Actions for creating a healthy physical activity environment in the Netherlands

Only 45% of the Dutch population moves sufficiently. A nationwide, integrated approach is needed, involving not only public health but also education and spatial planning, for example. There is already a lot of knowledge about physical activity policy, but little about the implementation of that policy. This is precisely the focus of the report: it describes the extent to which policy measures to encourage physical activity have been implemented in the Netherlands and what actions are needed to improve this.

For the study, the PA-EPI instrument was used. The PA-EPI has been developed within the Policy Evaluation Network (PEN), in which 28 research institutes from seven European countries pooled their expertise. PEN was funded by HDHL and ran from 2019 until 2022. Ireland was the first country in which the PA-EPI was developed further and used to assess government policies and actions for creating a healthy physical activity environment. Last year, the Dutch researchers received funding from The Netherlands Organisation for Health Research and Development (ZonMw) to also implement the PA-EPI in the Netherlands. 

The PA-EPI is an instrument to systematically assess and monitor government policy for a healthy physical activity environment, and the implementation of that policy across various domains. The instrument contains 45 indicators for policy implementation divided into eight policy domains and seven policy-supporting domains. The policy domains are: education, urban design, transport, workplace, healthcare, mass media, society/community, and sport for all. The policy-supporting domains are: leadership, governance, monitoring, funding, interaction, working group formation, health in policy.

The researchers, together with a group of stakeholders, applied the PA-EPI to all relevant Dutch government policies on physical activity and their implementation. This resulted in a report card that clearly shows which areas of physical activity policy are well-executed and where there are opportunities for improvement. Based on these opportunities, policy actions (measures through which the government can influence and promote physical activity) and policy-supporting actions (measures through which the government can facilitate policy development and implementation for creating a healthy physical activity environment) have been formulated.

There are 10 actions that have the highest priority for implementation in the Netherlands, according to professionals and independent experts. For example, one of the policy actions is: “Formulate clear guidelines for urban design focused on attractive and socially safe walking and cycling routes (domain: urban design).” An example of policy-supporting actions is: “Initiate media campaigns to increase awareness of the importance of physical activity, with attention to physical activity guidelines (domain: governance)”.

The PA-EPI report was handed over to Florien van der Windt, Director of Public Health at the Dutch Ministry of Health, Welfare and Sport. She emphasized that collaboration between ministries is very important and mentioned that her ministry actively puts health and physical activity on the agenda of other ministries. The PA-EPI report contains many concrete tools that ministries can use to make regular physical activity the “new normal”.