National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia.
J Urban Health. 2011 Oct;88(5):860-74. doi: 10.1007/s11524-011-9606-1.
Urban living is the new reality for the majority of the world's population. Urban change is taking place in a context of other global challenges--economic globalization, climate change, financial crises, energy and food insecurity, old and emerging armed conflicts, as well as the changing patterns of communicable and noncommunicable diseases. These health and social problems, in countries with different levels of infrastructure and health system preparedness, pose significant development challenges in the 21st century. In all countries, rich and poor, the move to urban living has been both good and bad for population health, and has contributed to the unequal distribution of health both within countries (the urban-rural divide) and within cities (the rich-poor divide). In this series of papers, we demonstrate that urban planning and design and urban social conditions can be good or bad for human health and health equity depending on how they are set up. We argue that climate change mitigation and adaptation need to go hand-in-hand with efforts to achieve health equity through action in the social determinants. And we highlight how different forms of governance can shape agendas, policies, and programs in ways that are inclusive and health-promoting or perpetuate social exclusion, inequitable distribution of resources, and the inequities in health associated with that. While today we can describe many of the features of a healthy and sustainable city, and the governance and planning processes needed to achieve these ends, there is still much to learn, especially with respect to tailoring these concepts and applying them in the cities of lower- and middle-income countries. By outlining an integrated research agenda, we aim to assist researchers, policy makers, service providers, and funding bodies/donors to better support, coordinate, and undertake research that is organized around a conceptual framework that positions health, equity, and sustainability as central policy goals for urban management.
城市生活是世界上大多数人口的新现实。城市变化是在经济全球化、气候变化、金融危机、能源和粮食安全、新旧武装冲突以及传染性和非传染性疾病模式变化等其他全球挑战的背景下发生的。在基础设施和卫生系统准备程度不同的国家，这些卫生和社会问题对 21 世纪的发展构成了重大挑战。在所有国家，无论贫富，向城市生活的转移对人口健康既有利也有弊，并导致了国家内部（城乡差距）和城市内部（贫富差距）健康的不平等分配。在本系列论文中，我们表明，城市规划和设计以及城市社会条件对人类健康和健康公平可能有利也可能不利，具体取决于其设置方式。我们认为，气候变化缓解和适应需要与通过社会决定因素中的行动实现健康公平的努力齐头并进。我们强调了不同形式的治理如何以包容和促进健康的方式塑造议程、政策和方案，或者使社会排斥、资源分配不均以及与这种情况相关的健康不平等现象永久化。虽然今天我们可以描述一个健康和可持续城市的许多特征，以及实现这些目标所需的治理和规划过程，但仍有许多需要学习，特别是在针对这些概念并将其应用于中低收入国家的城市方面。通过概述一个综合的研究议程，我们旨在帮助研究人员、政策制定者、服务提供者和供资机构/捐助者更好地支持、协调和开展研究，这些研究围绕着一个概念框架组织，该框架将健康、公平和可持续性作为城市管理的核心政策目标。
