This blog is part of an online learning platform which includes the Pathways to New Community Paradigms Wiki and a number of other Internet based resources to explore what is termed here 'new community paradigms' which are a transformational change brought about by members of a community.


It is intended to offer resources and explore ideas with the potential of purposefully directing the momentum needed for communities to create their own new community paradigms.


It seeks to help those interested in becoming active participants in the governance of their local communities rather than merely passive consumers of government service output. This blog seeks to assist individuals wanting to redefine their role in producing a more direct democratic form of governance by participating both in defining the political body and establishing the policies that will have an impact their community so that new paradigms for their community can be chosen rather than imposed.


Sunday, September 4, 2011

Collaborating to Create Healthy Cities

This is third of the first three posts of this new blog. Its mission as stated below the masthead is to help others in defining new community paradigms for themselves. "Paradigms" is one of those words not used much in everyday conversation. Here, the objective is to find means of expanding beyond everyday thinking and discovering new ways of creating our communities. That is going to take some time. It will not be accomplished in a few posts. In this post, we are still digging deeper and finding new avenues for creating new community paradigms.

In the first post, A Beginning: Working to create Liveable Cities through Liveanomics | EIU BUSINESS RESEARCH I wrote about some government staff, consultants and officials being able to quickly get to "no". It was a caution, not a guiding principle. Local government should be the focal point of inclusion in the process to achieve the best results. Sometimes local government needs help to get away from the "no" to finding new solutions, sometimes it needs a kick in the pants. First though try finding with whom you can work and ways of getting to "yes".

I do not write about any particular city for which I worked directly or had dealings with to avoid any conflicts, but I know from my own experience that if as a government worker you have a knowledgeable, dedicated, independent and engaged community group which with to work it makes the job all the more meaningful.

I raise this point because, in the last post, Healthy Cities make for Livable Communities we began discussing what a Healthy City is and gave an example of one community building tool that was not government based but created by an organization dedicated to civil rights. This type of outside influence will remain an important source of the creation of new community paradigms but far more can be done if the local government is on your side. To build a livable city through the use of Healthy Cities type programs is best done with local government playing a major role.

Better yet would be if you as the community members saw yourselves as an active component of the local government and fully understand that this means more than just being the consumers of government but its producers as well. Whatever approach is taken working from the inside or the outside, a guiding principle for making this work as a community is taking a collaborative approach to addressing important issues.

What are the collaborative methods governments can use to incorporate the concepts of Healthy Cities into their planning and decision-making process? This goes beyond the currently prevalent focus of city governments on environmental concerns. It requires recognizing that there is a definite need for action as the statistics on chronic disease become ever more alarming. It argues that both the planning and health professions need to come together in a substantive way to deal with creating healthier, age-friendly communities. This will be a challenge to both our planning systems and health approach in fundamental ways. The objective of this effort is to pioneer a new interface between health and planning.

In the previous post, we talked about the World Health Organization's (WHO) definition of what is meant by a Healthy City. WHO also has a global healthy cities project.

The Healthy Cities movement promotes comprehensive and systematic policy and planning for health and emphasizes
  • the need to address inequality in health and urban poverty
  • the needs of vulnerable groups
  • participatory governance
  • the social, economic and environmental determinants of health.

This is not about the health sector only. It includes health considerations in economic, regeneration and urban development efforts.

As stated before, these are factors that all communities can aspire to around the world. What is need are tools to implement these goals. One tool is a Health Impact Assessment (HIA), which as defined by WHO is a means of assessing the health impacts of policies, plans and projects in diverse economic sectors using quantitative, qualitative and participatory techniques.

Health Impact Assessment is similarly defined by the United States CDC Health impact assessment (HIA) is commonly defined as “a combination of procedures, methods, and tools by which a policy, program, or project may be judged as to its potential effects on the health of a population, and the distribution of those effects within the population” (1999 Gothenburg consensus statement, http://www.euro.who.int/en/what-we-do/health-topics/environmental-health/health-impact-assessment).

This definition of HIA is related directly to the WHO definition and demonstrates a global network of cooperation to which communities starting to build their own systems can tap into. Local issues for example transportation can use national studies such as CDC's policy statement on transportation and health.

In the State of Kansas, they used a Community Toolbox, a public service of the University of Kansas, to create HIAs as a way of connecting health impacts to the community from development projects.

Some communities approach to establishing healthy living in the built environment goes beyond a Health Impact Assessment exercise which means being even more proactive than reactive. Some communities in California are now including a Health and Wellness Elements in the General Plans required by California State law.

The city of Richmond, California was one of the first cities in the United States to develop a comprehensive general plan element that addressed the link between public health and community design. A full profile on this effort is available from the Prevention Institute of Oakland, CA and more information can be found at the Healthy Cities blog.

An initial step in the process is to form a community-based Health and Wellness Advisory Committee that helps scope and direct the nature of the element. It is important to conduct several community meetings to ensure the element is responding to the needs and concerns of each individual community.

The experience of many who of have done this before demonstrates that these types of programs are more effective when worked through with both professionals and stakeholders who then understand the rationale of the underlying concepts and are better able to apply them.

The City of El Monte, California, with support and coordination with the PLACE Program out of Los Angeles County's Public Health Department, was able to create a thorough approach to achieving a healthy community.

The work does not stop there, though, there is a continuing need to measure and assess. The City of San Francisco has available the Healthy Development Measurement Tool, a tool to guide Health Impact Assessments for development projects. GP RED from Lafayette, Colorado is continuing to develop a "Healthy Communities Surveillance and Management Toolkit (pdf) that can help communities go through a process of convening and engaging the community, staff, and stakeholders to create a warrant for agency action, conduct an inventory and assessment (similar to an HIA but targeted), project outcomes, create an action plan, and again, continue conducting monitorings and evaluations.

These are only some examples out there that community groups interested in creating their own new community paradigms can tap into. Each can be studied more in depth. While it is obvious that this is not something that one can do alone, it should also be obvious that one does not need to. There are help and resources available out there.  These resources and more are being made available on the Healthy Cities wiki page under Livable Communities of the New Community Paradigms Wiki.

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