Healthy Cities, Municipalities and Communities: A Global Perspective

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Healthy Cities, Municipalities and CommunitiesA
Global Perspective

• Dr Iain Butterworth
• Deakin University

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The WHO Healthy Cities project

• A long-term, comprehensive, community-based
  development project
• Places health on the agenda of cities around the
  world
• Addresses the broad range of factors that
  influence the health and quality of life in
  cities
• Builds a constituency of support for public
  health at the local level
• Born in 1984 at Beyond Healthcare conference,
  Toronto
• Healthy islands, villages and municipalities
• 10,000 projects worldwide

(National Civic League, 1998 Tsouros, 1994)
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Characteristics of Healthy Cities Projects

• Commitment to health
• Political decision-making
• Intersectoral action
• Community participation
• Innovation
• Healthy public policy

(Duhl Sanchez, 1999)
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11 key parameters for healthy cities and
communities (Hancock Duhl, 1988)

• A clean, safe, high-quality environment
• A stable, sustainable ecosystem
• A strong, mutually supportive community.
• A high degree of public participation in and
  control over the decisions affecting life, health
  and wellbeing.
• The meeting of basic needs (food, water, shelter,
  income, safety, work) for all people.

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11 key parameters

• Access to a wide variety of experiences and
  resources, with the possibility of multiple
  contacts, interaction and communication.
• A diverse, vital and innovative economy.
• Encouragement of connections with the past, with
  the varied cultural and biological heritage and
  with other groups and individuals.

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11 key parameters

• A city form (design) that is compatible with and
  enhances the preceding parameters and forms of
  behaviour.
• An optimum level of appropriate public health and
  sick care services accessible to all.
• High health status (both high positive health
  status and low disease status).

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Healthy Cities Europe

• Large cities, local government plays key role as
  both planner and health provider
• May be administered at the senior corporate level
  
• Huge bureaucratic program
• Legacy of theory and practice
• Strategy, methodology

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Healthy Cities and Communities - USA

• Cultural values of individualism and minimal
  involvement by the State in corporate affairs
• Pseudo-anarchic process, more like the
  development of Linux
• Reflects state of health care system
• History of involvement of health care industry
• Connotations of health in USA

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Healthy Cities - Taiwan

• Confucian tradition
• Integration of politics and academe
• Government support for collaboration across
  sectors
• New democracy
• Reaction to China

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Healthy Cities - Canada

• Began with tripartite system of planners, public
  health and local government
• Has aimed at promoting economic sustainability of
  programs

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Healthy Cities - Australia

• Canberra, Illawarra, Nourlanga
• Cultural expectations of government
• 2nd International Conference on Health Promotion,
  Adelaide, 1988
• South Australian Community Health Research Unit
  (SACHRU), Department of Public Health, Flinders
  University
• Healthy Localities Victoria, 1989-1993
• Victorian Municipal Public Health Planning
  Legislation

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Victorian Healthy Localities Project, 1989 1993

• Six Healthy Localities projects funded a total of
  3m
• Altona, Benalla, Broadmeadows, Coburg, Colac,
  Maffra Shire
• Ottawa Charter
• Social model of health / social determinants
• Emphasis on community participation, capacity
  building
• Collaborative planning between local government
  and their communities

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Victorian Healthy Localities Project, 1989 1993

• Aimed to assist non-award councils and their
  communities to engage in similar systemic health
  promotion
• Informed development of Victorian Municipal
  Public Health Planning
• Garrard Schofield (1991) Evaluation of MPHP
  pilot program
• Systematic evaluation on effectiveness of
  strategies to create supportive environments and
  change behaviors
• Garrard, Hawe Graham (1995)

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Alliance for Healthy Cities
www.alliance-healthycities.com/

• Auspiced by the World Health Organization
  Regional Office for the Western Pacific
• Will provide opportunities to
• share experiences of Healthy Cities,
• recognize and promote outstanding practice and
  innovation
• mobilize resources
• develop new knowledge and technology for the
  advancement of Healthy Cities through
  international collaboration.

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Alliance for Healthy Cities

• Full Member
• City governments,
• Governing units of cities/municipalities/equivalen
  t organizations
• Associate Member
• Individuals
• Non-government organizations
• National government agencies
• Private organizations
• International agencies
• Academic institutions

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Alliance for Healthy Cities

• US500.00 per year
• WHO Awards for Healthy Cities
• Secretariat of the Alliance for Healthy Cities
• c/o WHO Collaborating Center for Healthy Cities
  and Urban Policy Research, alliance.ith_at_tmd.ac.jp

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Alliance 20 Full Member Cities

• Cambodia
• China
• Japan
• Republic of Korea
• Malaysia
• Mongolia
• Vietnam

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Alliance for Healthy Cities Associate Members

• South Australian Community Health Research Unit
  (SACHRU), Department of Public Health, Flinders
  University Adelaide, South Australia
• Healthy Cities Illawarra
• Healthy Cities Noarlunga (Member of the Steering
  Committee)
• Centre for Health Education and Health Promotion,
  The Chinese University of Hong Kong Hong Kong
  (Member of the Steering Committee)
• Health Promotion/International Health, Division
  of Public Health, Tokyo Medical and Dental
  University Tokyo
• National Coordinator of Healthy Cities Malaysia
  National Agency (Member of the Steering
  Committee)

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Documentation for joining the Alliance

• Written policy statement in support of Healthy
  Cities
• Future vision and goal
• Profile of the city (baseline data)
• Analysis of priority health problems

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Other documentation for joining the Alliance

• Intersectoral coordination mechanism in place
• Mechanism for community participation
• Local action plan to resolve the problems
• A set of indicators for monitoring and evaluation
• A system of information dissemination and sharing

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Opportunities for Victoria

• Link Victorian local governments to International
  Alliance for Healthy Cities
• Strengthen visibility of Victorian local
  governments
• Leverage in related policy areas eg Melbourne
  2030

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Opportunities for Victoria

• Share policy framework with colleagues in other
  Australian states
• International networking
• Learn from international approaches
• Share expertise with cities across Western
  Pacific
• Publishing Victorian experience models of best
  practice
• Theoretical perspectives
• Healthy Cities Alliance Conference, China 2006

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Opportunities for Collaboration

• Deakin University Healthy Cities Short Course
  2005
• Visit by Prof Leonard Duhl
• Visit from international practitioners
• Collaborations with Universities across Australia
• Research collaborations with Planning Institute
  of Australia, VCOSS, DVC, DHS
• Consulting nationally and internationally