one of the most promising avenues to do just that. EuroHealthNet is currently developing new guidance with examples on impact investment linked to social infrastructure projects for prevention and health promotion, so stay tuned!
Shaping healthier environments across Europe
This edition of the magazine showcases several highly interesting articles on healthy living environments. The Swansea University and Public Health Wales describe their innovative work that brings together architecture, sustainability, and public health to create homes designed to actively promote wellbeing.
From Bulgaria, we learn about the WISE initiative that empowers citizens and establishes local support hubs to confront energy poverty.
Through a compelling interview, we hear about the struggle in rural Galicia, where citizens were deprived of clean air and safe drinking water. Environmental justice is a powerful tool in ensuring everyone has access to healthy environments.
The article by Professor Molly Anderson presents innovative ideas about food democracy and a new eco-communalism model, in which communities steward land, seeds, and supply chains as a common rather than a commodity.
We also included an article from our own EuroHealthNet colleagues showcasing their insights and work on EU Horizon projects such as BEST-COST, BlueAdapt, and Resonate on nature-based social prescribing.
Finally, I am delighted to present to you an article from the London School of Hygiene and Tropical Medicine on children’s digital environments and how they shape their mental health, with a strong health equity focus. It goes beyond social media to consider broader online harms and the influence of commercial actors in the school environment.
I hope you will enjoy reading this 26th edition, and please do not hesitate to share your feedback with us!
The report
Click the link below to access the 2025 EuroHealthNet-CHAIN report with CHAIN and take action to reduce health inequalities by promoting fairer, healthier living environments across Europe.
In this edition
Caroline Costongs
Caroline Costongs is Director of EuroHealthNet and expert in public health and health promotion. Caroline leads a multi-disciplinary team working on European and (sub)national policy, advocacy, research and capacity building addressing health inequalities. Caroline is active in various EU and WHO fora, Advisory Boards and various EU projects, and is a member of the ICC – International Council for the European Public Health Conference.