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Design For Health

Global Health Data from the WHO

For those interested in the broad situation of health and place globally, the World Health Organization’s Global Health Observatory is a useful resource. The observatory includes data repository, reports, and a useful map gallery. Maps, using data at the country scale, cover a wide range of topics from average cholesterol and avian influenza to health expenditure. These are clear maps at a similar scale and a terrific resource.

WHO Maps

WHO Healthy Cities

The WHO Healthy Cities Program has been around since the mid-1980s and but is not as well known in the United States as it perhaps should be. The program is focused on “health development through a process of political commitment, institutional change, capacity-building, partnership-based planning and innovative projects” (http://www.euro.who.int/en/what-we-do/health-topics/environment-and-health/urban-health/activities/healthy-cities). Healthy city activities typically focus on fostering collaborations and partnerships to promote health with a refreshing mix of interventions—policies, programs, and plans. Activities that won Healthy Cities Awards in recent years include schools that promote urban health, injury and violence prevention activities, best practices in public toilets, and healthy urban transportation (http://www.alliance-healthycities.com/htmls/awards/index_awards.html).


It’s hard to find exactly how many cities participate but the WHO European office claims that over 1,400 European cities take part in 30 national networks. As the network is global, presumably the overall numbers are much larger. An Alliance for Healthy Cities brings some of these cities together: http://www.alliance-healthycities.com/htmls/about/index_about.html 

The WHO European office has a useful healthy cities checklist that shows the wide range of topics of interest to the program from ecosystem health and public participation to diversity and economic vitality. You can read the whole list at http://www.euro.who.int/en/what-we-do/health-topics/environment-and-health/urban-health/activities/healthy-cities/who-european-healthy-cities-network/what-is-a-healthy-city/healthy-city-checklist

Design for Health on Flickr: Sets and Collections

 

Cyclist: Photo by Ann Forsyth

The Design for Health photostream now has hundreds of photos organized into “sets” such as “pedestrians” or “markets” and collections such as “Landscape”. Hundreds more photos will be added in the coming month. Check it out at http://www.flickr.com/photos/designforhealth/

UN Habitat Reports on Health

UN Habitat produces and distributes a large number of reports, many related to health with numerous publications on water infrastructure, social inclusion, disaster management, housing issues, and climate change. Although you can buy printed reports that isn’t always necessary as many can be found for free.

Hidden Cities: Unmasking and Overcoming Health Inequities in Urban Settings (2010), produced in collaboration with the World Health Organization, provides a good overview of the history and current situation in terms of cities and health. Topics cange across the natural and build environment, social and conomic issues, food secutiy, health services, and general urban governange http://www.unhabitat.org/pmss/listItemDetails.aspx?publicationID=3049
Diagram from Hidden Cities
Collection of Municipal Solid Waste , Key issues for Decision-makers in Developing Countries (2011) grapples with an important problem in public health. Written in a very accessible style it answers practical questions about how too extend solid waste collection to a wider population. http://www.unhabitat.org/pmss/listItemDetails.aspx?publicationID=3231
A Global Assessment on Women’t Safety (2008) focuses on tools for enhancing safety including public education, adviacey, participatory approaches, and changing public spaces. It’s part of a series of reports on this topic http://www.unhabitat.org/pmss/listItemDetails.aspx?publicationID=2848

Research: High Density and Overweight Adolescents

I typically don’t report on scholarly studies in this blog but recently came across a nicely designed study that makes a larger point—that the links between health and place are complex. Fei Xu, JieQuan Li, YaQiong Liang, ZhiYong Wang, Xin Hong, Robert S Ware, Eva Leslie, Takemi Sugiyama, and Neville Owen have produced a report  on the Nanjing High School Students’ Health Survey, published in the Journal of Epidemiology and Community Health in 2010 (64, 1017-1021, http://jech.bmj.com/content/64/11/1017). Titled: “Residential density and adolescent overweight in a rapidly urbanising region of mainland China” the study used data collected from 2,375 adolescents in 2004 to examine the relationship between (large-scale) district level densities and weight.

New high rise behind village
residences in suburban Shanghai, 2010

Densities are reported per square kilometer but in range from 5 persons per hectare to 307.  The study divided the sample into high, medium, low density residents. Youth in the middle and higher density areas (that is over > 35 person per hectare) were roughly  twice as likely to be overweight.

The relationship was reduced a bit but still significant after controlling for TV time, study time, recreation, age, gender, and parents education. Physical activity data came from self reports through a version of the International Physical Activity Questionnaire (IPAQ) that only asked about some kinds  of activities. Given a lack of data on overall physical activity and food intake the authors speculate on a number of reasons for this difference e.g. youth in higher density and potentially higher income areas eating more, higher density areas having less recreational space, or (and here I am paraphrasing quite loosely) that higher density areas may just be too convenient with too much internet access so youth don’t have to expend much energy getting places. The high densities in China are also quite high compared with the US and Australia in particular, where much research has been done. They are also increasing rapidly—the authors report overall densities in Nanjing, presumably including some rural districts, increasing from 14 persons per hectare in 1997 to 23 in 2007.

The study is interesting because in many studies of adults, those in higher densities walk more for transportation (though they may not walk more overall) and some find they are thinner (though not all studies measure this or find it to be true, including my own). In this study of youth, with a large group and fairly good measures, those in higher densities are chubbier. While it is important not to make too much of one study, this is yet another example of the complexity of the relationship between health and place, and the importance of social factors.

Blogs about Health and Places

As blogs have proliferated some have begun to deal with health and places. Below I list a sampling of the range of such sites, many dealing with health issues as part of a larger interest in topics such as urban development or housing. They are in alphabetical order.

City Parks Blog (http://cityparksblog.org/) is the blog of the Trust for Public Land’s Center for City Park Excellence and the City Parks Alliance. One of the interests of the center is in health: http://cityparksblog.org/2009/01/06/parks-mediate-our-urban-mental-health/
From State of the Planet blog

Healthy Cities (http://healthyurbanplanning.blogspot.com/) is the blog of Jason Corburn, a faculty member at Berkeley. It focuses on highlighting resources such as reports and statistics and has an international flavor.

Squatter City (http://squattercity.blogspot.com/) is maintained by Robert Neuwirth. Neuwirth is journalist and author of Shadow Cities, a 2006 book based on a total of two years of living in four different squatter settlements. My undergraduate students find it a compelling read. Neuwirth’s blog deals with a wide range of issues about urban settlements.

State of the Planet (http://blogs.ei.columbia.edu) is a compilation of blogs from the Earth Institute at Columbia University. It is by far the most elaborate in this list with fancy graphics, multiple contributors, and obviously represents a lot of staff time. It has a useful keyword search.

Urban Chickens (http://www.urbanchickens.net/) is an example of a blog about local food production. Entries deal with many of the practicalities of raising one’s own eggs. The proliferation of these kinds of blogs really help people who have a DIY approach. Keep an eye out for next year’s listing of urban chicken coop tours: http://www.urbanchickens.net/2010/03/urban-chicken-coop-tours-in-2010.html
Walk Score, the blog (http://blog.walkscore.com/) builds off the popularity of the walkscore tool. In the main web site an automated calculation based on destinations such as shops. As an expert on pedestrian planning I think this is oversimplified but the tool itself is fun and the blog is a mix of example results and tips about using the scoring (e.g. how to customize scores).
Other web resources about health and places are available at: http://designforhealth.net/blogs-about-health-and-places/

Technical Resource 1: Gapminder www.gapminder.org

With a focus on international development, health, and globalization, Gapminder shows what it is possible for Swedish statisticans to to do with flash animations and time on their hands on long cold nights. You can see founder, Hans Rosling, in action on video and then try it yourself with online and downloadable animations. His most famous video is at now a few years old but gives a good sense of how to use the tool. You might want to check out what he said at the U.S State Department in Washington DC last year and it is instructive to compare with a presentation for an Indian audience: http://www.gapminder.org/videos/hans-rosling-asias-rise-ted-india/.

While data are provided by country, one of the data sets is the percent urban population making it possible to see the relationships between urbanization and many health and environmental indicators. Several tools allow comparison of regions and states within countries for example, comparing countries with Chinese provinces and U.S. states: http://www.gapminder.org/labs/
Gapminder makes the important point that more wealth does not always lead to better health.
This blog owes something to an earlier Planetizen entry: http://www.planetizen.com/node/42744. For more on the various ways health intersects with place, see: http://www.designforhealth.net/resources/generalhealthissues.html

Finding Information about HIA: Design for Health Blog

>How health impact assessment can make a difference is an issue of some interest at present. For those wanting to explore HIA online, several major clearinghouses provide a wealth of information from legislative updates to workbooks.



For more information about HIA go to the Design for Health web site at http://www.designforhealth.net/ resources/healthimpact.html.

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