5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20101 |

Urban Health Equity Assessment and Response Tool

– Urban HEART

Urban Health Equity Assessment and Response Tool

– Urban HEART

Megumi Kano, DrPHWHO Centre for Health Development

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20102 |

OverviewOverview

WHO Kobe Centre and its urban health equity agenda

Urban HEART– The tool and its development– Case examples from pilot study sites– Dissemination and scale-up plan for 2010-2011

WHO Campaign Year for Urbanization and Health

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20103 |

WHO Kobe Centre and Urban Health EquityWHO Kobe Centre and Urban Health Equity

WHO lead for initiatives on urban health equity

2005-07 Hub of the Knowledge Network on Urban Settings

2008 Report to the Commission on Social Determinants of Health

2010 Leading the WHO Campaign for Urban Health

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20104 |

Programme AreasProgramme Areas

Urban HEART

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20105 |

What is Urban HEART?What is Urban HEART?

User-friendly guide to identify health inequities and develop an action planUser-friendly guide to identify health inequities and develop an action plan

Assessment componentAssessment component

Response componentResponse component

National government

National government

Target audiencesTarget audiences

Mayors, local authorities

Mayors, local authorities

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20106 |

Why use Urban HEART?Why use Urban HEART?

Urban HEART has primarily been used as a planning tool for decision-makers at national and local levels to:

– Assess and monitor inequities in urban health outcomes

and social determinants

– Identify viable and effective actions to optimize urban

health and reduce inequities

– Determine priorities and plan for resource allocation

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20107 |

Six Steps of Urban HEARTSix Steps of Urban HEART

STEP 1

Build inter-sectoral team

STEP 2

Define local

indicators

STEP 3

Data collection

STEP 4

Data analysis

STEP 5

Identify responses

STEP 6

Prioritizerelevant

responses

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20108 |

Urban HEART Core IndicatorsUrban HEART Core Indicators

Health outcomes

Infant mortality

Diabetes

Tuberculosis

Road traffic injuries

Physical environment & infrastructure

Access to safe water

Access to improved sanitation

Social and human

development

Completion of primary

education

Skilled birth attendance

Fully immunized

children

Prevalence of tobacco smoking

Economics

Unemployment

Governance

Government spending on

health

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 20109 |

Health Equity AssessmentHealth Equity Assessment

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201010 |

Health Equity MonitoringHealth Equity Monitoring

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20

30

40

50

60

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Urban average

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201011 |

Health Equity ResponseExample of tobacco control

Health Equity ResponseExample of tobacco control

Prevalence of tobacco smoking

&

Second-hand smoke

exposure

Prevalence of tobacco smoking

&

Second-hand smoke

exposure

Policy domain: Social and

human development

Policy domain: Social and

human development

Strategy A: Urban planningStrategy A: Urban planning

Strategy B:Primary health careStrategy B:Primary health care

Strategy C:Health equity focusStrategy C:Health equity focus

Strategy D:Local agendaStrategy D:Local agenda

Strategy E: National agendaStrategy E: National agenda

Prioritize an issue based on

AssessmentDesignate tobacco-free areas in the communityDesignate tobacco-free areas in the community

Create a smoke-free cityCreate a smoke-free city

Put tobacco control higher on the national agenda

Put tobacco control higher on the national agenda

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201012 |

Prioritizing ResponsesPrioritizing Responses

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201013 |

Urban HEART Pilot SitesUrban HEART Pilot Sites

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201014 |

Air Quality AssessmentUlaanbaatar, Mongolia

Air Quality AssessmentUlaanbaatar, Mongolia

District200020012002200320042005200620072008

1+ 20%+ 1%N/A- 17%- 36%-12%- 8%- 71%- 29%

2- 7%+ 35%+ 15%+ 27%+ 70%+ 55%+ 75%+ 41% + 58%

3- 58%- 35%N/A- 32%+ 23%+ 26%- 1%- 3%+ 123%

4- 15%- 12%+ 20%+ 27%+ 66%+ 105%+ 79%+ 62%+ 75%

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201015 |

Safe Water and Solid Waste RemovalGuarulhos, Brazil

Safe Water and Solid Waste RemovalGuarulhos, Brazil

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201016 |

Social Gradient in Access to SanitationJakarta, Indonesia

Social Gradient in Access to SanitationJakarta, Indonesia

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201017 |

Dissemination and Scale-upDissemination and Scale-up

Policy Brief, Tool Document and User Manual

Pilot study reports and evaluation

Training workshops in additional countries

Urban HEART website

Urban Health Equity Metrics development

Continuous improvement …

5th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April 201018 |

2010 WHO Campaign

Urbanization and Health2010 WHO Campaign

Urbanization and Health

7 April - World Health Day

Global Report – “Hidden Cities”

15-17 November - Global Forum