Health Issues in Urban Areas

Health Issues in Urban Areas HEALTHY SETTING INTRODUCTION Currently, more than half of the world’s population lives in an urban area. It is estimated that by 2050, more than two-third of the world’s population will be living in towns and cities (WHO 2015). Rapid urbanization leads to significant changes in our standards of living, lifestyles, social behaviour and health. Living in urban area offer many opportunities, including potential access to better health care. However, today’s urban environments can concentrate health risks and introduce new hazards. Health problems in cities include issues of water, environment, violence and injury, non-communicable diseases such as cardiovascular diseases, cancers, diabetes and chronic respiratory diseases, unhealthy diets and physical inactivity, harmful use of alcohol. (Eckert Kohler 2014; WHO 2015). The prevalence of non-communicable diseases such as cardiovascular diseases and respiratory diseases are worsened by pollution. Urban air pollution kills around 1.2 million people each year around the world (WHO 2015). A major proportion of urban air pollution is caused by motor vehicles, although industrial pollution, electricity generation and in least developed countries household fuel combustion are also major contributors. Mass marketing in urban areas, availability of unhealthy food choices and accessibility to automation and transport all have an effect on lifestyle that directly affect health (WHO 2015). These environments tend to discourage physical activity and promote unhealthy food c onsumption. Community participation in physical activity is poor due to by a variety of factors including overcrowding, high-volume traffic, and heavy use of motorized transportation, poor air quality and lack of safe public spaces and recreation or sports facilities (WHO 2015). Apart from that, urbanization affects the spread of diseases including tuberculosis, malaria and HIV/AIDS. Incidence of tuberculosis in New York City is four times the national average. While in the Democratic Republic of the Congo, 83% of people with tuberculosis live in cities. Setting like recreational park in urban area is supposed to be a place for healthy activities such as jogging, exercise and some sports. However, for some people they use this park for negative behaviour such as sexual misconduct including indecent exposure, offensive touching, sexual acts, or prostitution. This behaviour may lead to unintended pregnancy and subsequently some of them will desperately dump the baby especially among teenagers. THE CONCEPT STRATEGY OF HEALTHY SETTING Healthy Settings as one of health promotion approaches, involve a holistic and multi-disciplinary method which integrates action across risk factors. The goal is to maximize disease prevention via a whole system approach. This approach begins in the WHO â€Å"Health for All† strategy and, more specifically, the Ottawa Charter for Health Promotion. Key principles of Healthy Settings include community participation, partnership, empowerment and equity. The best-known example of a successful Healthy Settings programme is Healthy Cities. This programme initiated by WHO in 1986 and have spread rapidly across Europe and other parts of the world. Building on this experience, a number of parallel initiatives based on similar principles were established during the late 1980s and early 1990s within a number of smaller settings such as villages, schools, or hospitals. The Healthy Settings movement came out of the WHO strategy of â€Å"Health for All† in 1980. The Ottawa Charter for Health Promotion (1986) clearly explained this approach. These documents were important steps towards establishing the holistic and multifaceted approach embodied by Healthy Settings programmes, as well as towards the integration of health promotion and sustainable development. Then, in 1992, the Sundsvall Statement called for the creation of supportive environments with a focus on settings for health. The Jakarta Declaration in 1997 subsequently emphasized the value of settings for implementing comprehensive strategies and providing an infrastructure for health promotion. Nowadays, various settings are used to facilitate the improvement of public health throughout the world. Figure 1: Ottawa Charter for Health Promotion (WHO 1986) WHO defined setting for health as the place or social context in which people engage in daily activities in which environmental, organizational, and personal factors interact to affect health and wellbeing (Health Promotion Glossary 1998). A setting is where people actively use and shape the environment and it is also where people create or solve problems relating to health. Settings can normally be identified as having physical boundaries, a range of people with defined roles, and an organizational structure. Examples of settings include schools, work sites, hospitals, villages and cities. Health promotion through different settings can take many forms and these often involve some changes to the physical environment or to the organizational structure, administration and management. Settings can also be used to promote health as they are vehicles to reach individuals, to gain access to services, and to synergistically bring together the interactions throughout the wider community. Healthy setting programmes took off predominantly in Europe and the Americas following the Ottawa Charter and Jakarta Declaration. The primary form of implementation has been the Healthy Cities programmes. Through pilot projects and expansion efforts, many other Healthy Settings have been established throughout the two regions. Today, efforts have been made in all WHO regions to expand the movement. Other settings include villages, municipalities and communities, schools, workplaces, markets, homes, islands, hospitals, prisons, universities and healthy ageing (Figure 1). Approach in healthy settings involves a focus on both structure or place and agency or people. It should be understood that a setting not only as a medium for reaching ‘captive audiences’ but also as a supportive context and environment which directly and indirectly impacts wellbeing. Apart from that, it is a commitment to integrating health and wellbeing within the culture, structures and routine life of settings. Healthy City is defined as a 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 and Duhl 1988). Healthy Cities Initiative features political commitment in multi-sector to health and well-being in the most ecological sense; commitment to innovation; community participation; and the resultant healthy public policy. Health and well-being must be planned and built ‘into’ cities and presented as everyone’s business. Political endorsement is important in ensuring inter-sectorial collaboration. Systems for participatory decision-making must be developed to ensure that all voices are heard, especially those of marginalised people (Baum 1993). Healthy Cities is essentially an empowerment process that embeds the Ottawa Charter’s core definition of hea lth- â€Å"The process of enabling people in a community or city to increase control over and improve all the many different factors that affect their health† (WHO 1986). Healthy Cities is based on the recognition that city and urban environments affect citizens’ health, and that healthy municipal public policy is needed to effect change (Ashton 1992). In the early stages of the Healthy Cities approach, 11 key parameters were identified for healthy cities, communities, and towns (Hancock and Duhl 1988): A clean, safe, high-quality environment (including housing). An ecosystem that is stable now and sustainable in the long term. A strong, mutually supportive and non-exploitative community. A high degree of public participation in and control over the decisions affecting life, health, and well-being. The meeting of basic needs (food, water, shelter, income, safety, work) for all people. Access to a wide variety of experiences and resources, with the possibility on multiple contacts, interaction, and communication. A diverse, vital, and innovative economy. Encouragement of connections with the past, with the varied cultural and biological heritage, and with other groups and individuals. A city form (design) that is compatible with and enhances the preceding parameters and forms of behaviour. An optimum level of appropriate public health and sick care service accessible to all. High health status (both high positive health status and low disease status). Hancock (1993) conceived of a Healthy Cities and Communities model in which human health and wellbeing – or human capital – is the ultimate outcome of a sustained, integrated effort to build community (social) capital, environmental capital and economic capital (See Figure 2). Figure 2: Healthy Cities Model Healthy Cities approach built on community involvement; political commitment, in which the local government is a major player; partnerships between sectors; and enabling, healthy public policy to create conditions for health. These approaches build on local capacity, by building on assets, strengths and resources. The application of the concepts, principles and practice of health promotion at the local level is important. Central to local health promotion is the key role played by local government. Many of the major determinants of health are within the scope of local government. WHO (1997) offers a systematic strategy for progressing through three phases of development of a Healthy Cities initiative in their document, Twenty Steps for Developing a Healthy Cities Project. Three main phases are start-up, initiative organisation and areas for action and strategic work. Twenty Steps makes it clear that the role of a Healthy Cities initiative is to offer effective advocacy to promote healthy public policy. Figure 3: Twenty Steps for Developing a Healthy Cities Project LESSONS LEARNED Healthy Cities Europe As the site of the first pilot Healthy Cities initiatives by WHO in the mid-1980s, Europe has in many ways served as the engine house of Healthy Cities concepts and approaches. WHO Europe has developed a legacy of theory and practice; strategy and methodology, buttressed by a huge bureaucratic initiative. Typically, the European approach has featured large cities, in which local governments play a key role as both planner and health provider. Many HC initiatives are administered at the senior corporate level of a city (such as Copenhagen or Dublin). The European Healthy Cities approach has typically involved the establishment of a peak intersectoral working group, supported by a project team. The European Healthy Cities approach has progressed through several phases: First phase 1986-1992; Second phase 1993-1998; Third phase 1998-2002; Fourth phase (2002 onwards). Only the European region of WHO has had rigorous entry requirements to the Healthy Cities initiative. For all phases of HC initiative, member cities have had to demonstrate: (i) a political commitment to Health for All and the Healthy Cities vision; (ii) that they have adequate resources to employ a full-time initiative coordinator and support staff in a HC office; and (iii) commitment to specific objectives leading to development of local health policies (De Leeuw, 2001). During the first phase of the Healthy Cities initiative, a primary objective for all cities was to establish an Urban Health Profile through completion of a Healthy Cities Questionnaire. This phase produced the well-regarded document, Twenty Steps for setting up Healthy Cities Initiative which is described in detail below. The second phase objective for cities was to create a City Health Plan. ‘A City Health Plan is a policy document including the Health Profile identifying health challenges, their determinants, and roles various actors should play in targeting those challenges’ (de Leeuw, 2001, pp. 37-38). This phase produced a plethora of case studies and models of good practice. The third phase objectives were to produce a City Health Development Plan, and engage in rigorous internal and external monitoring and evaluation. A City Health Development Plan builds on Phases I and II in that it ‘identifies strategic development issues, incorporating also urban planni ng, sustainable development and equity concerns on a longterm basis’ (de Leeuw, 2001, p. 38). In Phase III of European HC initiatives, City Health Development Plans were required to embody a more rigorous internal and external monitoring and evaluation process to identify the impact of actions identified in Health profiles and City Health Plans. WHO established an extremely comprehensive (some would argue over-bureaucratic and unwieldy) requirement that HC initiatives would assess their performance against ‘health determinants analyses, and sound and responsible approaches towards influencing determinants of health’ (De Leeuw, 2001, p. 41). Initial annual reports were eventually received from 25 out of 40 cities: many struggled with the human resources needed to complete the reports. Over 1000 HC-related activities were reported. However, ‘very few of those activities showed a strategic perspective, thus underscoring [a] degree of ‘projectism’ in cities†¦ that would hinder the development of healthy urban policies’ (De Leeuw, 2001, p. 42) and thus City Health Development Plans in Phase III. It was anticipated that the requirement to produce these Annual Reports might help create a cultural shift away from ‘projectism’ towards a more strategic planning approach. Phase IV of Healthy Cities (2003 – 2007) has attempted to address health development comprehensively, with an emphasis on partnerships, determinants and governance. This phase has also focused on developing knowledge, tools and expertise on core developmental themes of healthy urban planning, health impact assessment and healthy ageing: Healthy urban planning. Urban planners should be encouraged to integrate and supported in integrating health considerations in their planning strategies and initiatives with emphasis on equity, well-being, sustainable development and community safety. Health impact assessment. Health impact assessment processes should be applied within cities to support intersectoral action for promoting health and reducing inequality. By combining procedures, methods and tools, health impact assessment provides a structured framework for mapping how a policy, initiative or initiative affects health. Healthy ageing. Healthy ageing works to address the needs of older people related to health, care and the quality of life with special emphasis on active and independent living, creating supportive environments and ensuring access to sensitive and appropriate services. (WHO 2003) Healthy Cities and Communities USA The Healthy Cities scene in Europe compares interestingly with that in the United States. Leonard Duhl noted that whilst the Europeans made Healthy Cities a bureaucratic initiative, the Americans have seen it as a pseudo-anarchic process (personal correspondence, 10 September 2004). The approach adopted in the United States, for instance, has been driven more at a grassroots level, reflecting the realities of an individualistic cultural tradition of ‘life, liberty and the pursuit of happiness’ and small government (National Civic League, 1998: 287), from which the collective notions of the Ottawa Charter may be viewed by some with suspicion (Baum, 1993). Furthermore, with a somewhat chaotic private health care system, much government attention in the US is focused on ensuring access to basic health care, rather than addressing, at the intersectoral community level, the social determinants of health advocated in Healthy Cities (Wolff, 2003). The long and ‘embeddedâ €™ history of the involvement of health care industry in US health policy also needs to be considered. Wolff argued that the term ‘healthy communities’ is a problem in a country like the US, in which ‘health’ is dominated by privatized health care industry. Although many community organizations may be working along the lines of the Ottawa Charter to enhance population health through civic engagement and community building, they may not in fact identify ‘health’ as a primary goal of their efforts. Intersectoral collaboration has frequently been harder to achieve in the US than in countries such as Australia or Canada, in which government is expected to provide some sort of leadership (Twiss and Duma 2003, Wolff 2003). Taiwanese and Chinese examples In contrast to European, American and Australian experiences, the Taiwanese expression of Healthy Cities reflects a strong Confucian tradition of the integration of politics and academe. Many senior government personnel met during Dr Iain Butterworth’s visits to Taiwan in 2004 and 2005 – including the Ministers for Health and Culture had held academic positions. As a result, strong national government support existed for forging collaboration across sectors. As a relatively new democracy with a culture evolving as a reaction to mainland China, there also exists a strong commitment to grass-roots civic engagement and participation. In comparison, Chinese Healthy Cities-style initiatives might be characterised by central government-mandated edicts to establish initiatives and for various sectors to participate. Western notions of democratic participation led by grass-roots activists with the potential to advocate and dissent do not translate readily or easily into a desc ription of a Healthy Cities initiative led and driven by a more centralised, interventionist state. In Shanghai, one of the approaches for healthy setting includes availability of Healthy Path Building and people were encouraged to do ‘Walking 10,000 Steps Everyday’. Apart from that, there were constructions of exercise sites in communities and training personnel for sports instruction. Other activities include ‘Healthy Rhythm’, ‘Stair Climbing’, ‘Three calisthenics’ and ‘Three Balls’ Activities During the 3rd round of Shanghai Healthy City Initiative evaluation conducted in 2011, the short version of the International Physical Activity Questionnaire (IPAQ) was administered among 3,999 Shanghai residents. The result showed that 81.2% of the respondents were physically active (37.0% were highly active), and 73.6% of the residents investigated were active in walking (13.4% were highly active). REFERENCES Eckert, S. S. Kohler 2014. Urbanization and health in developing countries: a systematic review. World Health Population 15(1): 7-20. WHO. 2015. Urbanization and health. World Health Organization, Bulletin of the World Health Organization (BLT). http://www.who.int/bulletin/volumes/88/4/10-010410/en/ (Accessed 1/3/2015). WHO (1986). Ottawa charter for health promotion. Available: http://www.euro.who.int/AboutWHO/Policy/20010827_2. Accessed 3 March 2015.

Michael Manley

Michael Norman Manley (December 10, 1924 – March 6, 1997) was the fifth Prime Minister of Jamaica (1972 – 1980, 1989 – 1992). The second son of Jamaica's Premier Norman Manley and Jamaican artist Edna Manley, Michael Manley was a charismatic figure who became the leader of the Jamaican People's National Party a few months before his father's death in 1969. Contents [hide] 1 Reforms 2 Diplomacy 3 Violence 4 Opposition 5 Re-election 6 Family 7 Retirement and death 8 Sources 9 Notes Reforms Manley soundly beat the unpopular incumbent Prime Minister Hugh Shearer (his cousin) in the election of 1972 after running on a platform of â€Å"better must come,† giving â€Å"power to the people† and leading â€Å"a government of truth. † Manley instituted a series of socio-economic reforms that yielded mixed success. Though he was a biracial Jamaican from an elite family, Manley's successful trade union background helped him to maintain a close relationship with the country's poor, black majority, and he was a dynamic, popular leader. Unlike his father, who had a reputation for being formal and businesslike, the younger Manley moved easily among people of all strata and made Parliament accessible to the people by abolishing the requirement for men to wear jackets and ties to its sittings. In this regard he started a fashion revolution, often preferring the kariba shirt or bush jacket over a formal suit. Diplomacy Manley developed close friendships with several foreign leaders, foremost of whom were Julius Nyerere of Tanzania, Olof Palme of Sweden, Pierre Trudeau of Canada and Fidel Castro of Cuba. With Cuba just 145 km (90 miles) north of Jamaica, he strengthened diplomatic relations between the two island nations, much to the dismay of United States policymakers. At the 1979 meeting of the non-aligned movement, Manley strongly pressed for the development of what was called a natural alliance between the Non-aligned movement and the Soviet Union to battle imperialism. In his speech he said, â€Å"All anti-imperialists know that the balance of forces in the world shifted irrevocably in 1917 when there was a movement and a man in the October Revolution, and Lenin was the man. Manley saw Cuba and the Cuban model as having much to offer both Jamaica and the world. In diplomatic affairs, Manley believed in respecting the different systems of government of other countries and not interfering in their internal affairs. Violence Manley was the Prime Minister when Jamaica experienced a significant escalation of its political culture of violence. Supporters of his opponent Edward Seaga and the Jamaica Labour Party (JLP) and Manley's People's National Party (PNP) engaged in a bloody struggle which began before the 1976 election and ended when Seaga was installed as Prime Minister in 1980. While the violent political culture was not invented by Seaga or Manley, and had its roots in conflicts between the parties from as early as the beginning of the two-party system in the 1940s, political violence reached unprecedented levels in the 1970s. Indeed, the two elections accompanied by the greatest violence were those (1976 and 1980) in which Seaga was trying to unseat Manley. Violence flared in January 1976 in anticipation of elections. A State of Emergency was declared by Manley's party the PNP in June and 500 people, including some prominent members of the JLP, were accused of trying to overthrow the government and were detained, without charges, in a specially created prison at the Up-Park Camp military headquarters [1]. Elections were held on 15 December that year, while the state of emergency was still in effect. The PNP was returned to office. The State of Emergency continued into the next year. Extraordinary powers granted the police by the Suppression of Crime Act of 1974 continued to the end of the 1980s. Violence continued to blight political life in the 1970s. Gangs armed by both parties fought for control of urban constituencies. In the election year of 1980 around 800 Jamaicans were killed. While the murder rate in Jamaica has long been high, Jamaicans were particularly shocked by the violence at that time. In the 1980 elections, Seaga's JLP won and he became Prime Minister. Opposition As Leader of the Opposition Manley became an outspoken critic of the new conservative administration. He strongly opposed intervention in Grenada after Prime Minister Maurice Bishop was overthrown and executed. Immediately after committing Jamaican troops to Ronald Reagan's invasion of Grenada in 1983, Seaga called a snap election – two years early – on the pretext that Dr Paul Robertson, General Secretary of the PNP, had called for his resignation. Manley, who may have been taken by surprise by the maneuver, led his party in a boycott of the elections, and so the Jamaica Labour Party won all seats in parliament against only marginal opposition in six of the sixty electoral constituencies. During his period of opposition in the 1980s, Manley, a compelling speaker, travelled extensively, speaking to audiences around the world. He taught a graduate seminar and gave a series of public lectures at Columbia University in New York. In the 1980s a Judicial Enquiry, the Smith Commission, was held on the 1976 State of Emergency. Manley admitted that he declared it on evidence that was manufactured to help him win the forthcoming election. In 1986 Manley travelled to Britain and visited Birmingham. He attended a number of venues including the Afro Caribbean Resource Centre in Winson Green and Digbeth Civic Hall. The mainly black audiences turned out en masse to hear Manley speak. Re-election By 1989 Manley had softened his socialist rhetoric, explicitly advocating a role for private enterprise. With the fall of the Soviet Union, he also ceased his support for a variety of international causes. In the election of that year he campaigned on a very moderate platform. Seaga's administration had fallen out of favor – both with the electorate and the US – and the PNP was re-elected handily. Manley's second term was short and largely uneventful. In 1992, citing health reasons he stepped down as Prime Minister and PNP leader. His former Deputy Prime Minister, Percival Patterson, assumed both offices. Family Michael Manley had 5 children: Rachel Manley, Joseph Manley, Sarah Manley, Natasha Manley and David Manley. Retirement and death Manley wrote seven books, including the award-winning A History of West Indies Cricket, in which he discussed the links between cricket and West Indian nationalism. Michael Manley died of prostate cancer on 6 March, 1997, the same day as another Caribbean politician, Cheddi Jagan of Guyana

Religion and the Meaning of Life Essay

According to Frederich Nietzche, â€Å"A man who has a why to live can bear any how†. To me this statement provides massive insight into the human experience: all people need a purpose in life. As humans we need a constructive outlet through which we can invest our thoughts, emotions, efforts and energies. We need something to thrive for and strive toward. Religion, for many people provides this outlet in life in a most positive manner. It allows people to find themselves by losing themselves foremost. Religion encourages service to others, selflessness, forgiveness and ascetic values that allow people to displace personal prejudices and mental barriers that are roadblocks on the path toward self awareness and understanding. Religion teaches that human beings are direct creations of God. Due to this, the religious person places immense gravity into the definition of what it means to be human. To the religious person human life is sacred therefore all human beings are treated as if they are sacred entities. Dignity is vital to this experience and the religious person lives a decent life based largely on the fact that they find it a grave injustice to engage in dehumanizing acts. A dehumanizing act is any action that undermines the value of what it means to be human, and because human life to the religious person is sacred; treating other people and oneself with respect is part of the job description. Religious people also are heavily focused on remaining loyal to traditions and place heavy emphasis on the concept of togetherness through ceremonies, rituals and even celebrations. Religious people congregate and come together in a forum of mutual understanding of one another’s beliefs and values, and respect for the characteristics that make individuals unique. This is how religious institutions have survived throughout the ages. People of all sorts come together based on a mutual understanding of the same truths. The idea of coming together forms a family-like atmosphere that strengthens dynamics within individual households and strengthens interpersonal bonds among all people whom the religious person encounters. The religious person lives a life of kindness, simplicity and dignity highlighted by unity, loyalty and fairness. These concepts are vital to becoming a well integrated person which is the key component to finding one’s purpose and meaning in life. Once a person gains a sense of purpose, the other aspects of their lives fall into place based around what that person chooses to life for. When a person lives for their faith, their lives are based around morals that encourage reverence for all human beings and a genuine perceptive of righteousness. This is why religious people not only have a strong sense of self, but also have unshakable character based in a solid affection for mankind.

The Geography of Panama and the Panama Canal Essay

The Geography of Panama and the Panama Canal The Panama Canal is one of the greatest works of engineering and modern achievements of mankind. An all-water passage through the continental divide of the Panama region had been suggested since early Spanish colonial times of the 16th century. Today a canal that was cut through the Isthmus of Panama is a reality. Its presence has greatly affected Panama in many ways, politically, economically, and socially. The Panama Canal is possibly one of the most well known man made geographic features ever. Only five days after the U.S. secured Panamas independence from Columbia, the first canal treaty was signed with the United States. Signing the treaty†¦show more content†¦The canal is bordered on both sides by the Panama Canal Zone, a strip of land given to the United States in 1903 but returned to Panama in 1979. The United States turned over the control of the canal to Panama in 1999. While the Panama Canal is a bridge of water connecting two oceans, building it ripped Panama apart. For Panama the opening of the canal meant a great boom in its economy. Panama has probably earned about $200 million form the canal every year. In war or peace, more than 12,000 ships from around the world sail through the fifty-one-mile long Panama Canal every year, carrying 160 million tons of cargo, representing about 5% of the worlds total sea borne trade. The canal is particularly vital to the economies of South America, connecting the Atlantic coast with the Orient, and the Pacific coast with Europe. Fifteen percent of all U.S. trade goes through the canal, and the oil pipeline beside it caries 600,000 barrels of Alaska crude oil to the U.S. eastern seaboard and beyond. Panamas special geography and history make its people the most cosmopolitan in the region. Nearly 40 percent of all Panamanians have ancestors who were neither Spanish nor Indian, but who had came to the isthmus over the last 110 years to build or traverse the canal. Panama is a service economy, trading, fina ncial, and transportation services account for threeShow MoreRelatedPanam A Unique Country1540 Words   |  7 Pagesresearched Panama and discovered that it is a very unique country. Traits such as religion, geography, and food are great examples when showing Panama’s differences from other countries. Sports is also another sample that illustrates Panama’s self-faith, which is going to be my first topic. The main sport of Panama is baseball. The stadium is located eight kilometers from the city centre and named after Rod Carew, a Major League Baseball Hall-of-Fame player that actually originated from Panama. As aRead MoreDescriptive Essay : The Heart Of The Universesounds Exciting And Remarkable1471 Words   |  6 Pagesadventure! 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