Our research

SURREAL is based on three central concepts: the urban health system, exposome and inequality.

Urban Health System

How do urban stressors impact cardiovascular and mental health?

We will investigate the urban health system by focusing on interactions between people and their social, cultural, ecological and economic milieu. In doing so, we will examine how urban stressors, such as, pollution, unhealthy food cues, a lack of green space and stressful experiences, impact the cardiovascular health, mental health, brain development and life aging of urban dwellers.

By taking into account both environmental and individual factors, we hope to develop a deeper understanding of the weaknesses found in our urban health system.
Every characteristic of someone's living environment is important to measure.


Identifying a variety of environmental exposures

Instead of investigating a single environmental exposure in isolation in a specific timeframe, we embrace the exposome concept. This means examining how variations in environmental exposures over the life-course, starting as early as the prenatal period, impact health.
We can use new technologies to measure people's environment.

Advanced methods to measure the effect of environment on behavior

With the help of new technologies and large data-sets, we will measure the changes that have occurred over time to people’s environments, behaviour and health. Moreover, we are also interested in examining how potential changes to an urban environment may modify future behaviour. By using Virtual Reality experiments, we hope to explore potential solutions for improving our urban health system.


Investigate the health consequences of inequalities in inner cities

To inform policy on how to tackle inner-city inequalities, we will develop a deeper understanding of the complex interplays that lead to significant disparities in mental health, cardiovascular health and life expectancy. We will use a systems approach to analyse how your socioeconomic status influences your level of exposure to urban stressors as well as your resources to recover from distress.
By using a systems approach, we investigate these complex relationships with a holistic perspective in mind. We use innovative conceptualisation and methodology to fill the current gaps.

Research on the individual and population level

At the individual level, we will examine how to develop interventions to improve the health standards of people living in low SES neighborhoods. Citizen science and co-creation processes will be used to develop a strong collaborative relationship between researchers and participants to improve the efficacy and legitimacy of interventions.

On a wider population level, we will improve current urban health models by addressing the lack of data on the movements of people, the type of exposures people face and the lack of equity assessments.

Our key objectives

Develop an in-depth understanding of the equity impact of urban environmental exposures to health behavior (physical activity, dietary intake) and health outcomes (stress, cardiometabolic).
Analyzing the impact of changes in life stage as well as changes in and of residential environments on health and health equity using a systems approach.
Develop and assess interventions in the urban health system that involve residents and co-creation practices to reduce exposures to environmental stressors, to enhance healthy behaviors and to reduce health inequalities

Identifying, implementing and developing methods that involve the most promising portable sensing technique and virtual reality tools for exposure measurement and recording of momentary and daily cardiovascular and mental health states.
Train 15 Early Stage Researchers as future professionals via research, network-wide activities, secondments and collaborative learning in practice to participate in the urban health system and to integrate knowledge in order to improve health and health equity.



Sleurs H, Silva AI, Bijnens EM, Dockx Y, Peusens M, Rasking L, Plusquin M, Nawrot TS. Exposure to residential green space and bone mineral density in young children. JAMA Netw Open 2024;7:e2350214.


Mishra S, Van der Stukken Cm Drury S, Nawrot TS, Martens DS. Prenatal air pollution exposure in relation to the relomere-mitochondrial axis of aging at birth: a systematic review. Environ Res 2023;244:117990


Dahal U, Veber T, Åström DA, Tamm T, Albreht L, Teinemaa E, Orru K, Orru H. Perinatal health inequalities in the industrial region of Estonia: a birth-registry-based study. Int J Environ Res Public Health 2022;19(18):11559

Veber T, Dahal U, Lang K, Orru K, Orru H. Industrial air pollution leads to adverse birth outcomes: a systematic review of different exposure metrics and health effects in newborns. Public Health Rev 2022:43:1604775.
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