The testbed region of North Rhine-Westphalia (NRW) is the most populous state of Germany, with its capital at Düsseldorf. NRW is situated in the middle western part of Germany and shares borders with Belgium and the Netherlands. As one of 16 German states, it is organized in 5 District Authorities and 53 local public health departments. The region of North Rhine-Westphalia consists of several major cities, including Cologne, Dortmund, Essen, Duisburg, and Bonn. NRW’s central location, well-connected transportation network, and robust healthcare infrastructure contribute to its potential as a conducive environment for health promotion initiatives. 

With a population of around 18 million people, North Rhine Westphalia is home to more than 20% of the German population. The state has a significant proportion of older adults, with a growing number of people reaching retirement age. Socioeconomic status in NRW varies across different regions and cities within the state. Major cities like Düsseldorf, Cologne, and Bonn tend to have higher average incomes and a higher standard of living. The proportion of citizens with a migration background can be estimated up to 28,7% (in 2017). There are significant differences in the share of people with a migration background among the districts and independent cities in North Rhine-Westphalia. 

Women have a higher life expectancy than men in NRW, with women living on average nearly five years longer. Women have better health behaviors overall, but there is a tendency towards convergence.  

Musculoskeletal disorders accounted for more than one-fifth of absences from work (21.5%), in all of Germany in 2021, followed by mental disorders (12.0%), injuries (10.0%), respiratory diseases (9.8%), and diseases of the circulatory system and digestive organs (4.9% and 3.9% respectively). Older workers are increasingly affected by musculoskeletal, mental, and cardiovascular diseases. These types of illnesses often result in long periods of absence from work. On average, employees are absent for only 7.6 days due to respiratory diseases, whereas musculoskeletal disorders lead to an average of 17.6 days of absence. Due to these results, preventive measures, comprehensive care, and addressing social determinants of health are crucial for promoting well-being in North Rhine-Westphalia in the future. 

There are 345 general hospitals in NRW which contain a combined number of 119,595 hospital beds. NRW has a proportionally higher number of hospital beds per 100,000 inhabitants compared to the average in Germany. The testbed region has an excellent medical research landscape with its university and non-university medical research institutions, including the Helmholtz Center “German Center for Neurodegenerative Diseases” (DZNE) and several Max Planck Institutes, as well as university hospitals.  

On July 25, 2015, a law to strengthen health promotion and prevention efforts in Germany came into effect.The “Gesetz zur Stärkung der Gesundheitsförderung und Prävention” (Prevention Act / PrävG) focuses on measures for behavior-related prevention, prevention in living environments, and workplace health promotion. The social security institutions, especially statutory health insurance funds, support and implement these measures based on the criteria outlined in the Prevention Guidelines. 

Additionally, the State Centre for Health in North Rhine-Westphalia (LZG.NRW) provides funding for municipal projects in the field of health promotion and prevention. LZG.NRW supports selected projects that focus on specific priority topics. Through this financial support, municipal initiatives for promoting health and prevention in North Rhine-Westphalia are made possible.  

The FIR at the RWTH Aachen is responsible for the testbed region and  has partnerships with key stakeholders in the health sector, including health insurance companies and regional enablers. For more information visit