Healthy Cities Project Research Articles

From projects to policy: 'healthy cities' as a mechanism for policy change for health?

One of the aims of the European Healthy Cities project was to contribute to the development of healthy public policy. This paper examines the evidence from ten cities in the Netherlands and the United Kingdom which are either part of the World Health Organization (WHO) Healthy City Project or part of their respective National Networks. Five key issues are identified based on current thinking in political and administrative science concerning change and policy-making. These provide a framework for the analysis of key informant interviews undertaken in the ten case studies. It was concluded that, at the time of the research, a substantive policy change had not taken place and in most cases the Healthy city initiatives were still projects rather than policies and, where plans or strategies had been developed, they were still insufficient in their impact in raising health as opposed to health care up the policy agenda.

Promoting healthy aging in cities: the Healthy Cities project in Europe.

Health promotion is a growing field, spreading into various settings. This paper focuses on the city as a setting for health promotion and on the "Healthy Cities project" (HCP) of the Regional Office for Europe of the World Health Organization in particular. In the context of the HCP, various activities to promote the health of older citizens have been carried out in recent years. These are illustrated in this paper through case studies.

Joint working and the production of a City Health Plan: the Liverpool experience

Several cities within the WHO Healthy Cities Project are developing City Health Plans, a broad strategy to improve health in the city.This paper examines the eiectiveness of joint working during the production of the City Health Plan in Liverpool, from the point of view of the participants' perceptions. The results of the study were used to inform the reform of joint planning. The results suggested that joint working had been reasonably eiective in developing theCityHealthPlan inLiverpool, but that more attention should be paid to the process of people working together, rather than an emphasis on formal interorganisational structures.

California's healthy cities: Governance in action

National Civic ReviewVolume 86, Issue 1 p. 81-91 Article California's healthy cities: Governance in action Joan Twiss, Joan Twiss Joan Twiss is director of the Center for Civic Partnerships and the California Healthy Cities Project. The center, based in Sacramento, manages the project and other community-building initiatives.Search for more papers by this author Joan Twiss, Joan Twiss Joan Twiss is director of the Center for Civic Partnerships and the California Healthy Cities Project. The center, based in Sacramento, manages the project and other community-building initiatives.Search for more papers by this author First published: 01 February 2007 https://doi.org/10.1002/ncr.4100860112Citations: 3 AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Citing Literature Volume86, Issue1Spring 1997Pages 81-91 RelatedInformation

A Multisectoral Approach to Prevention of Lead Poisoning in Hungary: Lessons Learned and Potential for Replicability Elsewhere.

Hungarian and American occupational and environmental health professionals are collaborating in a research and demonstration project designed to prevent lead poisoning in Hungary. Using a multisectoral approach, the project has three phases: data collection and review, risk communication, and facilitation of program and policy development. First, the project team reviewed relevant data of many types through a workshop at which commissioned papers were presented, key-informant interviews, and a survey of knowledge, attitudes, and practices. The team then conducted a multifaceted risk-communication program to disseminate information about lead hazards in general and what had been learned about lead exposures and lead poisoning in Hungary. It presented training workshops for workers exposed to lead at work and for groups serving as "mediators" who could affect others' behavior, such as nongovernmental organizations, labor unions, public health nurses, pediatricians, teachers and students, and coordinators of the Hungarian Healthy Cities Project. It also conducted a campaign of "concentrated action," using a variety of communication approaches directed to car owners, pregnant women, mothers of small children, and others, in order to convey knowledge and change attitudes, emphasizing emotional appeals. Project leaders will organize a multisectoral working group to develop, coordinate, and implement an overall activity plan aiming to reduce lead pollution. The approach developed and used in this project provides a model for preventing lead poisoning that may be transferrable or adaptable for use for preventing lead poisoning and other environmental health problems elsewhere.

The ‘healthy’ city, expertise, and the regulation of space

This paper critically examines the concept of the ‘healthy’ city as it has been articulated in the health promotion literature and the policy documents and programme evaluations of the World Health Organization's Healthy Cities project. It begins by discussing the emergence of this concept within health promotion and the new public health, then questions the claim that the Healthy Cities project represents a fundamentally new approach to urban health problems. Attention is drawn to the continuing modernist belief in the power of science and in rational administrative solutions to problems. The paper focuses on some assumptions, limitations and implications of the strategy of ‘community participation’, which is a key feature of the Healthy Cities project and Health for All by the Year 2000. It is concluded that it is important for those who are concerned about advancing the health of urban populations to critically examine the basic concepts of Healthy Cities and the new public health.

Sustainable urban health in developing countries

This paper analyses how health-sector professionals view the discussion of sustainability, takes these discussions further by applying the concept to urban health, and compares key issues of sustainable urban health with other aspects of sustainable development. The health sector's respective emphasis on health services versus environmental health is discussed and current action within the World Health Organisation's Healthy City projects is considered in the light of sustainable urban health. Finally, a discussion of the concept “think globally, act locally” is considered and the proposal to “think locally, act globally” is presented in relation to the UN Summit on Human Settlements, Habitat II.

The implementation of the Healthy Cities Project in developing countries: Lessons from Chittagong

This paper uses the case of Chittagong, Bangladesh to illustrate the problems of implementing the Healthy Cities Project of the World Health Organisation in developing countries and makes recommendations to resolve them. The paper presents findings of the evaluation of the Chittagong Healthy City Project, which was carried out in late 1994. The evaluation was based on internationally generated process indicators related to the institutional aspects of the Project. The issues here analysed may be useful as an initial check-list for detecting problems in forthcoming Projects. 1 These issues include: 1. (i) the appropriateness of the institutional organisation of the local authorities; 2. (ii) conceptual understanding about the Project among the existing institutions (and the Project's members); 3. (iii) existence of legislation that would make the activities of the Project officially legitimate; 4. (iv) existence of a public authority with enough power to co-ordinate the process of urban development; 5. (v) co-operation between different layers of government; 6. (vi) co-ordination/co-operation between the ministries which have agencies operating in the city; 7. (vii) the Project's office capacity to stimulate and build co-operation and to co-ordinate ongoing activities; 8. (viii) the implementation of internationally funded projects in co-ordination with existing activities; and 9. (ix) the degree of community organisation.

WHO Healthy Cities and the US family support movements: a marriage made in heaven or estranged bed fellows?

The family support movement in the US emerged at about the same time that the WHO Healthy Cities project was gaining momentum in Europe and the underlying principles and ecologic frameworks of the two have much in common. However while many Healthy Cities in Europe have included activities that benefit families this has not been made a major focus. There seems to be little awareness of experience gained in the US in terms of establishing programs with limited or no government funding using volunteers and developing social marketing and advocacy strategies sustain long term viability. Similarly cities and states in the US are struggling to develop networks of family support programs and they appear to be doing this without the benefit of experience gained in Healthy Cities projects on how to engage political leadership develop public policies establish intersectoral councils fund a coordinator position mobilize neighborhoods and evaluate community wide health promotion programs. The purpose of this paper is to examine how these two movements might join forces and learn from each other. (authors)

Healthy research in cities: a case study on the translation of health research into action in The Netherlands

Health research plays a prominent role in Healthy City projects in urban neighbourhoods. This article explores the problems that arise when research is used as a tool to promote health action. A special focus is on strategies to assess health needs. Additionally, a theoretical framework of 'Cultures of Health' is introduced. In a case study, a health promotion project in an urban neighbourhood is examined in which research plays a major role. The research, designed as action research, originates positive outcomes and demonstrates an adequate role for research on healthy cities.

Healthy Cities: Toward Worldwide Health Promotion

Healthy Cities is a community problem-solving process for health promotion that began in Canada and Europe in the mid-1980s. Although Healthy Cities have expanded worldwide, there is limited scientific literature that documents the effects of these efforts. This review describes the dynamic status of Healthy Cities globally and summarizes what is known about these efforts. It is difficult to draw generalizations or clear differences between Healthy Cities and other efforts with similar objectives in the United States. There appears to be less variation among Healthy Cities in Europe, most likely because of the extensive technical support provided by the WHO European Regional Office to the Healthy Cities Project. Case descriptions present the diversity and types of activities of Healthy Cities. It is concluded that community participation and broad involvement from different sectors of the community are promising approaches to addressing urban problems.

Characteristics of Pregnant Women, Utilization, and Satisfaction with Prenatal Services in St. Petersburg, Russia

A descriptive study with a convenience sample of 47 subjects drawn from two birthing houses was conducted in St. Petersburg, Russia, under the auspices of the World Health Organization Healthy Cities Project. Data were collected with a self-administered questionnaire given to women in birthing houses after delivery and prior to discharge. Subjects ranged in age from 16 to 38 years. Sixty-one percent of women began prenatal care within the 1st trimester, 35% within the 2nd trimester, and 2% received no prenatal care. Younger women were more likely than older women to start prenatal care in the 1st trimester, but received less teaching by health care providers. Younger women also expressed more stress and need for counseling. In addition, 83% of low-birthweight babies were born to younger women. These findings indicate a focus by health care personnel on older pregnant women, although younger pregnant women were at higher risk for poor pregnancy outcome. The strongest statistically significant correlations were found among the patient satisfaction variables, indicating that satisfaction with prenatal services may influence when women begin prenatal care services.

The evaluation of healthy city projects in developing countries

In international public health and other disciplines there is a debate about the use of process versus impact (sometimes referred to as outcome) indicators in project evaluations. With growing international and national support for Healthy City Projects in developing countries it is timely to address the issue of how to evaluate such projects. This paper briefly describes process and impact indicators, considers the importance of process indicators given the role of institutional strengthening and capacity building in Healthy City Projects and discusses the balance between locally and internationally generated indicators. A case study of the first Healthy City Project in a developing country in Asia (Chittagong, Bangladesh) illustrates how the project is linked with urban management and can enhance co-operation, co-ordination, motivation, internal organisation, decentralisation and community participation. Finally, some institutional indicators for evaluation are suggested.

The WHO Healthy Cities Project: state of the art and future plans

The WHO Healthy Cities Project: state of the art and future plans

Empowering communities: action research through healthy cities.

The Healthy Cities process uses action research to empower communities to take action for health. Five concepts that link community empowerment and action research are: focus on community, citizen participation, information and problem solving, sharing of power, and quality of life. Two city examples from Healthy Cities Indiana, a pilot program of CITYNET Healthy Cities, provide illustrations of these concepts. The dynamics of community participation in action research and the successes and barriers to community participation are presented. Outcomes that empowered the community are suggested: the extent to which Healthy City projects are initiated, their progress monitored, continued action in health supported, resources obtained, and policies promoted that contribute equity in health.

New health promotion movement: a critical examination.

In the last decade, a revolution has been occurring in the field of health promotion. Guided to a large extent by position papers disseminated by the World Health Organization (WHO) Europe Health Promotion Office, and furthered by the Ottawa Charter, the Epp Report in Canada, the Healthy Cities project, as well as by other efforts, this new health promotion movement has introduced new ideas, new language, and new concepts about what constitutes health and how health promotion efforts should be configured to achieve health. Punctuated by the terms like empowerment and community participation, this movement has generated a whole new discourse about the theory and practice of health promotion. This paper explores the multiple meanings that surround these terms, and the implications for practice, by addressing questions like: What does health mean in this new context? What is empowerment? What does participation look like? Has the tyranny of the professional been replaced by the tyranny of the community? Has anything changed about the practice of health promotion other than the language? Finally, it is argued that an acknowledgment of the multidimensionality of these concepts may facilitate their translation from rhetoric into health promotion practice.

The Valencian Community Healthy Cities Network: assessment of the implementation process

In 1986 WHO-Euro began to develop the Healthy Cities project which was later extended to Spain, in this paper the factors related to the initial development of the Healthy Cities Project in the member towns and cities of the Valencian Community Healthy Cities Network, and the level of their development will be described. The project began in 1987 and the Network, at the time of this study (March 1991), was made up of 48 towns and cities. The instrument used to assess the process of the project development was a questionnaire administered by personal interview with the three people responsible for the project in each city: the Mayor, Health Councillor and Health Officer. A score was established to measure the level of development of the project in each city which included performance of the health diagnosis and plan, the existence of intersectoral committees and the creation of channels of community participation. A large proportion of the cities (72%) have carried out the Health Diagnosis; 26% of the cities have intersectoral committees and community participation is as yet in the initial stages. Political parties' support of their city's membership in the Network, has been almost unanimous with only three exceptions. Resources allocated to the project are not yet constant, although there is important support from different levels, and on the part of local and autonomous institutions. Differences can be observed in the level of development of the cities which make up the Network, related partly to length of time of membership, to the size of the city and to other factors difficult to assess.

Healthy cities project

Healthy cities project

California healthy cities project: Piloting community-based health promotion statewide

Given the steadily rising costs of medical care — and increasing recognition of the role of individual responsibility in maintaining personal health — the concept of the “healthy city” may indeed be an idea whose time has come. The problem-solving approach emphasizes prevention, an expansive definition of health and broad-based participation.

The Healthy Cities Project: A Challenge for Health Education

The World Health Organization Healthy Cities Project assists participating cities in developing and implementing plans to create health promoting policies, programs, and environmental conditions. The project, which has its origins in the strategy of Health for All by Year 2000, seeks to bring the rhetoric down to earth and ground it in policy and practice. So far the project has been very successful in interesting and involving people at the local level. What began as a small European project in 1986 has become part of a global movement four years later. This movement is based on a recognition of the ecological context of health and the need to reconcile human lifestyles with their environmental and planetary impact. In the process of involving many people from nonmedical sectors in urban health promotion, the continuing relevance of health education to public health is becoming apparent. The challenge to Health Education is to broaden its perspective from the individual and biological, to the social and environmental if it is to play a full part in tackling the ecological crises which confront us.