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.
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).
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.
|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 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.
|Diagram from Hidden Cities|
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.
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.
|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.
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.
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/.
>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.
- Centers for Disease Control HIA Resources: http://www.cdc.gov/healthyplaces/hia.htm
This page is a useful index of major sources and an easy place to start.
- Health Impact Assessment Clearing House Learning and Information Center—HIA-CLIC at UCLA: http://www.hiaguide.org/
This terrific site had a wonderful training section with lots of resources: http://www.hiaguide.org/training/training-guides. They also have a section tracking legislation in the U.S.
- HIA Connect in Australia: http://www.hiaconnect.edu.au/index.htm
The HIA Practical Guide by HIA Connect, downloadable from this page, is a fairly short and very clear guide to HIA. HIA Connect also has an active eNews service.
- HIA Gateway, UK: http://www.apho.org.uk/default.aspx?QN=P_HIA
One of the best listing of HIAs around the world with a good advanced search feature that allows you to search by keyword, date, and geography: http://www.apho.org.uk/resource/advanced.aspx.
- Human Impact Partners, Oakland: http://www.humanimpact.org/
I particularly like their tools and resources section which includes a number of guides and worksheets: http://www.humanimpact.org/hips-hia-tools-and-resources. Be sure to scroll down the page.
- RWJF/Pew Health Impact Project: http://www.healthimpactproject.org/hia?id=0007
This is a fairly new project and their web site is evolving. Their news section is a useful part of the site: http://www.healthimpactproject.org/news.
- World Health Organization HIA: http://www.who.int/hia/en/
Determinants of health from .
Originally G. Dahgren (1995) European Health Policy Conference
Providing an international perspective this web site has a particularly strong section on HIA examples, classified by sector: http://www.who.int/hia/ examples/en/.
For more information about HIA go to the Design for Health web site at http://www.designforhealth.net/ resources/healthimpact.html.