Takehito Takano is Professor of the Department of International Health Development in the Division of Public Health, Graduate School of Tokyo Medical and Dental University, and Director of the WHO Collaborating Center for Research on Healthy Cities and Urban Policy. Therefore, the World Health Organization has been involved in the Healthy Cities Project since 1986 to institutionalize a system to ensure and promote the health of urban residents. Furthermore, the book provides clear explanations of the project, practical guidance and directions to those who want to launch a Healthy Cities project.
Preface
This book will provide readers with the solid foundation of the Healthy Cities Project and help practitioners and researchers take the project to a higher level. This book is a collection of eleven articles by leading experts from academia or international organizations who have long been involved in the Healthy Cities movement. I hope this book gives you a better understanding of the Healthy Cities movement and provides you with a scientific foundation that will improve your urban health planning and policy making.
Development of Healthy
Cities and need for research
As urbanization results in economic development, improved urban infrastructure and more Developing Healthy Cities 5. Research in Healthy Cities refers to research conducted by parties currently developing Healthy Cities. 2001a) An analysis of health levels and various indicators of urban environments for healthy cities projects.
The third phase (1998–2002) of the Healthy Cities Project
- Leadership and empowerment
- Partnerships and infrastructures for change
- Integrated planning for health and sustainable development Drawing on relevant expertise, we will develop city health devel-
- Networks
- Monitoring and evaluation
The Athens Declaration provides the policy and strategic framework for the third phase of Healthy Cities. We give a specific commitment to phase III of the WHO Healthy Cities Project as a project city or national network city. Active support for the European Cities and Towns campaign, in collaboration with other major networks and associations, will provide a further opportunity to advance the goals of Healthy Cities Project and advance the agenda of health for all and sustainability.
REQUIREMENTS
1993) The WHO Healthy Cities Project: Review of the first five years a working tool and a frame of reference for project evaluation. WHO/Centre for Urban Health (1997) WHO Healthy Cities Project: Phase III Requirements and Designation Process for WHO Project Cities. WHO Healthy Cities Project Office (1993) Setting Standards for WHO Project Cities: Requirements and Designation Process for WHO Project Cities.
Healthy Cities Project in the Western Pacific
In Western Pacific countries, approximately 180 cities are currently implementing Healthy Cities projects. A national network of Healthy Cities projects should be created using appropriate communication technology in the country. The central government also plays an important role in the development of Healthy Cities projects.
Health and sustainability gains from urban
Integration of urban issues has been extensively pursued since the publication of the Green Paper on the Urban Environment (Commission of the European Communities [CEC] 1990). In the third rationale, the developer is seen as having a duty to return some of the financial profit from the development to the community. In the second rationale, the emphasis is on the connection between the development and its impact.
Analysis of health
However, it is the broad environmental factors that are the primary determinants of a community's health. This was a requirement for cities that wanted to be involved in the second phase of the project. Many lessons were learned from this first attempt at systematic analysis of Healthy Cities indicators.
Furthermore, there were difficulties in analyzing the data, even when there were reasonably consistent interpretations of the definition. Preliminary findings show that the problems that arose in the analysis of the first set of indicators have not all been resolved. The statistical analysis of the indicators developed so far must take into account the shortcomings of the data described above.
The collection of one set of indicators can only provide a snapshot of the city at a specific moment. Cluster analysis of the first set of indicators was hampered by the insufficiency of the data. The use of indicators to demonstrate the progress of the cities concerned can be valuable in this context.
The entire intent and purpose of the Healthy Cities movement is to change the city toward better health for all citizens.
Indicators for Healthy Cities
Nitrate quality measurements of the water supply exceeding 50 mg/l (NO3) as a percentage of total number of measurements. Fluoride quality measurements of the water supply that exceed 1.5 mg/l as a percentage of total number of measurements. Benzene quality measurements of the water supply exceeding 10µg/l as a percentage of total number of measurements.
Water supply chlordane quality measurements above 0.2µg/l as a percentage of the total number of measurements.
The effectiveness of
Ideally, community-based health promotion initiatives emerge from problems identified by community members, rather than by health care professionals. Therefore, one of the ways to assess the success of a Healthy Cities community-based health promotion project is the extent to which it targets people in the poorest health in a city and seeks to increase equity within the city. These debates should be addressed when assessing the effectiveness of community-based health promotion initiatives.
The Effectiveness of Community-Based Health Promotion 111 The compatibility between these principles and the philosophy of the Ottawa Charter and the Healthy Cities movement is clear. The framework discussed here attempts to combine some of the accuracy provided within a predictive model with the flexibility required within community-based health promotion. In the example of the health promotion program for mothers and children under eight years of age (Figure 7.2), intermediate health and well-being outcomes are evident.
The involvement of the project participants in predicting the desired outcomes encourages participation in the evaluation. This example is of the development of a community-based strategy by a district health system to promote the health of mothers and children under eight. Using multiple methods will build a picture of the community-based health promotion initiative.
Marketing empowerment and constructing the health consumer: a critique of health promotion.
Applicability of information technologies for health
Improving the quality of home health care through smart use of resources is becoming critical. We compared the improvement in functional independence of clients and the time spent by professionals providing home health services with and without videophones. Telecare cases and conventional home care cases were selected from communities where home health care typically includes home physician visits, home care services, meals on wheels, and housekeeping services.
Cases of usual home care were selected as reference cases from usual cases of home health care provided by usual home health care services. Videophone devices were installed in the homes of individual remote care clients and in the offices of home health professionals, namely doctors, nurses, physiotherapists, occupational therapists and social workers. Although two telecare cases were categorized as Grade G in the Katz ADL Index, matching cases with conventional home care cases was not successful.
This evidence demonstrates the potential of telecommunications technologies to improve the quality of home care. It is believed that differences in the level of home care provided by geographic area lead to unequal access to care. The added effectiveness of videophones in home care turned out to be significant.
Evidence has shown that the use of information technology in home health care has increased the ability of senior citizens and their families to control and improve their health.
Nurturing Healthy Cities
Endorsement of principles and strategies
Cities must have retained the support of local government and the support of key decision makers in other sectors for the principles and objectives of the project. Particular emphasis should be placed on the three issues: 1) reducing health inequalities, 2) pursuing social development, and 3) pursuing sustainable development. A.4 Cities should select at least one additional health for all goal for the 21st century that is of particular local importance.
Establishment of project infrastructures
B.7b Cities should implement an ongoing program of healthcare training/capacity building activities and sound public policy making; this program should have two pillars: involving key decision makers from different sectors in the city, and involving local communities and opinion leaders; the impact of this program needs to be evaluated.
Commitment to specific goals, products, changes and outcomes
Investment in formal and informal networking and cooperation
Caring for healthy cities 147 Still, inspiration from a good story is only one piece of evidence. The field of research in, with, for and about healthy cities seems to have much to gain from a rigorous use of the matrix presented here. In the health model, Healthy Cities uses the WHO vision to develop and implement innovative health promotion interventions.
In the city model, Healthy Cities feel able to use the concept to develop and improve intersectoral urban policies for health. Research for Healthy Cities does not necessarily have to take place in the Healthy City itself. Such healthy and responsible approaches have now been identified as core principles of the Healthy Cities Project.
Research in, with, for and in healthy places has always been a key component of the European project. In the first phase, cities were invited to contribute to our general knowledge by completing the "Healthy Cities Questionnaire". This means that the Healthy Cities movement is very fertile ground for a flourishing field of research.
CONCLUSION: THE FUTURE OF HEALTHY CITY RESEARCH More research in, and into, Healthy Cities is needed, especially at a comparative and cross-cultural level.
These nine health determinant indices explained 51.6 percent of the variance in the health index as a whole in the urban studies. The health determinant indices showed interrelationships in addition to the high correlation of individual health determinant indices with the population health level index. Simultaneous analysis of the interrelationships between health determinants will assist evidence-based decision-making in the formulation of urban health policies.
Explained deviations from the health index by sets of health determinants Sets of health determinants and the sequence of inputs. Creating an urban environment that supports the health of city dwellers has become firmly established as a consideration in the urban planning of Tokyo. Tokyo's health level ranking, once one of the highest in the country, has declined since 1980.
The local allocation tax system allocates a certain percentage of taxes collected by the national government to local governments. The results suggested that visual localization facilitates the illustration and analysis of the geographic distribution of community health needs at the local level. Examples of Research Activities 183 principles of GIS for assessing community health needs are applicable to different communities.
Examples of research activities 187 Table 10.12. Comparison of the most important sources of health information-.
