Healthy Cities Programme Research Articles

How to Make Future Cities Smart in the Realm of Environmentally Friendly Healthy Cities? Looking from the Perspective of Ease of Living Index

Rapid urbanization and environmental issues have led the Government of India to implement urban development initiatives like Heritage City Development and Augmentation Yojana, Atal Mission for Rejuvenation and Urban Transformation, Smart Cities Mission, Deen Dayal Antyodaya Yojana-National Urban Livelihood Mission, and Swachh Bharat Mission-Urban to improve citizens' quality of life. The Ease of Living Index (EOL), developed to assess the outcomes of these initiatives, is a data-driven assessment tool aligned with the Sustainable Development Goals that enables cities to adopt evidence-based planning and execution. It assesses the well-being of citizens in 111 cities, including cities under the Smart Cities Mission, capital cities, and cities with populations over one million. The concept of healthy cities gained popularity in the South-east Asian Region of the World Health Organization, with the Healthy City Network Assessment Tool being introduced in 2021 to help cities assess their health profile in its eleven member countries, including India. In view of NITI Aayog's 2021 recommendation for the development of 500 healthy cities by 2030, there is a need to expand the scope of the existing EOL Index (2020). This research aims to integrate the healthy city evaluation criteria from WHO's South-east Asia Regional Guidelines with the EOL Index 2020 to develop an integrated tool for data-driven assessment of India's proposed healthy cities program. The study based on literature review and comparative analysis identifies 8 determinants, 28 sub-determinants and 112 indicators, enhancing the comprehensiveness of the EOL Index to promote smart, environmentally friendly, healthy, and sustainable urban development.

Health equity via inclusive communications: self-censorship of marginalized health needs in qualitative research

ABSTRACT Based on a multi-phase study conducted on the World Health Organization’s (WHO) age-friendly cities program, healthy-cities program, and global sustainable-cities initiatives, this paper assesses how older adults – particularly those living with chronic health conditions and disabilities – discuss mobility challenges in qualitative research. Initial results indicate that demobilizing levels of travel cost and travel risk are implied, with older adults refraining from direct discussion. Reflective analysis is performed on marginalized older adults’ conceptual associations, ideologies, and response to social norms, to identify sources of pressure which may lead to downplaying or self-censorship on transport disadvantage. Results highlight that inequalities may arise from both the built environment and how research trainees communicate in research. Despite literature which suggests severe impacts of transport disadvantage, older adults may face difficulties in voicing their needs when research trainees adhere to the following social norms. First, physical access and feasibility may be minimized as mere matters of convenience to the able-bodied individual; second, overcoming transportation barriers may be seen as based on one’s effort – as opposed to the disabling effects of the built environment; third, health and fitness in general may be also associated with one’s effort, and increasingly also to one’s commitment to environmental-sustainability; fourth, older adults may feel pressure to align perspectives with more privileged stakeholders, or with the general public; fifth, money and income may be delegitimized as apt research topics, regardless of how inability to overcome travel costs may impact daily-wellbeing. Implications for educating future gerontology-research trainees conclude the study.

Describing physical activity in public open spaces in Brazil: Active City, Healthy City Program

This study aimed to describe the physical activity (PA) in public open spaces (POS) in a medium-sized city in Brazil. The System for Observing Play and Recreation in Communities (SOPARC) was applied to evaluate a representative sample of users in 10 POS which received actions from the Active City, Healthy City Program. The places were evaluated four days a week (Tuesday, Wednesday, Saturday, and Sunday) at four times (8 am, 10 am, 2 pm, and 4 pm). The proportion of users by gender, age group, skin color, and PA level was compared between the POS using the chi-square test for heterogeneity in the STATA software (p<0.05). As main results, 32,768 scans were performed in 64 target areas and identified 8,634 individuals. The highest proportion of people were males (58%), adults (38%), with white skin color (97%), and in light or moderate PA (76%). Except for skin color, there was a significant difference in the proportion of all other variables between the POS (p < 0.05). In conclusion, the POS was more commonly used by men, adults, and people of white skin color for light and moderate PA. Based on the results, program managers could reallocate resources to increase utilization and PA at each place.

Healthy City Project: An application of data envelopment analysis.

PurposeThe importance of Korea’s Healthy City Project has recently increased due to the growth of the elderly population and chronic diseases. Consequently, local governments are expanding the project to manage health at the local level; however, because local government resources are limited, efficient business operation is required. Thus, the purpose of this study is to present a plan for effective project management by developing a strategy for a Healthy City Project that is suitable for the scale of local governments.MethodsFor efficiency analysis, data were collected from the homepages of 90 local governments that are implementing the Healthy City Project in Korea, and data envelopment analysis (DEA) was conducted using both the CCR model and the BCC model. The input variables for the DEA included budget, manpower, organization, planned projects, and research education. In addition, we selected program, network, and project performance as output variables.ResultsAnalysis results indicated that the CCR model identified 22 (out of 90) municipalities in which Healthy City Projects are implemented efficiently, while 68 are inefficient. The BCC model identified many more efficient regions than the CCR model; however, the difference was insignificant. Thus, the budget, manpower, planned projects, and network must be increased to improve efficiency.ConclusionFirst, to improve the efficiency of the Healthy City Project, a sufficient budget must be secured during its implementation. Second, long- and short-term plans are needed to expand the Healthy City Program. Third, networks must be created for local governments to benchmark Healthy City Projects.

Vulnerability and Resilience of Urban Traffic to Precipitation in China

The concept of Healthy Cities, introduced by the World Health Organization, demonstrates the value of health for the whole urban system. As one of the most important components of urban systems, transportation plays an important role in Healthy Cities. Many transportation evaluation systems focus on factors such as road networks, parking spaces, transportation speed, accessibility, convenience, and commuting time, while the vulnerability and resilience of urban transportation are rarely evaluated. This study presents the preliminary progress in the evaluation of traffic vulnerability and resilience during precipitation events in 39 Chinese cities. Traffic congestion index data, derived from the Baidu Map Smart Transportation Platform, and rainfall data, derived from NASA’s global precipitation measurement, are utilized. Traffic vulnerability index, traffic resilience index, and the corresponding quantitative methods are proposed, and the analysis results are presented. This study is of value in improving the understanding of urban traffic vulnerability and resilience, and in enabling the quantitative evaluation of them in urban health assessment and the Healthy Cities program.

Dietary Behavior of Adolescents in the Qassim Region, Saudi Arabia: A Comparison between Cities with and without the Healthy Cities Program.

This study reports dietary behaviors of adolescents in the Qassim region, Saudi Arabia, and comparison of these behaviors between cities with and without the Healthy Cities Program (HCP). We surveyed 1133 school-attending adolescents aged 15–19, using a multi-staged cluster sampling with probability proportionate to size. Prevalence of daily breakfast consumption was 27.7% among the adolescents. Prevalence of daily vegetables, fruits and milk or milk products consumption was 35.9%, 28.6% and 51.1%, respectively. Meanwhile, the prevalence of daily consumption of fast-food and carbonated drinks was 7.5% and 37.1%, respectively. There was no significant association between living in the healthy cities and daily intake of breakfast (OR: 1.15, 95% CI: 0.87–1.53), fruits (OR: 1.02; 95% CI: 0.77–1.36), vegetables (OR: 1.27; 95% CI: 0.98–1.67), or milk/milk products (OR: 1.0; 95% CI: 0.77–1.29); and the daily intake of fast-food (OR: 0.81; 95% CI: 0.49–1.35) or carbonated drinks (OR: 0.80; 95% CI: 0.60–1.05). These findings warrant further in-depth evaluation of the HCP in the Qassim region of Saudi Arabia.

Physical inactivity and its predictors among adolescents in Saudi Arabia: A cross-sectional comparison between cities with and without a Healthy Cities Program.

Objectives:To estimate the prevalence of insufficient physical activity and excessive screen time among adolescents living in cities participating in the Healthy Cities Program (HCP) and cities not running the program in the Qassim region of Saudi Arabia.Methods:We surveyed 1133 adolescents from the Qassim region using systematic random sampling between April and September 2017. Multivariable logistic regression analyses were conducted to investigate the predictors of insufficient levels of PA and excessive screen time.Results:The prevalence of <60 minutes of moderate- to vigorous-intensity physical activity/day was 82.4% and <3 days of vigorous intensity physical activity/week among adolescents was 59%. There was no significant association between living in healthy cities (HCPs) and insufficient levels of physical activity. The odds of excessive screen time were higher in HCPs than in cities not running the program (NHCPs) (OR: 1.49). The odds of insufficient daily PA (OR: 2.19) are higher among girls than boys. Increasing age is positively associated with insufficient weekly PA (OR: 1.19). The prevalence of excessive recreational screen time is 84.6% with higher odds in HCPs than in NHCPs (OR: 1.51).Conclusion:Our findings report a lack of evidence of any impact of the HCP on adolescents’ physical activity behaviors. This outcome warrants a further in-depth evaluation of the process and outcomes of the HCP in Saudi Arabia.

Physical Activity and Adherence to the Mediterranean Diet among Spanish Employees in a Health-Promotion Program before and during the COVID-19 Pandemic: The Sanitas-Healthy Cities Challenge.

Physical activity and a healthy diet are key factors for avoiding major noncommunicable diseases. The aim of the present study was to analyze how physical activity (PA) and adherence to the Mediterranean diet among employees participating in the Healthy Cities program have been affected during confinement due to the COVID-19 pandemic. The sample was composed of 297 employees from 40 leading companies based in Spain, who participated in the 5th edition of the Sanitas “Healthy Cities” challenge. The participants (148 women and 149 men), aged between 24 and 63 years old (M = 42.76; SD = 7.79) completed the short form of the International Physical Activity Questionnaire (IPAQ) and the PREDIMED (Prevención con Dieta Mediterránea) questionnaire to measure adherence to the Mediterranean diet before and during the pandemic. Pearson χ2 tests revealed that workers were more likely to show sedentary behaviors during the pandemic than before (83.5% vs. 66.7%). Additionally, they were more likely to reach high levels of PA (51.2% vs. 64%), and Wilcoxon tests revealed that energy expenditure measured in Metabolic Equivalent of Task (MET) was higher during the pandemic (4199.03 METs) than before (3735.32 METs), due to an increase in moderate PA. Lastly, a higher adherence to a Mediterranean diet during the pandemic (76.4%) than before (54.5%) was reported. The findings of this investigation suggest a positive effect of working from home for employees involved in a health-promotion program, and highlight the relevance of this kind of action among this population.

The Effect of the Implementation of Makassar Healthy City Based on Capacity Building and Sustainability

BACKGROUND: This research analyzed the effect of the implementation of healthy city in Makassar City based on the aspects of capacity building and program sustainability.&#x0D; AIM: This research aimed to analyze the implementation of healthy city in Makassar City based on capacity building and program sustainability aspects. &#x0D; METHODS: The research was conducted qualitatively in which the data were collected through direct interview, observation, and field note. Thirteen people were involved as informants consisting of vice mayor of Makassar, two organizers of the healthy city of Makassar City, one member from the forum of the healthy center of Makassar City, and nine community members from nine sub-districts including Makassar, Mamajang, Mariso, Panakkukang, Rappocini, Tallo, Regional Development Planning Agency (Bappeda) of Makassar City, and Indonesian Public Health Bachelor Association (PERSAKMI). &#x0D; RESULTS: The training and socialization are often ineffective since it is only participated by the coordinators from the healthy city itself. The sustainability of the healthy city program of Makassar City has been implemented well. It was proven by various healthy city appreciation obtained since the implementation of the program. Active involvement and participation from the government, community, agency, and all related stakeholders, as well as strong commitment and desire in the program implementation are the main factor of the sustainability of healthy city program in Makassar City. The suggestion given by this research is to improve the quality of healthy city program but is not based on the consideration of the appreciation.&#x0D; CONCLUSION: The improvement of the capacity needs to even all forum members of healthy city of Makassar at the level of city, sub-district, and sub-village.

Psychosocial factors of the neurotic disorders treatment and prevention in metropolis

This problematic article considers the role of the psychosocial factors on neurotic disorders manifestation in metropolis citizens. The specific factors impact on the neurotic disorders incidence is analyzed. The role of the metropolis psychological and social influence on the ones global functioning is represented. The article describes the specific of the development and course of the neurasthenic, histrionic, obsessive anxiety disorders and non-chemical addictions.Problems highlighted in this article belongs to the main modern life challenges, taking by WHO as the global problems, that were included in the targeted Healthy Cities program also aimed to treat and prevent metropolis mental disorders.

Effects of the Health Promotion Programs on Happiness

The Healthy City program is a comprehensive health promotion program implemented by local governments to improve citizens’ health. The Healthy City program aims to improve citizens’ quality of life through health promotion activities in daily life. It also improves health by eliminating health risk factors and increasing citizens’ happiness. Therefore, this study investigated the effects of the Healthy City program on the happiness index of local residents and the correlation between the Healthy City program and the happiness index using quality of life as a parameter. We conducted a questionnaire survey of residents of Seoul, where Healthy City networks are actively promoted. A total of 392 responses were obtained. Structural equations were used to analyze the collected data. The Healthy City program had positive effects on the happiness index. In other words, it increased the happiness index by improving the health of the local residents. Relevant policy efforts are also being made to advance health services through Healthy City programs. For an effective Healthy City program, it is necessary to implement policies regarding health equity, to expand Healthy City programs based on a settings approach, and to implement a sustainable Healthy City program through the establishment of Healthy City governance.

Developing safe community and healthy city joint model.

:Background:Healthy city and safe community programs are the most common initiatives gaining increasing appeal in various communities to improve safety and health, independently. The aim of this study was to develop a joint application model of safe community and healthy city. Methods:A comprehensive literature review was conducted on healthy city and safe community programs using PubMed, Web of Science, Scopus and Science Direct and also related websites such as WHO regional offices in 2018. The preliminary list of joint model dimensions and topics were extracted and then assessed by the expert through two rounds of decision Delphi and four expert panel sessions. Eventually, the visual model was developed and approved by the experts.Results:Literature review resulted in the identification of 11 programs on safety and health promotion in the community of which 35 topics were extracted. After investigating the topics accordance, they were judged (correction, merging or eliminating) by experts through Delphi rounds and panel sessions. Eventually a joint model comprising 14 dimensions, 3 core principles and 4 values called "Safe and Health Promoting Community, SHPC_ model" was developed. Conclusions:SHPC model provides a parallel and comprehensive view on safety and health topics in a community. The implementation of an integrated model could be one possible way to enhance the commitments on behalf of state and local government, and health system leaders to prioritize injuries and non-communicable disease prevention to address promotion, prevention, treatment and social consequences of mutual community-based interventions.

Stakeholder Involvement and Policy Changes of Healthy City Implementation in Makassar City

The healthy city program in Makassar City has been implemented since 2007. The implementation of the program has had various impacts on the progress of the Makassar city. This research was conducted to evaluate the impact of stakeholder involvement and the impact of city policy changes as a result of implementing a healthy city program in Makassar. The research method used was a qualitative research design with a phenomenological approach. The study was conducted in the city of Makassar, with 13 informants. Data collection techniques used was in-depth interviews and document review. Data analysis was performed using data presentation techniques. Based on the results of the study note the impact on stakeholder involvement in the implementation of healthy cities in Makassar city is not only the government, but also includes the community and the Makassar healthy city forum, each of which has a role that can help the progress of the city of Makassar. In addition, the implementation of healthy cities directly affects various policies that already exist in Makassar, and even the implementation of healthy cities can produce a variety of new regulations that are also able to support the progress of the city of Makassar. The implementation of a healthy city in Makassar has two major impacts, namely stakeholder involvement and influence in policy, both of which have shown quite good results

Does Health Promotion Program Affect Local Resident' Emotions?

Healthy cities continuously attempt to improve residents’ health. Health is affected by psychological factors, such as happiness and emotions. Therefore, this study investigates the effects of healthy city program performance on individuals’ emotions, as well as the correlation between healthy city program performance and emotions using personal happiness index as a parameter. We conducted a questionnaire survey of residents in areas implementing healthy city projects. A total of 596 responses were obtained. We used structural equations to analyze the relationship of structural influences. Results showed that healthy city program performance had significant static effects on emotion. This observation shows that healthy city programs decrease local residents’ negative emotions, such as stress and depression. Therefore, healthy city programs stabilize residents’ emotions by increasing health friendliness. To improve the performance of healthy city programs, it is necessary to mitigate health risk factors and positively affect individuals’ emotions.

Safe and Health Promoting Community: Developing a Model

Background: Healthy City and Safe Community programs are the most common initiatives gaining increasing appeal in various communities to improve safety and health, independently. The aim of this study is to develop a joint application model of safe community and healthy city. Here, we have tried an applied model development effort. Methods: A comprehensive literature review was conducted on healthy city and safe community programs in 2018. The preliminary list of joint model dimensions and topics were extracted and then assessed by the experts. Eventually, the visual model was developed and approved by the experts. Results: Totally, 35 safety and health promotion topics were extracted. After investigating the topics accordance, they were assessed by experts via two-rounds of Delphi study and panel sessions. Eventually a joint model comprising 14 dimensions, 3 core principles and 4 values called Safe and Health Promoting Community, SHPC_ model was developed. Conclusion: SHPC model provides a parallel and comprehensive view on safety and health topics in a community. The implementation of an integrated model could be one possible way to enhance the commitments on behalf of state and local government, and health system leaders to prioritize injuries and non-communicable disease prevention to address promotion, prevention, treatment and social consequences of mutual community-based interventions.

Cidades saudáveis, movimento que integra planejamento urbano e saúde: uma análise dos principais enfrentamentos para sua implantação em Portugal e Brasil

Este artigo tem por objetivo contribuir com os estudos que percebem que o entendimento da saúde em sua concepção ampliada é um caminho para integrar Saúde e Planejamento Urbano, como proposto pelo Programa Cidades Saudáveis, da OMS. Realiza uma análise comparativa entre os enfrentamentos para a implantação do programa na Rede Portuguesa de Municípios Saudáveis (RPMS), estruturada há mais de 20 anos, e em experiências brasileiras. A metodologia utilizada para estruturar o problema de pesquisa foi o Problem Structuring Methods - PSM, mais especificamente a construção de mapas cognitivos orientada pelo método Strategic Options Development and Analysis (SODA). O mapa cognitivo SODA foi desenvolvido a partir de entrevistas com atores da RPMS e o levantamento das experiências nacionais foi realizado pela revisão não sistemática da literatura, com base em artigos acadêmicos que relataram os enfrentamentos para a implantação do programa em municípios brasileiros. Foram identificados 59 construtos chave, agrupados em três clusters: conhecimento, governança e condições socioespaciais para uma vida saudável. Os enfrentamentos para a implantação do programa observados em Portugal foram igualmente observados no Brasil. Em Portugal, o tempo e a consolidação do programa na forma de rede propiciaram avanços na implantação da proposta. O Programa Cidades Saúdáveis pode ser utilizado como uma estratégia para integrar o Planejamento Urbano e a Saúde.

Cultural religiosity as the determinant factor of a successful healthy city in South Kalimantan, Indonesia

The concept and processes of a healthy city was vary depends on the region. Each city should be allowed to develop and adapt to the uniqueness, culture and value of the respective society. This study aimed to explore the culture of community in Banjar, South Kalimantan, which related to realize healthy city. Qualitative research was conducted through community observation in the form of a documentation study, including an in-depth interview with several people and the respective community leaders. The data was analysed using the Miles and Huberman Model, including data reduction, data presentation and conclusion. There is the existence of a religious culture of the Banjar people of South Kalimantan. Religious cultures can be integrated into people’s lives such as in the execution of healthy behaviour, which can be a determinant of a successful healthy city program.

Promoting healthy aging in cities

Introduction: At a time of unpredictable challenges for health, whether from a changing climate, emerging infectious diseases, or the next microbe that develops drug resistance, one trend is certain: the ageing of populations is rapidly accelerating worldwide. For the first time in history, most people can expect to live into their 60s and beyond. The consequences for health, health systems, their workforce and budgets are profound. A healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential. Aim: This presentation focuses on the city as a setting for health promotion and on the role of healthy city projects in promoting healthy aging. Methodology: The main approach of this study is to provide a review of previous research about successful and healthy ageing that have been utilized by many countries in their policy responses towards the demographic changes brought about by ageing. Results: These will be illustrated in this paper through case studies. Conclusion: In the context of the healthy city programs, various activities to promote the health of older citizens have been carried out.

Harnessing urbanisation for human wellbeing and planetary health

Harnessing urbanisation for human wellbeing and planetary health

A Conceptual Model for Integrated Management of the Urban Environment in Tehran Metropolis (Based on the Good Governance Guidelines)

Environmental protection is a key element in urban management. In metropolises due to complex relationships between human and environment the importance of environment is ever-in- creasing. In this paper The current situation of environment in Tehran metropolis including air, water, biodiversity and human habitat along with the most crucial threats, their effect as well as the associ- ated agencies and organizations have been investigated, using the indicators of OECD (Organization for Economic Co-operation and Development), UNEP (United Nation Environmental Program) and GFF (Global Environmental Fund). The current management of Tehran environment is studied based on a conceptual model and using SWOT analysis. Then, an ideal urban environmental management model is proposed for Tehran, with regard to the higher order legal documents of national and international levels and the global models such as: UN Habitat Program, Sustainable Cities Program, Policy and Regulatory Framework for Sustainable Cities Program, Healthy Cities Program, Agenda 21, Strategies of the Environmental European commission and a Good Governance Model, as well as the results of the SWOT analysis. In this model, the authorities in charge of urban management and their responsibilities are determined and classified at three levels of policy-making, decision making and implementation. The target and the relationship between them are clarified.