Journal of urban health : bulletin of the New York Academy of Medicine
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The article reviews the evolution and process of city health development planning (CHDP) in municipalities participating in the European Network of Healthy Cities organized by the European Region of the World Health Organization. The concept of CHDP combines elements from three theoretical domains: (a) health development, (b) city governance, and (c) urban planning. The setting was the 77 cities which participated in Phase IV (2003-2008) of the network. ⋯ Analysis revealed a trend away from "classic" CHDPs with a primary focus on health development towards ensuring a health dimension to other sector plans, and into the overarching strategies of city governments. Linked to the Phase IV priority themes of Healthy aging and healthy urban planning, cities further developed the concept and application of human-centered sustainability. More work is required to utilize cost-benefit analysis and health impact assessment to unmask the synergies between health and economic prosperity.
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In the spring of 2009, New York City (NYC) experienced the emergence and rapid spread of pandemic influenza A H1N1 virus (pH1N1), which had a high attack rate in children and caused many school closures. During the 2009 fall wave of pH1N1, a school-located vaccination campaign for elementary schoolchildren was conducted in order to reduce infection and transmission in the school setting, thereby reducing the impact of pH1N1 that was observed earlier in the year. In this paper, we describe the planning and outcomes of the NYC school-located vaccination campaign. ⋯ The team model achieved vaccination of more children per day and required fewer vaccination days per school. NYC's campaign is the largest described school-located influenza vaccination campaign to date. Despite substantial challenges, school-located vaccination is feasible in large, urban settings, and during a public health emergency.
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Community severance occurs where road traffic (speed or volume) inhibits access to goods, services, or people. Appleyard and Lintell's seminal study of residents of three urban streets in San Francisco found an inverse relationship between traffic and social contacts. The extent of social networks predicts unhealthy behaviors, poor health, and mortality; high rather than low social integration is associated with reduced mortality, with an effect size of similar magnitude to stopping smoking. ⋯ There is empirical evidence that traffic speed and volume reduces physical activity, social contacts, children's play, and access to goods and services. However, no studies have investigated mental or physical health outcomes in relation to community severance. While not designed specifically to do so, recent developments in road design may also ameliorate community severance.
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In this article, we discuss an appropriate methodology for assessing complex urban programs such as the WHO European Healthy Cities Network. The basic tenets and parameters for this project are reviewed, and situated in the broader urban health tradition. This leads to a delineation of the types of questions researchers can address when looking at a complex urban health program. ⋯ The former are value-driven, the latter intervention-driven. These approaches lead to the acknowledgment of a logic of method that includes situational and contextual appreciation of unique Healthy City experiences in a Realist Evaluation paradigm. The article concludes with a reflection of evaluation and assessment procedures applied to Phase IV (2003-2008) of the WHO European Healthy Cities Network and an interpretation of response rates to the range of methods that have been adopted.
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Suicidal behavior on the subway often involves young people and has a considerable impact on public life, but little is known about factors associated with suicides and suicide attempts in specific subway stations. Between 1979 and 2009, 185 suicides and 107 suicide attempts occurred on the subway in Vienna, Austria. Station-specific suicide and suicide attempt rates (defined as the frequency of suicidal incidents per time period) were modeled as the outcome variables in bivariate and multivariate Poisson regression models. ⋯ Completed suicides seem to vary most with train type used. Suicide attempts seem to depend mostly on passenger-based characteristics, specifically on the station's crowdedness and on its use as meeting point by drug users. Suicide-preventive interventions should concentrate on crowded stations and on stations frequented by risk groups.