social mental physical

HEALTHY CITIES - SAFER CITIES

SUPARNA DASGUPTA
13AR60R-38


Healthy city The concept
Historical development of Health Cities
Mental health
Social health
Physical health
Waste
Pollution
Slum transport
People
Healthy city
Rural health
Sick Metros
Safer cities basic concept
Reasons for crime
Physical environments affecting safety
Disaster management
Comilation of -CASE STUDY-Dhaka &
Chittagaon, Bangladesh
Social crimes in India


HEALTHY CITY THE CONCEPT
1842.
British
Government
Health of
Towns
Chadwick
report
1977
World Health
Assembly
Alma Ata
Declaration
1980
European
countries
adopted
Health for All
1984
Toronto
conference
Beyond
Health Care
1986
Healthy
Cities
movement
1988
Adelaide
Declaration
1996
WHO
established
Healthy Cities
the theme of
the WORLD
HEALTH DAY
2004
Alliance for
Healthy Cities
organized in
Western Pacific
region
supported by
WHO & WPRO
1200 cities in
europe & 7500
cities wordwide
participated
local action needs
political support and
commitment to
reorient policies towards
achieving equity, health
and disease prevention
HEALTHY CITIES
CONCEPT
According to Hancock and Duhl, two founders of the Healthy Cities
project, in Hong Kong 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
in developing to their maximum potential.
Hancock, T. and L. Duhl. Promoting Health in the Urban Context.
WHO Healthy Cities Papers No. I.
Copenhagen: WHO; 1988.
The Healthy Cities concept focuses on the process, not just the
outcome. It is obvious from the definition that a Healthy City requires
a continuous development process that has no end point. lt is not
necessarily one that has achieved a particular health status. It is
conscious of health as an urban issue and is striving to

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SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
Building Healthy Cities - Guidelines for
implementing a Helathy Cities Project in Hong
Kong
Dependent on
health determinants
water supply,
sanitation,
nutrition,
food safety,
health services,
housing conditions,
working conditions,
education,
lifestyles,
population changes,
income
physical and social environments are
important determinants of health
-in order to take effective actions to
solve urban health problems, it is
necessary to integrate the efforts of
various sectors include not only the
health and other departments of
governments, but also non-governmental
organizations, private companies as well
as the communities
improve it.
Any city can be a Healthy City if it is committed to health and has a
structure and process to work for its improvement
PUBLIC HEALTH & ITS IMPORTANCE IN SOCIETY
-Diseases poverty and slums were the result of industrial revolution and
urban growth.
-The basic ideology of public health has now undergone many
changes and includes several facts, a basic concern with
conservation of life, health , and awareness of the need to apply
medical knowledge to man in his social state, a broadened view of
societys role in public life and recognition of health as a global
matter.
-However, in the developing countries like India, the public health
problems continue to be the environmental sanitation,
communicable disesaes, nutritional diseases, etc and certain
medico- social problems such as illiteracy, ignorance, prejudicial
social customs and beliefs, low standards of living and the population
explosion.

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Understanding health in urban area..

QoL
- health in urban area is always related to QoL.
-and The physical, mental and social health which are three sides of
the same coin (if a coin could have three sides, that is). These three
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
SOCIAL HEALTH
-concerned with aspects of working and living circumstances of
people
-positive social atmosphere is always related to the health of
people
-Social inequality affects the health of city
-Poor social and economic circumstances affect health throughout
the life.
-Relative difference in income of people cause the deprivation of
use of some basic requirement of slum people such requirement
include : healthcare, water, housing
- Social cohesion is important for health

Social Problems
Social isolation
-People become more isolated in low-density development in which
people spend more time in cars and walk less.
- Low-density development is linked with less civic engagement and
weakened sense of community.
-It can also lead to social exclusion for those who do not have a car.
-Social isolation may result due to differences in income, racism,
discrimination.
-Most of the time this prevents people to use basic rights like
education, health and housing which affects psychologically.
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components form what is popularly
known as the health triangle
- need to have physical, mental and
social health simultaneously to feel
like you are living up to your full
potential
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
The more are the disadvantages of such circumstances people are
subjected to poor health.
Individuals in communities with higher social cohesion tend to live
longer, experience better cardiovascular health, recover faster
from minor illness and be psychologically healthier
Unemployment
Job security increases health
Health effects of unemployment are related to both psychological
and financial.
Mental health
Green spaces into built environments - improve learning effectiveness
and work productivity, and help alleviate mental stress and illness.
-Green space and natural settings help overcome fatigue by relaxing
and restoring the mind.
-The experience of nature helps to restore the mind from the mental
fatigue of work
- Exercise improves cognitive function, learning, and memory.
- Urban nature, when provided as parks and walkways and
incorporated into building design, provides calming and inspiring
environments and encourages learning
-Green space for physical activity
-Green spaces provide necessary places and opportunities for
physical activity
-Play and exercise are an important part of childrens and adults
development and brain function.
-green spaces Are a more healing environment than indoor settings,
with a greater positive effect on mental health
-A neighbourhood than incorporates easily accessible green spaces
into its design may also improve social cohesion and interaction
which improves mental health.
PHYSICAL HEALTH
community physical health ( environmental health)
The way urban areas are planned and laid out known as urban
form shapes peoples life choices and has a strong bearing on
health outcomes.
Urban form affects where we live, how we travel to work or school,
how clean our air and water

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SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES

-whether we are active, and what shops or other facilities we use
physical environment is important because it shapes peoples living
environments
and influences the decisions they make about their lifestyles
public health originated over a century ago in the organised provision
of potable drinking water, sewage disposal and general waste
disposal to reduce infectious diseases

Understanding a city as a person
and its healthiness of its parts
Transport
Waste disposal
Sanitation
Slum
people
ISSUES
Land use and urban health
Urbanization and health
Transport
-If designed appropriately, urban
form and transport can increase
physical activity, improve air
quality, reduce road traffic
injuries, increase social cohesion,
and achieve maximum health
benefits from services and
facilities
-Walking and cycling are some of
the most accessible and effective
ways to meet the required
physical activity levels
Road traffic injuries & Traffic
accidents are strongly tied to
certain features of contemporary
urban areas
Pedestrian injuries are and
transport-related deaths more
common in urban areas
6
Barrier free
Street furniture
Cycle lane
A street with well defined edges,
sufficient pavement width, shade for
pedestrian and strong vertical element
to reduce the speed.
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
Populations most affected by urban
environment..
The populations whose health is greatly affected
by urban environments are those that are more
constrained in getting around urban area
Children
Children are less likely to play outdoors or
walk/cycle to school where there is limited access
to recreational areas
Children with asthma, for instance, are particularly
affected by air pollution because of their lung
Development
Older people
The outdoor environment greatly influences the
extent to which older people remain active.
older people who live in communities with quality
footpaths, safe street crossings, and services close
to home are more likely to walk and use public
transport
People with disabilities
Urban areas are generally designed around the
needs of an average commuter, rather than the
more varied needs of other populations, including
people with disabilities
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WASTE DISPOSAL
-The concentration of populations in urban areas
also means an increased accumulation of waste
products. Removal of human waste and garbage
is a major commitment in any city
- in indian context waste collection on community
level is a big problem leaving unhygienic big
disposal bins.
- apart from this when it comes to the disposal part
of it the location has a major role to play on
planning levels
- acceptance and processing of urban waste has
been welcomed by some economically suffering
rural areas which certainly affects their health.
HEALTHY CITIES - SAFER CITIES
Pollution
a
i
r


Industries
Vehicles

w
a
t
e
r


Gray water
Improper
sanitation
l
a
n
d

Waste
disposal
lands
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RELATIVE PROPORTION OF
SLUM POPULATOIN IN
CITIES
Small cities and towns
house the vast majority of
developing-country urban
residents. Rates of poverty
in these smaller settlements
often exceed the rates in
large cities, with shortages
of health services similar
to rural areas.
In India cities with population
more than million 24% of it
resides in slums.
1 billion people in a global
population of 6 billion live in
urban slums
Slum
It is seen that that most of the informal
but essential services like laborers, waste
pickers, domestic workers are provided
by less educated/ illiterate people
residing in unhealthy overcrowded
dwelling units
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-Levels of health and consumption
expenditures are positively correlate
Overcrowding (High levels of
overcrowding also make poor urban
residents vulnerable to contracting
communicable diseases such as tuberculosis)
Poor housing
Unhygienic environment (increases risk of malaria) deficient access to
safe drinking water and sanitation
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
9
SAFETY IN CITY BASIC CONCEPT
Urban safety and security is vital for development
At the same time, however, cities that attract economic power
and foster growth can also spawn crime, violence, and overall
insecurity
Urban safety concerns itself with institutional, physical and
environmental design, and social issues.
The inclusion and empowerment of the urban poor, particularly
poor women in issues of urban spatial design, planning, and
management is an important component of inclusiveness and
good governance.

The causes of crime, violence, and insecurity are multiple and
interconnected; they can however, be broadly attributed to social
exclusion.

Poor management of the urbanization process resulting in lack of
services and facilities
Failure to incorporate security related issues in urban
management policies;
Poorly protected and managed open spaces;
Lack of ownership and informal protection of spaces by city
residents;
Lack of formal controls and overprotection of urban space by the
private sector.
Planning, designing and managing for safer cities
Urban and physical planning, design and management can
contribute to the prevention of crime and violence within cities
through integrated approaches that incorporate strategic and
systematic upgrading of public spaces.
A combination of design and management principles, when
innovatively and consistently implemented, can create an
environment that enhances urban safety, builds investor
confidence, and strengthens social and cultural interaction.
The quality of health care available in the poor neighborhoods are
low
Unaffordability to food shelter & other urban basic services generally
leads to poor health conditions.
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
Crime and violence always occur within a physical setting, often
public open spaces parks, streets, squares, formal and informal
markets, and transportation nodes/facilities Approaches to improving
safety in urban public spaces are multiple, some of which include:
Security conscious design and management principles;
Revision of city by laws and regulations;
Mixed zoning and planning for diversity;
Integrated management of public space;
Conflict resolution and rapid responses in maintenance;


UN STRATEGIES FOR SAFE CITIES
PHASES FOR IMPLEMENTATION
FIRST PHASE
Contribution of safety to sustainable urbanization
Linkages with all focus areas of MTSIP
The delivery of key outputs contributing to normative and global role of SC
Identi cation of speci c deliverables and operating tools for UN-HABITAT,
and their design in detail
Mechanisms and ways of plugging them in the overall management
mechanisms, under speci cally the planning, governance and management
focus area of MTSIP.
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
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In parallel, development of Regional Strategies (4 regions), RO
led, to be validated against global strategy
Relevant institutional set up to be negotiated and put in place

THE SECOND PHASE,
Delivery within the Enhanced Normative Operations Framework
Setting up and operations of consolidated steering mechanism
Partnerships in delivery
Harmonization of regional and global strategy
Development of specic country strategies
This phase will run from 2009 to 2013

WORK PLAN:
A tool for partnership development and maximization of synergies
among networks members, and as a structured set of activities and
outputs
RESOURCES
a combination of global, regional and country/city level resources
Resources directly executed by UN-HABITAT should be
complemented with partners resources being used on agreed
outputs
FOLLOW-UP AND MONITORING MECHANISMS
International Steering Group will provide guidance and advice on
major issues of coordination, policy development and advocacy.

A Consultative Group of key partners will be convened in order to
ensure stakeholder participation in project formulation (yearly
workplans design), implementation, follow-up, and evaluation
Safer Cities Network will provide guidance on policy issues and
coordinate the overall linkages.

SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
12
UN STRATEGIES FOR SAFE CITIES
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
13
Dhaka, the capital city of Bangladesh, has a population exceeding
10 million. Rapid population increase over the past decade has
resulted in its transport services becoming no longer able to respond
to the travel needs of its residents. This demand has not been
matched by sufficient investment in transport infrastructure, services
and management. Greater Dhaka Integrated Transport Study (DITS,
1994) called for the 1
st
transport intervention in Bangladesh.
Improve urban transport infrastructure and services in the dhaka
metropolitan area (DMA) in an economically and
environmentally sustainable manner; and
strengthen institutional and policy framework and address long-
term transport planning and coordination issues in the DMA
KEY FEATURES IN ENABLING
ENVIRONMENT AND MACRO
CONTEXT
POLITICAL COMMITMENT
ESTABLISH GENDER EQUALITY
Women in decision-making
levels
Legislative and administrative
framework
TRANSPORT POLICY
regulate public transport
fares;
meet the public interests
with proper standards of
safety,
securing transport
provision for social needs
transport planning and
implementation process
effective measures to
improve public transport,
reduce congestion and
improve the
environment.


give priority to pedestrians by
promoting walking as a safe mode of
transport;
promote integration between
pedestrians and other modes of
transport;
make facilities friendly, safe and
accessible for pedestrians;
continue a progressive ban on use of
rickshaws on major arterial roads;
reduce the number of trips made by
rickshaw by half over the next 10 years;
ensure that all auto-rickshaws in
Dhaka are powered by 4-stroke CNG
or petrol engine and
banning use of two-stroke engine
three-wheelers;
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
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encourage the use of auto-rickshaw as a feeder mode to buses;
increase the bus fleet to 5,000 operating buses by 2012;
replace tempos and mini-buses by conventional buses;
implement bus-only lanes on main roads;
introduce route tendering;
develop a comprehensive traffic management plan for the Dhaka City;
introduce new technologies for traffic control;
adopt a priority program for better pedestrian and crossing facilities;
incorporate safety measures in road and traffic management, especially for
vulnerable road users;
DEMONSTRATION PROJECT: MIRPUR CORRIDOR
The indicators to assess the impact of the first demonstration corridor (World
Bank 2002) were:
change in traffic flow;
improvement of traffic safety, especially for pedestrian;
improvement of public transport services;
reduction in motor vehicle pollution in DMA; and
progress in integrating transport planning and management in DMA
PROBLEMS WITH IMPLEMENTATION OF SUCH STRATEGIES
substantial contribution to transport in Dhaka with cycle rickshaws
rickshaws are the preferred mode of transport for a significant
population
travel by rickshaw is not cheap (compared to buses) but offers
considerable advantages in
convenience, safety (although not always), flexibility and the ability
to carry goods to or
from markets
PERCEPTIONS OF USERS AND OPERATORS
Road congestion has been reduced on this route, according to
61% of the women and 81%
of the men interviewed
About half the respondents reported that better traffic
management was due to better
performance by police who were imposing high fines on this route
About 47% of the women and 68% of the men thought that road
accidents had been reduced by restrictions on rickshaws
There has been an increase in
congestion in buses, expressed by 36% women and 53% men.

SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
15
Pedestrian facilities (e.g., foot paths) have improved according to
50% of the women and 82% of the men. This improvement has led
many men to walk short distances.
Users and operators at the Gabtoli bus terminal noted that
congestion has been reduced by the efforts of DCC, police, bus
and truck owners and drivers associations. Most counters have
moved to the city center and women feel secure to travel from
within the city.
IMPACT ON USERS
No knowledge of bus routes
Bus: Journey is Interrupted (as compared to rikshaws)
Rickshaw: Detour Journey rickshaw-more accessible,
Safe, easily available.
SUMMARY AND RECOMMENDATIONS
Women-friendly steps could include locating bus stops near schools,
colleges and hospitals, with zebra crossings.
Women consider foot over bridges to be arduous detours and
unsafe as they are potential grounds for theft. They prefer zebra
crossings to foot over bridges. Frequent zebra crossings
with traffic signals are needed on the Shamoli to Gabtoli route, to
reduce pedestrian accidents.
Rickshaws not only dominate the transport system of Dhaka but
also provide a major source of employment. The NMT restrictions on
rickshaws/van pullers have reduced operators incomes by 25-50%.
About 63% of garment workers walk to work. Bus services could be
provided to them through a public-private partnership between
BRTC and BGMEA.
The NMT restrictions mean rickshaws have to travel in lanes that
often have potholes and lack streetlights. Hence female users often
face harassment by street boys and mugging.
These lanes should be paved and streetlights should be provided.
DTCB was established under this project for coordination. Better
coordination among key stakeholders is need


SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
16
LESSONS LEARNT
All data should be kept by gender (M/F) as is done for road
accidents.
Addressing womens needs through more frequent buses,
frequent stops and sitting service,
queuing and advance ticketing can mainstream gender.
A gender needs assessment study should be done and its
recommendations should be
included in the design and implementation of the Project.
Public Consultative Committees should be formed during
preparatory and implementation
stages, not only to sell the project but also to bring about
changes in its design.
Adequate preparation should be taken before implementing
projects.
SUPARNA DASGUPTA
13AR60R-38
17


HEALTHY CITY, CASE STUDY-
Chittagong, Bangladesh

BACKGROUND
Rapid urbanization and the lack of planned growth in Chittagong has led to
serious environmental hazards. For example, nearly 25% of daily rubbish is not
collected and left piles on roads and drains. Moreover, there are no sewage or
wastewater treatment facilities. As a seaport, Chittagong is also ripe for natural
disasters such as cyclones and tidal surges. These issues prompted government
officials to seek disaster mitigation and environmental improvement that
involved local communities.
In 1993, the World Health Organization declared Chittagong as a participant in
the Healthy Cities movement. Representatives of a multitude of organizations,
both public and private, have committed themselves to using a holistic view of
urban management as a means to address environmental degradation and
the related health problems. Owing to limited resources, the project organizers
started by dividing the city into several wards.
The first area, the Jamal Khan Healthy Ward, is centrally located and thus
makes supervision and monitoring by the Chittagong Healthy City Programme
manageable. Their objective is to create success on a small level and then to
replicate this success across other wards.

The Jamal Khan Healthy Ward has reached many goals, but the most striking
success is in creating a stronger and healthier urban environment through
improved environmental services.
Solid waste management has improved through a tricycle rickshaw programme
that provides equal benefits for both rich and poor areas.
It has also created a ripple effect: residents have been inspired to keep
surrounding spaces clean and get involved in other Healthy City initiatives.
Moreover, solid waste management efforts have created decent paying jobs
for Chittagong residents.
The positive effects have not only addressed environmental hazards, but have
created broadly-based benefits that consider the whole (70).world, they can
serve as a mentor to those considering taking on efforts that advocate for
healthy public policies.
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES


The role of emergency management in India falls to National Disaster
Management Authority of India, a government agency subordinate
to the Ministry of Home Affairs.
In recent years there has been a shift in emphasis from response and
recovery to strategic risk management and reduction, and from a
government- centered approach to decentralized community
participation.

Disaster Management Act, 2005
3.1.1 The Act lays down institutional, legal, financial and coordination
mechanisms at the national, state, district and local levels. These
institutions are not parallel structures and will work in close harmony.
The new institutional framework is expected to usher in a paradigm
shift in DM from relief-centric approach to a proactive regime that
lays greater emphasis on preparedness, prevention and mitigation.
The entire strategic management process is divided into four fields
to aid in identification of the processes.
The four fields normally deal with

DISASTER MANAGEMENT IN INDIA
Disaster management
Emergencies, Disasters, and Catastrophes are not gradients, they
are separate, distinct problems that require distinct strategies of
response.
Disasters are events distinguished from everyday emergencies by
four factors:
Organizations are forced into more and different kinds of
interactions than normal;
Organizations lose some of their normal autonomy;
Performance standards change, and;
More coordinated public sector/private sector relationships are
required.
Hazards are categorized by their cause, either natural or human-
made.
and
returning as close as possible to the state before the hazard
incident.
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
Design inputs which can make the built environment safe
Sightlines
Lighting
Predictable routes
Entrapment spots
Isolation
Land use mix
Activity generators
Signs and information
Overall design
Areas of concern for safety:
Transportation
Neighborhood
downtown


Crime is present in various forms in India. Organized
crime include drug trafficking, gunrunning, money
laundering, extortion, murder for hire, fraud, human
trafficking and poaching. Many criminal operations engage in black
marketing, political violence, religiously motivated violence, terrorism,
and abduction. Other crimes are homicide, robbery, assault etc.
Property crimes include burglary, theft, motor vehicle theft, and arson.
Corruption is a significant problem.
Root causes of committing a crime
1.Poor parenting skills
2. Peer influence
3. Drugs and alcohol
4. Income and education
5. TV violence
6. Easy access
Social crimes in India
risk reduction,
preparing resources to respond to the hazard,
responding to the actual damage caused by the hazard
and limiting further damage (e.g., emergency
evacuation, quarantine, mass decontamination, etc.),
SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES
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REFERENCES
Building Healthy Cities - Guidelines for implementing a Helathy
Cities Project in Hong Kong
Strategic Plan for Safer Cities 2008-2013, Summary Document
October 2007
HEALTHY CITIES AND THE CITY PLANNING PROCESS BACKGROUND
DOCUMENT ON LINKS BETWEEN HEALTH AND URBAN PLANNING by
L.J. Duhl & A.K. Sanchez

SUPARNA DASGUPTA
13AR60R-38
HEALTHY CITIES - SAFER CITIES