Conceptual principles and trends of the development of a "healthy city"

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Conceptual principles and trends of the development of a "healthy city"

Oksana Skliarska PhD in Geography,

Associate Professor of the Department of Geography of Ukraine Ivan Franko National University of Lviv, Ukraine

Summary

Key words: healthy city, urban planning, concept, urban trends, health profile

Over the past few decades, the concept of "health" and its importance for the development of society has been redefined. Public health is seen as an important medical and social resource and, at the same time, an indicator of the state of social development, so its assessment cannot be limited to indicators of morbidity and disease prevalence.

The concept of a "healthy city" exists on a global scale in the form of the WHO Healthy Cities Network and involves the creation of an urban environment in which people are protected. The issue of spatial planning of a "healthy city" is actively studied by scientists from different countries: Brown T., Barton N., Bostrom H., Galea S., Shulaker B., Tsourou S., Petersen A. and many other scientists. In Ukraine, the issue has not yet been widely covered in the scientific literature. Among the few publications, the work of M. Gabrel on the urban planning foundations of urban health is noteworthy [1]. The issue of urban health is also present in studies of sustainable spatial development (O. Balatskyi, V. Kravtsiv, M. Dolishnyi, M. Malanchuk, V. Rodchenko, etc.) and living conditions or quality of life in cities (S. Pokliackyi, M. Fashchevskyi, etc.), since scientists consider health, well-being and safety to be one of the key indicators in the study of these categories.

A healthy city is a city that continuously creates and improves its physical and social environment and expands community resources that allow people to fulfill all life functions [2]. WHO experts have recognized the following as the most important priorities of a healthy city:

1) people: prioritizing investment in people and ensuring access to common goods and services for all;

2) community participation in decision-making, increased responsibility for individual health and well-being;

3) community prosperity and asset building through value-based management of common goods and services;

4) planet: the well-being of both people and the planet is at the center of all internal and external policies of the city;

5) place: creating accessible social, physical and cultural environments that promote health and well-being;

6) peace: a healthy city maintains peace in all its actions, policies and systems [2, p. 5].

The WHO European Network of Healthy Cities brings together about 100 leading cities and approximately 30 national networks. The network was organized into phases of about 5 years with different priorities. For example, Phase III (19982002) focused on social determinants of health, while Phase IV (2003-2008) implemented "healthy aging" programs. The current Stage VII prioritizes the topics dictated by the UN's 2030 Agenda for Sustainable Development. The goal today is to continue to promote the important role that local governments play in the development of health and well-being through national approaches [3].

One of the key tasks for each city in the network is to develop a comprehensive health profile. This profile includes population health indicators, information on lifestyle, environmental and social factors in the city that affect health. Profiles are important tools for change and an integral part of the strategic planning process [4]. The profiles analyze data on 42 indicators related to basic human needs, foundations of well-being, and opportunities, which can be viewed as an interactive scorecard for different districts.

Due to the limited amount of detailed data, it is currently very difficult to develop a health profile for Ukrainian cities, but it is important to monitor the state of health in cities and comprehensive methods need to be developed. Thus, M. Gabrel offers the following list of indicators for assessing the health of a city: 1) sociopolitical status of the city; 2) economic activity of residents; 3) quality of the urban environment for living 4) state of the real estate market; 5) orderliness of the city space 6) efficiency of resource use 7) quality of investment in the city in accordance with social, environmental and economic effects; 8) attitude to special social groups; 9) state and pace of development of social and engineering infrastructure; 10) spatial and compositional effects of new construction in the city space; 11) preservation, protection and use of the historical environment [1, p. 143].

Urban spatial planning is a critical factor in ensuring health and well-being in cities. The WHO's Practical Guide to Healthy Spatial Planning (2023) identifies specific measures and areas in urban planning that can prevent communicable and non- communicable diseases and injuries [5, p. 3-5]. Urban spatial planning through the "prism of health" should include the following 5 criteria: compactness, connectivity, integration, resilience, inclusiveness.

The developed methodological recommendations and practical solutions of WHO scientists, specialists and experts on healthy urban planning provide answers to the questions that are so relevant for Ukrainian cities today: how to provide comfortable conditions in the city to preserve human health and safety and promote a healthy lifestyle; how to respond quickly to unforeseen factors; how to plan urban space for the benefit of people; how to effectively regenerate industrial zones or abandoned areas so that they benefit people and do not put a burden on the environment. It is also about energy conservation, public spaces for children, the elderly, people with disabilities, young people, and all residents in general. Spatial planning in this case is fully consistent with the goals and objectives of health care.

The lack of many health data in Ukrainian cities is the main limiting factor for a comprehensive health assessment according to the proposed city profiles, much less for comparison and ranking. However, we can analyze the actions taken to ensure that the city provides conditions for the health and safety of its residents. In accordance with the proposed recommendations of European experts in the field of healthy urban planning, it is important to identify whether a particular city implements those activities that promote public health. In particular, it is important to track the activities of the city authorities and the public in the following areas greening the city, the number of new sports grounds, the length of bicycle paths (planned and implemented), access to quality healthcare services (network of public and private institutions, the need for beds), whether new public places are being built for children, the elderly, and people with disabilities, measures to combat sources of pollution, whether there are new ecological areas in the city or cottage towns on the outskirts (development ideas like "urban villages" with solar panels, charging stations for electric vehicles, etc.), whether the space of industrial zones and abandoned territories is being properly restored. Regarding the latter, the issues of regeneration of old industrial zones and gentrification are considered in close connection with the health of city residents in modern studies by European urbanists. For example, multivariate logistic and Poisson regression models are used to assess the relationship between the amenities and socioeconomic status of residents and the development of health indicators or health care utilization [6].

Further research on this issue involves developing a clear methodology for assessing the "health of cities," monitoring and comparing the morbidity rates of cities, conducting a survey among young people and identifying their needs to ensure a healthy lifestyle in cities.

References

[1] Urban planning principles of city health formation: analysis, diagnostics and development forecasting. Lviv Polytechnic National University Institutional Repository, 2018. 139-147.

[2] National Networks of Healthy Cities in the WHO European Region. WHO. 2015. 128 p.

URL: https://apps.who.int/iris/bitstream/handle/10665/344404/9789289051026-eng.pdf?sequence=1 &isAllowed=y

[3] Framework for the implementation of Phase VII (2019-2024) of the WHO European Network of Healthy Cities: Goals, requirements and strategic approaches. URL: https://apps.who.int/iris/rest/bitstreams/1377634/retrieve

[4] Urban Health Index. URL: https://urbanhealth.org.uk/insights/data/urban-health-index- uhi-for-lambeth-and-southwark

[5] Integrating health into urban and territorial planning: a guide, WHO, 2023. 90 с. URL: https://www.who.int/publications/i/item/9789240003170.

[6] Bhavsar, NA, Young, LZ, Phelan, M, et al. The relationship between gentrification and health and health care utilization. J Urban Health 99, 984-997 (2022). URL: https://link.springer.com/article/10.1007/s11524-022-00692-w

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