1. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region WP 1 – Integrating health considerations into spatial planning and development A discussion paper for the HEPRO kick-off meeting in Turku To make health objectives central to the decision making process and train key staff in using “the Health Planning Circle” Coordinator Heini Parkkunen

2. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Planned results of WP1 Increased competence (including skills, knowledge, attitudes) among a significant number of participants about the impacts that spatial health planning can have on human health, well- being and quality of life in BSR. 80% of the participants think that the training was very useful in their professional jobs. All should confirm that they have increased knowledge about good public health and new approaches that work. Outputs of the WP1: All regional and local authorities will show how to integrate health considerations into spatial planning processes. Produce a report on the living and social conditions of the citizens within the partnership. Deliver one training pack.

3. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Content of the paper About City Health Development Plan The principles of spatial planning and development Planning Circle The Evaluation in WP 1

4. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region questionnaire and data WP 1 -process The integration of health considerations into spatial planning and development What must be taken into account when aiming at integrating health into spatial planning and development?

5. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region About City Health Development Plan

6. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Determinants of health by European Commission and WHO According to European Commission’s Health and Consumer Protection Directorate-General health determinants can be categorised as: According to WHO’s publication ‘The solid facts: social determinants of health’ social determinants of health can be categorised as: 1) personal behaviour and lifestyles; influences within communities which can sustain or damage health; 2) living and working conditions and access to health services; and 3) general socio-economic, cultural and environmental conditions. (Source: Health Determinants) 1) the social gradient, 2) stress, 3) early life, 4) social exclusion, 5) work, 6) unemployment, 7) social support, 8) addiction, 9) food, and 10) transport. (Source: Wilkinson, R. & Marmot, M. (eds.) 2003. )

7. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region The principles of spatial planning and development

8. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region The principles of spatial planning and development according to HEPRO project plan Governance bottom-up empowerment Strategic planning / Communicative planning intersectoral action participation engagement

9. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Planning Circle

10. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Attention Insight/ knowledge Basis and Structure Implementation Documentation Evaluation Foundations A vision Managing the process Collecting data Setting priorities Developing strategies Drafting the plan Implementation and monitoring The HEPRO circle for a sustainable public health policy A planning circle based on a seven-step model for city health planning by WHO Planning Circle

11. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region POLICY DEVELOPMENT Attention and foundations Identification of the present situation A vision Strong political base and commitment Partnership, intersectoral action “At its best the vision is the clear and exact picture of the future, but it can also be an unclear and dreamful idea in the mind of the leaders and managers. Vision is more than a goal. It cannot be evinced only by numbers. Coherent, logical and real vision helps organisations to understand what changes are necessary. At its best the vision creates tension between present and future by detecting problems and guiding strategies. At its worst the vision can be the list of truisms.” (Source: Sotarauta, M.)

12. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region POLICY DEVELOPMENT Managing the process Management Steering group Collecting data a data gives the picture of health and well-being; and health and well-being needs in communities WP 2 – develop an interregional tool for local health profiles

13. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region POLICY DEVELOPMENT Setting priorities the health profiling and the assessment of needs of the community produce a wide variety of information very difficult task because many forces are competing for increased budgets and time the goal is to reach a consensus on the priorities (themes of the plan) Developing strategies Strategy can be seen as a story, which shows the willingness and values of the city or organisation. It shows targets what the city or the organisation reach for and matters that the city or the organisation does not want to happen.

14. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Guidelines for Developing Strategies The issue should be thoroughly understood. It may be that some extra time is needed to explore the context surrounding the issue such as current policies, attitudes of key players and social factors. There should be a clear understanding of the characteristics of the target groups for the strategic interventions, including issues of age, gender, culture and their attitudes and beliefs about the issue. Research should be conducted into current strategies (to avoid duplication) and those that have been previously successful. The strategies should be achievable but not at the expense of discarding challenging strategies for the sake of easily achievable ones. Strategies should provide “early wins” (short-term achievements) so that both the local government and the community can see the efficacy of the time spent in planning. Strategies may include formalizing an already existing process and giving it direction. Source: adapted from The local Agenda 21 planning guide: an introduction to sustainable development planning. (Source: The local Agenda 21 planning guide: an introduction to sustainable development planning.)

15. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region POLICY DEVELOPMENT Drafting the plan according to the WHO Healthy Cities Project Office suggest the CHP (City Health Plan) contains the following information: –the political status of the plan; –the process of developing the plan; –the principles on which the plan is based; –the findings of the health assessment based on the health profile; –the background of and relationships with previous policy –and legislation; –priorities chosen, and the reasons, methods and criteria used; –the strategic aims, including targets; –the plans and action to be carried out by each sector and level of –government; and –follow-up and the process for monitoring, evaluation and review –the links between the health plan and other city plans should be shown

16. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region CARRYING OUT THE POLICY Implementation The plan is as good as its implementation! The first stage in getting the plan implemented in city organisations is to get it accepted as policy

17. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region RESULTS Monitoring and documentation Regular information-sharing reinforces interests and commitment to the plan a regular feedback to and from a community/ city Evaluation essential because of many reasons –it points successes and failures, allowing successes to be replicated and failures to be modified –it provides actors involved in the process with information that supports their continuing involvement –it creates the basis for further development and change  indicators should be useful when figuring the short and long term results of the plan: the change in the wellbeing of the community

18. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region The evaluation in WP1

19. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region The Evaluation How the planned results of WP1 are reached? How the cities have succeeded to integrate health considerations into spatial planning? OR A tool to the cities how to monitor/ evaluate the results of the integration process/ strategies.

20. WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region Sources City health planning and sustainable development. 1997. WHO, Regional Office for Europe, Centre for Urban Health. EUR/ICP/POLC 06 03 05B – European Sustainable Development and Health Series: 2. URL: http://www.who.dk/document/wa38097ci.pdf. Read 1.11.2005.http://www.who.dk/document/wa38097ci.pdf A working tool on city health development planning; concept, process, structure and content. 2001. WHO, Regional Office for Europe, Centre for Urban Health. March 2001. Health Determinants. European Commission, Health and Consumer Protection Directorate- General, Public Health. URL: http://europa.eu.int/comm/health/ph_determinants/healthdeterminants_en.htm. Read 26.10.2005 Wilkinson, R. & Marmot, M. (eds.) 2003. The solid facts: social determinants of health. URL: http://www.who.dk/document/e81384.pdf. Read 26.10.2005 http://www.who.dk/document/e81384.pdf Sotarauta, Markku. Verkostojen ja strategioiden utopia ja arki. University of Tampere. URL: http://www.uta.fi/~atmaso/verkkokirjasto/strategia%20ja%20verkosto.pdf. Read 1.11.2005. http://www.uta.fi/~atmaso/verkkokirjasto/strategia%20ja%20verkosto.pdf