Trojan Alf, Fehr Rainer
Institut für Medizinische Soziologie, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Deutschland.
Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2020 Aug;63(8):953-961. doi: 10.1007/s00103-020-03187-8.
The interactions between cities/settlements and health have been an issue of discussion since antiquity. Since the late 1970s, there has been renewed interest in the role of nonmedical determinants of health. This paper aims to retrace the development of relevant new concepts during the last 40 years, clarify their mutual relationships, and from this background present the concept of sustainable urban health. For this purpose, a secondary analysis is conducted and relevant documents and literature are being interpreted.After an introduction using illustrative examples of urban health, the paper describes how the WHO has provided crucial input to a renewed debate on public health since the 1970s, based on concepts such as "multi-/intersectoral action," "healthy public policy," and "health in all policies." Sustainable urban health, tying in with this tradition, is characterized as a program of expanding the horizon and of building bridges between disciplines and societal sectors. This is exemplified by a local initiative in the city of Hamburg.Rather than being substantially different, the WHO concepts may be seen as representing various shades of emphasis. Health in all policies (HiAPs) are in line with the UN Declaration of Human Rights and the UN Sustainable Development Goals; the concept succeeded in being integrated into both WHO and EU policy making. Additional work is required for the sustainable urban health goal to synchronously promote health and sustainability in urban societies.
城市/定居点与健康之间的相互作用自古以来就是一个讨论的话题。自20世纪70年代末以来，人们对健康的非医学决定因素的作用重新产生了兴趣。本文旨在追溯过去40年中相关新概念的发展，阐明它们之间的相互关系，并在此背景下提出可持续城市健康的概念。为此，进行了二次分析，并对相关文件和文献进行了解读。在通过城市健康的实例进行介绍之后，本文描述了自20世纪70年代以来，世界卫生组织（WHO）如何基于“多部门/跨部门行动”、“健康公共政策”和“所有政策中的健康”等概念，为重新开展的公共卫生辩论提供了关键投入。与这一传统相契合的可持续城市健康，其特点是一个拓展视野、在各学科和社会部门之间架起桥梁的计划。汉堡市的一项地方倡议就是一个例证。世界卫生组织的这些概念并非有本质区别，而可被视为代表了不同程度的侧重点。所有政策中的健康（HiAPs）符合《联合国人权宣言》和联合国可持续发展目标；这一概念已成功纳入世界卫生组织和欧盟的政策制定过程。要实现可持续城市健康目标，在城市社会中同步促进健康和可持续性，还需要开展更多工作。
