Creeping crises and public health: governance and well-being in Groningen, the Netherlands

Abstract Background Creeping crises are slow-onset, complex disasters, and they increasingly receive attention for their impact on public health. Environmental stressors such as air pollution, climate change, or the impact of mining erode well-being over time. Effective governance is crucial to mitigate their long-term health impact. This study draws lessons from a creeping crisis in the Netherlands: decades of gas extraction in Groningen, resulting in earthquakes and burdensome government-led procedures for damage repair and preventive reinforcement. Methods Two panels were approached: the Groninger Panel in 2016-2024 (N > 6000) and a reinforcement-specific panel in 2024 (N > 700). Respondents were categorized by house damage history and reinforcement phase. Outcomes were: mental health (MHI-5), trust in institutions, and exposure to damage and governance. Results Respondents with repeated damage consistently report significantly lower MHI-5 scores and lower trust in national government. These disparities have persisted since 2016 but have not worsened since 2023. At the individual level, scores deteriorate during the reinforcement process. The results show that this process constitutes a major stressor, especially in early phases when respondents experience little support from institutions. Respondents expressed feelings of injustice, powerlessness, and political neglect. Conclusions This crisis illustrates how inadequate policy in creeping crises can become a structural health threat. Transparent, inclusive, human-centered governance is vital to restore trust and reduce long-term health disparities. While results from the Groninger Panel have contributed to a parliamentary inquiry and policies have been put in place to support Groningen citizens, health disparities have yet to be resolved. Key messages • In creeping crises, inadequate policy response can induce health disparities. • Monitoring of health impact, trust-building, and early support mechanisms are crucial.