Design For Health

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

When in the Planning or Policy Process Does a Health Impact Assessment Fit?

Many people are interested in when to do an HIA. The simple answer is, it depends. There are a lot of different formats that may be used alone or in combination.

  1. Screening tools to see if an HIA is worth it
  2. Scoping tools to investigate the topics and dimensions worth exploring more
  3. Desktop or mini HIAs that can be done quickly in an office
  4. Rapid assessments or appraisals that re more participatory, drawing on expert and local knowledge (see an earlier post for some examples)
  5. Intermediate HIAs that are more comprehensive or multi-dimensional but not yet on a par with a full environmental impact assessment
  6. Full HIAs—a lot of work
  7. Integrated HIA that are plugged in to other processes
They may also be done prospectively—to figure out what may happen—or retrospectively to assess what did happen. This latter version is often looked down upon as not sufficiently proactive. However, it can be a great way to start a new planning process—looking at the current state of affairs to figure out what to do next. This can be a lot less threatening than assessing a draft plan or policy that people already invested in.
The attached diagram from a Design for Health training captures some of this variety.


Integrating health into planning often uses the approach called evidence-based practice. An article on this topic by some of the folks from Design for Health, including me, is currently available for free: http://www.informaworld.com/smpp/content~db=all~content=a918403162~frm=titlelink. It was a finalist in the Association of European Schools of Planning Best Paper Prize: [link no longer active]

Details about the paper are below.
Is There a Role for Evidence-Based Practice in Urban Planning and Policy?
Authors: Kevin Krizek; Ann Forsyth; Carissa Schively Slotterback
Planning Theory and Practice, 2009, 10: 4, 459 — 478.

Can the craft of planning take advantage of a growing body of planning-relevant research? Evidence-based practice proposes a better connection between research and professional work, but raises several concerns about the character of valid evidence, the strength and clarity of planning research, and inequalities in the available resources for integrating research into planning practice. Much of planning practice is a reflective craft where skills of mediation, negotiation, listening, and framing are prominent. As part of the planner’s work employing these skills, however, there is a valuable role for research-generated evidence to inform decision making. Evidence-based practice needs careful implementation but it can enrich the field of planning by linking research to practice.
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