Groningen again comes first in the list of healthiest cities in the Netherlands while Rotterdam brings up the rear, according to the Arcadis Gezonde Stad Index.

The index is based on data on the air quality, noise levels, and availability of public spaces as well how accessible the cities are by bike, on foot and public transport. The data, which covers 20 cities, comes from public health agency RIVM.

Both cities had the same ranking in the last edition of the index, two years ago. Emmen and Apeldoorn came second and third in the healthy city stakes while Amsterdam and Zaandam came close on the heels of Rotterdam at the bottom of the list. Utrecht and The Hague came 14th and 16th respectively.

All cities have become healthier in the last two years, the researchers said, but the four big cities only showed a relatively small improvement.

More greenery in public spaces has become a priority, a development which was boosted when walking became a more popular pastime following the pandemic, they found. Working from home has also boosted demands for a more attractive urban environment.

The researchers said cities are also concentrating more on combating heat stress caused by climate change as well as limiting smog and bad air quality.