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At least 19 recordsLinked to original sources
PubMedDate not supplied

Urban health: an urban planning perspective.

Urban planning processes and practices, and their impacts on the health and well being of citizens, are numerous and take many forms. Creating living urban environments that are conducive to health and well being requires an integrated approach between urban planners and health professionals. This article focuses on the almost 100 years of experience of Canada's National Capital Commission (NCC) in developing urban plans (policy plans, master plans) for planning and building Canada's Capital. To address the continuous growing public interest in environmental concerns, the NCC developed in the 1990s an integrated approach using a strategic environmental assessment (SEA). This approach could be easily transferred to various urban-planning contexts worldwide. This paper aims to describe the NCC approach, in order to stimulate discussion on growing environmental health concerns and urban planning.

Canada↗
PubMed2004

The Johns Hopkins Urban Health Institute: A collaborative response to urban health issues.

The authors provide background on the poor health and economic status of the residents of East Baltimore, Maryland--the neighborhood surrounding a significant part of Johns Hopkins University, including the School of Medicine, the School of Nursing, the Bloomberg School of Public Health, and the Johns Hopkins Hospital. The president of the Johns Hopkins University established a council on urban health, consisting of a broad array of individuals from across the university and the community to develop a recommended course of action to help deal with these conditions. Based on the recommendations of the council, the Johns Hopkins Urban Health Institute was established with the mission to marshall the resources of the university and external groups to improve the health and well-being of the residents of East Baltimore and to promote evidence-based interventions to solve urban health problems nationwide. After becoming fully operational in 2001, the institute established three major goals: (1) strengthen research and learning, (2) reduce disparities in health and health care for East Baltimore residents, and (3) promote economic growth in East Baltimore. The article describes the institute's major activities, including community-based participatory research projects, the Journal of Community-Based Participatory Research, and programs for research fellows to promote research and learning; HIV/AIDS counseling and testing centers and a primary care clinic for the uninsured to reduce health disparities; and a technology resource center providing training and job opportunities to promote economic growth. The authors conclude by outlining the next steps planned for the institute.

Academic Medical Centers↗
PubMedDate not supplied

[Formulating a health strategy at the local level using the "Urban Health Profile" and "Urban Health Planning"].

The aim of this article was to describe the method that Croatian cities have used in the development of the City Health Profile and City Health Plan. Selected as the most appropriate and applied was the Rapid Appraisal to Assess Community Health Needs. Three sources of information were used in this research: panelist essays reflecting local community views on health, problems and potentials of their city, observations about what is diminishing and what is giving beauty of living in their city and information derived from the existing written data sources. A free-text processing program analyzed essays. During the Consensus conference, based on presented data, participants had selected (Healthy City Project) priority areas. Between 1996 and 2002 The Rapid Appraisal was applied in six Croatian cities: Pula, Metković, Rijeka, Karlovac, Varazdin and Zagreb. By applying the method of Rapid Appraisal the cities assessed their health and health needs and created the City Health Profile. They selected their (Healthy City Project) priority areas, established the working groups on priority areas, and developed the City (action) Plan for Health. The method proved that communities have the capacity to recognize and deal with their health problems.

Community Health Planning↗
PubMedDate not supplied

[Community participation in health agencies in an urban health district of Bukavu (Democratic Republic of the Congo)].

We sought to evaluate the level of community participation in health agencies in the Bukavu urban health district, an alternative approach to assessing primary health care that can be especially useful in combating poverty. Accordingly we conducted a transversal survey of a population including 113 members of 12 functional health committees and the chief of the Bukavu Urban Health District, a physician. Subjects were most often 35 to 65 years of age, male, salaried employees, married, and Roman Catholic, and had not completed secondary school. Means were compared with Anova (analysis of variance). The level of participation by these health committee members is poor (29.0%), and very similar regardless of the health sector: Bagira (26.5%), Ibanda (25.9%), and Kadutu (32.6%). Relevant factors include the weak commitment of district health authorities, the poor participation by committee members in performing their roles, and their low level of motivation to participate. The results showed no significant difference between the three health sectors in the motivating power of roles and attributions. The authors recommend that health district authorities commit themselves to the selection, training and supervision of health committees.

Adult↗
PubMed1998

The roles and responsibilities of local public health systems in urban health.

In recent years, policy analysts have paid much attention to the precarious state and uncertain future of local public health departments and so-called safety net providers, usually treating each separately. This paper explores the ways in which these systems are converging, are adapting to a changing health marketplace, and are interacting with new private sector competitors and partners. Although threatened by policy, competitive, and financial forces, many of these local organizations are adapting successfully. An agenda for transforming these entities is described; the agenda emphasizes leadership, democratization, and partnerships with communities.

Community Health Services↗
PubMedDate not supplied

Art and community health: lessons from an urban health center.

Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

Art↗
PubMed2002

Equity in health care access to: assessing the urban health insurance reform in China.

This study evaluates changes in access to health care in response to the pilot experiment of urban health insurance reform in China. The pilot reform began in Zhenjiang and Jiujiang cities in 1994, followed by an expansion to 57 other cities in 1996, and finally to a nationwide campaign in the end of 1998. Specifically, this study examines the pre- and post-reform changes in the likelihood of obtaining various health care services across sub-population groups with different socioeconomic status and health conditions, in an attempt to shed light on the impact of reform on both vertical and horizontal equity measures in health care utilization. Empirical estimates were obtained in an econometric model using data from the annual surveys conducted in Zhenjiang City from 1994 through 1996. The main findings are as follows. Before the insurance reform, the likelihood of obtaining basic care at outpatient setting was much higher for those with higher income, education, and job status at work, indicating a significant measure of horizontal inequity against the lower socioeconomic groups. On the other hand, there was no evidence suggesting vertical inequity against people of chronic disease conditions in access to care at various settings. After the reform, the new insurance plan led to a significant increase in outpatient care utilization by the lower socioeconomic groups, making a great contribution to achieving horizontal equity in access to basic care. The new plan also has maintained the measure of vertical equity in the use of all types of care. Despite reform, people with poor socioeconomic status continue to be disadvantaged in accessing expensive and advanced diagnostic technologies. In conclusion, the reform model has demonstrated promising advantages over pre-reform insurance programs in many aspects, especially in the improvement of equity in access to basic care provided at outpatient settings. It also appears to be more efficient overall in allocating health care resources by substituting outpatient care for more expensive care at emergency or inpatient settings.

Adult↗
PubMed2001

Costs-effectiveness of the urban health center in Nakhon Ratchasima: a case study on diabetes and hypertension.

Health care reforms in Thailand are looking for a better health infrastructure within the urban setting. The urban health center is one of the models tried in many provinces. This study compared the costs--effectiveness of the urban health center in Nakhon Ratchsima with the Maharaj Nakhon Ratchasima Hospital, using diabetes and hypertension as tracer conditions. The point estimates by a retrospective review and cross-sectional study revealed that the overall costs (provider plus patient costs) of the urban health center for these tracers were lower than the costs of the Maharaj Hospital. The effectiveness of treatment at the urban health center was also better. It was concluded that the urban health center should be considered as a better alternative of primary care institution within the urban area.

Chronic Disease↗
PubMed2002

Why do patients with a cough delay seeking care at Lusaka urban health centres? A health systems research approach.

SETTING: Primary health centres in urban Lusaka, Zambia. OBJECTIVES: To describe the distribution and risk factors for delay among patients presenting with a cough to the urban health centres. DESIGN: A health systems research methodology was used. A participatory workshop analysed the problem and designed a cross-sectional survey of patients attending two urban health centres. Initial data analyses were performed in a second workshop, with results discussed with a broad range of policy-makers, health care staff and community members interested in tuberculosis. RESULTS: A total of 427 patients were interviewed; 35% had delayed for more than one month. Delay was associated with older age, severe underlying illness, poor perception of the health services, distance from the clinic and prior attendance at a private clinic. There was no relationship between delay and knowledge about tuberculosis, nor with education, socio-economic level or gender. Tuberculosis and HIV were felt to be closely linked and highly stigmatised, but stigmatising attitudes were not associated with longer delays. CONCLUSIONS: The health systems research methodology was an effective way to engage the staff of the district health services in action-oriented research. Investing in improvements in the health system and ensuring accessibility for older and more disabled patients is likely to reduce delays in diagnosis and help to improve tuberculosis control in Lusaka.

Adult↗
PubMed2005

Beyond urban penalty and urban sprawl: back to living conditions as the focus of urban health.

Researchers have long studied urban health, both to describe the consequences of urban living and to design interventions to promote the health of people living in cities. Two approaches to understanding the impact of cities on health have been dominant, namely, urban health penalty and urban sprawl. The urban penalty approach posits that cities concentrate poor people and expose them to unhealthy physical and social environments. Urban sprawl focuses on the adverse health and environmental effects of urban growth into outlying areas. We propose a model that integrates these approaches and emphasizes urban living conditions as the primary determinant of health. The aim of the model is to move beyond describing the health-related characteristics of various urban populations towards identifying opportunities for intervention. Such a shift in framework enables meaningful comparisons that can inform public health activities at the appropriate level and evaluate their effectiveness in improving the health of urban populations. The model is illustrated with two examples from current urban public health practice.

Community Health Services↗
PubMed2005

Urban health: evidence, challenges, and directions.

Urbanization is one of the most important demographic shifts worldwide during the past century and represents a substantial change from how most of the world's population has lived for the past several thousand years. The study of urban health considers how characteristics of the urban environment may affect population health. This paper reviews the empirical research assessing urban living's impact on population health and our rationale for considering the study of urban health as a distinct field of inquiry. The key factors affecting health in cities can be considered within three broad themes: the physical environment, the social environment, and access to health and social services. The methodologic and conceptual challenges facing the study of urban health, arising both from the limitations of the research to date and from the complexities inherent in assessing the relations among complex urban systems, disease causation, and health are discussed.

Causality↗
PubMed2000

Substance abuse in outpatients attending rural and urban health centres in Kenya.

OBJECTIVES: To estimate the prevalence and pattern of substance use among patients attending primary health centres in urban and rural areas of Kenya. DESIGN: A descriptive cross-sectional prevalence survey. SETTING: Urban health centres of Jericho and Kenyatta University (KU) and rural health centres in Muranga district. SUBJECTS: One hundred and fifty adult patients (seventy eight males and seventy two females) were included in the study. INTERVENTION: Semi-structured questionnaires and the DSM IV diagnostic criteria were used to record the socio-demographic data and to determine substance dependence or abuse. RESULTS: The substances commonly used in descending order of frequency were alcohol, tobacco, khat and cannabis. Only alcohol and tobacco were extensively used. Lifetime prevalence rates of alcohol use for the two urban health centres were 54% and 62% compared to 54% for the rural health centres. For tobacco the lifetime prevalence rates were 30% for Jericho, 28% for KU and 38% for Muranga. The differences between the rural and urban samples were not statistically significant. More males than females had used alcohol (average lifetime use 80.8% for males compared to 30.6% for females: p<0.05) and tobacco (average lifetime use 56.4% for males compared to 5.6% for females p<0.05). CONCLUSION: The rates of substance abuse were generally low with the exception of alcohol and tobacco. Socio-cultural factors might be responsible for the differences noted. It is suggested that preventive measures and education should be emphasised at the primary care level.

Adult↗