Why Healthy Cities are a good idea- a presentation for Manukau City Council, New Zealand

1. Healthy Cities Duncan Innes April 10

2. Definition: A healthy city is one that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and developing to their maximum potential. WHO Health Promotion glossary 1998

3. Social determinants of health 1. Whether people live healthily or become ill, is primarily affected by the economic and social conditions under which they live 2. Universal access to medical care is important but other resources are important including: social (class health) gradient, stress, early life, social exclusion, work, unemployment, social support, addiction, food, and transport.(Marmot)

4. What does a Healthy City do? Works towards full health for all citizens, through four elements for action: explicit political commitment; leadership; institutional change; intersectoralpartherships

5. So what does that look like? A city should strive to provide: 1. A clean, safe physical environment of high quality (including housing quality) 2. An ecosystem that is stable now and sustainable in the long term; 3. A strong, mutually supportive and non-exploitive community; 4. A high degree of participation and control by the public over the decisions affecting their lives, health and wellbeing; 5. The meeting of basic needs (for food, water, shelter, income, safety and work) for all the city's people;

6. And.. 6. Access to a wide variety of experiences and resources, with the chance for a wide variety of contact, interactions and communication; 7. A diverse, vital and innovative city economy; 8. The encouragement of connectedness with the past, with the cultural and biological heritage of citydwellers and with other groups and individuals; 9. A form that is compatible with and enhances the preceding characteristics; 10. An optimum level of appropriate public health and sick care services accessible to all; and 11. High health status (high levels of positive health and low levels of disease)

7. Where it all began World Health Organisation (WHO) initiative UN Local Agenda 21-sustainable development Health for All strategy - The Ottawa Charter for Health Promotion, adopted in 1986 Started with 11 European cities in 1986 Radiated out to other WHO Regions and developing countries- now over 1,000 cities worldwide

8. Ottawa Charter Prerequisites for health are: peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social justice, and equity. The five strands of the Ottawa Charter are therefore: building healthy public policy, creating supportive environments, strengthening community action, developing personal skills, and re-orienting health services.

9. Where are we now? Healthy Cities now in its fifth five-year Phase (Phase V 2009-13)-1800 cities worldwide Phase V overall aim: Health and health equity in all local policies. Cities are focusing on three core themes: caring and supportive environments, healthy living ,and healthy urban design.

10. What does success look like? The most successful Healthy Cities programmes maintain momentum from: the commitment of local community members; a clear vision; the ownership of policies; a wide array of stakeholders; a process for institutionalizing the programme.

11. What are the hazards? Lack of commitment from public officials stability of local coordinators Lack of resources to develop good guidance such as health profiles Insufficient evaluation time Variable regional and national networks to facilitate strategy sharing Little information published on country profiles and actual implementation plans outside of the WHO European Region.

12. Next steps Consolidate research about what works Bid for Super Healthy City National and international networking Manukau, Nelson, Lower Hutt, Gisborne, Porirua, and Merivale in Tauranga, Wanganui, Masterton and Palmerston North.