Healthy Cities and settings for health
The key strategic point of the settings approach was to move health promotion away from focusing on individual behaviors and communities at risk to developing a strategy that encompasses a total population within a given setting. This followed the thinking of Geoffrey Rose that an effective and sustainable public health strategy must lower the risk of the majority of individuals, not only those at the tail end of the distribution. The target of the intervention therefore moves from individuals or groups of individuals to their environments, the "settings of everyday life." The strategic objective becomes the strengthening of resources for health. The innovation of health promotion has been to include the participatory process and empowerment as part of the strategic objectives.
Kickbusch, Ilona, The Contribution of the World Health Organization to a New Public Health and Health Promotion American Journal of Public Health March 2003, Vol 93, No. 3, 383-388
In 1986 the WHO Healthy Cities Project was launched with the participation of 11 European Cities. This project has since become a global movement with cities, towns and municipalities around the world having taken up this intersectoral approach to health. From the Healthy Cities approach followed a number of other settings intiatives in health promotion: health promoting schools, healthy workplaces, health promoting hospitals and health in prisons.
All these programs take their starting point from a specific setting for health and engage all the actors within this setting in an organization process for making the setting a healthier place to „live, love, work and play“ – as expressed in the Ottawa Charter. Other settings include healthy villages, healthy markets and healthy communities and municpalities.
Healthy city and health promotion principles now eed to be applied to new challenges such as a potentional flu pandemic. An example of such thinking has been developed in a recent editorial for HPI 2006, Vol.21, No. 2. “Flu city – smart city" (*.pdf)
Ilona Kickbusch has been involved with both HABITAT and the WHO Kobe Center in developing further the relationship between urbanization and health – this includes a particular emphasis on health and slums and new urban settings. In particular she will serve as a member of the knowledge network on urbanisation of the WHO Commission on social determinants of health.
Some key readings:
- “Flu city – smart city, applyng health promotion principles to a pandemic threat. (together with Constantino Sakellarides) editorial for HPI 2006, Vol.21, No. 2. (*.pdf)
- Global + local = glocal public health, Journal of Epidemiology & Community Health, Vol. 53, No. 8, August 1999, pp. 451-452. (*.pdf)
- Health Promoting Environments - the next steps. Special issue of the Australian and New Zealand Journal of Public Health, Vol.21.No.4, 1997, pp 431-434
- The World Health Organization Healthy Cities Project (with Agis Tsouros) in: Global project Management Handbook, ed. D. Cleland and R. Gareis, Mc Graw Hill New York, 1994, pp.25.1-25.19.
- Healthy Cities: a working project and a growing movement in: Health Promotion,
4(2): pp. 77-82, 1989.
