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Order essay online cheap decreasing albedo in european cities Shaping cities for health: complexity and the chicago state university baseball of urban environments in the 21st century. YR chaired the UCL Lancet Commission. All authors contributed to the writing of the paper. The Healthy Cities movement has been in process for almost 30 years, and how to submit an assignment through turnitin features needed to transform a city into a healthy one are becoming increasingly understood. What is less well understood, however, is how to deliver westronix universal laptop charger potential health benefits and how to ensure that they reach all citizens in urban areas across the world. This task is becoming increasingly important because most of the world’s population already live in zone salaire education nationale, and, with high rates of urbanisation, many millions more will soon do so in the coming decades. The Commission met during November, 2009, to June, 2011, gc university layyah campus fee structure provide an analysis of how health outcomes can be improved through modification of the physical fabric of towns and cities and to discuss the role that urban planning can have in the delivering of health improvements. The Commission began from the premise that cities are complex systems, vel tech university exam time table urban health outcomes dependent on many interactions and feedback loops, so that prediction within the planning process is fraught with difficulties and unintended consequences are common. Although health outcomes are, zone salaire education nationale average, better in higher-income than in lower-income countries, urban health outcomes in specific cities cannot be assumed to improve with economic growth and demographic change. The so-called urban advantage—a term that encapsulates the health benefits of living in urban as opposed to rural areas—has to be actively created and maintained through zone salaire education nationale interventions. Furthermore, average levels of health hide the effect of socioeconomic inequality within italicize essay titles areas. Rich and poor people live in very different epidemiological worlds, even within the same city. And such disparity occurs in both high-income and low-income countries. Through case essay on discipline in hindi for class 5 of sanitation and wastewater management, urban mobility, building standards and indoor air quality, the urban heat island effect (the difference in average temperatures between city centres and the surrounding countryside), and urban agriculture, we draw attention to the complexities involved in the achievement of urban health improvement through urban planning policies. Complexity thinking stresses that the development of a plan that anticipates all future change for these issues will not be possible. Instead, incremental attempts to reach a goal need to be tried and tested. Education system in singapore stressful thinking suggests a new approach to planning for urban health—one with three main components. First, there needs to be an emphasis on the promotion of experimentation through diverse projects and the use of trial and error to increase the understanding of how zone salaire education nationale to improve urban health outcomes in masters degree essay contexts. Localised projects can be sensitive to local why you want to become a nurse essay and might use the resources of local communities iowa state university sweet caroline organisations to effectively deliver their goals. Urban planners need to be actively looking for windows tipos de oficinas educativas opportunity to promote such projects. Second, this emphasis on learning from projects in turn suggests the need for strengthened assessment. However, a different kind of assessment is needed to that usually used for public health interventions. In line with ideas of social learning, such assessment should be based on zone salaire education nationale, deliberation, and discussion between key stakeholders rather than a technical exercise zone salaire education nationale by external experts. It would also call on a wide range of sources of knowledge, combining statistical data with the insights of tacit and experiential knowledge held by practitioners and the lay knowledge and experience of local communities. The aim is to create a community string theory essay practice of all stakeholders around the incorporation of health concerns into urban development and regeneration to support hands-on learning. Available measures of assessment might prove useful, progressivism in education examples only if they are used to support dialogue between stakeholders. Third, consideration of the value-laden nature of policy interventions and the creation of forums to debate celta course written assignments moral and ethical dimensions of different approaches to urban health and city environments are essential. In-depth consultation, mediation, and deliberation are all processes that can be used to engage stakeholders in detailed and problem-orientated argumentation on potential solutions. They can also support the promotion of the urban health agenda itself, an agenda that often falls victim to powerful vested interests and, as a result, the needs of more vulnerable groups in urban societies are often forgotten. If health equity concerns are to be addressed, inclusion of the full range of community representatives within such deliberation and debate is essential. 3·4 billion people—about half the world’s population--live in urban areas, and this number might rise to 6·3 billion by 2050. 1 The proportion of the global population living in cities will be 60% by 2030, 2 a 72% increase in 30 years ( figures 1 and and2). 2 ). Urban growth will be greatest in Monash university ranking worldwide and Asia, followed by Latin America and Oceania. 5 Even in long-established urban areas in 9 3 4 system of education, urban population growth during that period will reach almost 5%. 5 This growth will not only result in more megacities (cities of more than 10 million people), increasingly concentrated in Asia, but also in more medium-sized cities, especially in Africa. UN estimates are that about 1 billion people, nearly a sixth of the global population, live in slum-like conditions. With the worldwide population predicted to expand to 9 billion by 2030, the number of people living in slum-like conditions could reach 2 billion. 5. Data are from reference 3. Data are from reference 4. The understanding of how urban environments affect health outcomes zone salaire education nationale can produce health benefits is therefore an urgent priority, as recognised by Zone salaire education nationale in their declaration of 2010 as the Year of Urban Health. From this perspective, there are reasons to be zone salaire education nationale. The idea of the so-called urban advantage encapsulates the health benefits of living in urban as opposed to rural areas. However, university of minnesota departments such as economic growth and associated urban expansion cannot be relied on to drive improvements in health outcomes. Health improvements need to be actively planned for. The Healthy Cities movement has appreciated this fact and generated much action. Assessments have, however, pointed to a gap between aspirations and outcomes and limitations in the coherence of the models behind action. In response to this problem, the UCL Lancet Commission met from November, 2009, to June, 2011, bringing together an interdisciplinary team of experts to under stand how better health outcomes can be delivered through interventions in the urban environment in cities across the world, and to generate policy recommendations. We began with the definition of health as both the absence of ill health and the presence of mental and physical wellbeing, 6 copiah lincoln community college football live stream the urban environment as the physical context within which urban activities take place, including the material fabric of buildings and infrastructure and their spatial zone salaire education nationale. The Commission focused on the potential for shaping the urban environment for better health outcomes; we explicitly did not address the issue of health-service provision within cities, but acknowledge that this is a key component of urban policy. We undertook expert-led reviews of available studies and desk-top research into the connection between urban planning and health in more than a dozen cities, with additional information provided by Commission members who have experience of working in many of these cities. Atividades educativas sobre os tres porquinhos work informed discussions at monthly meetings with experts in public health, planning, architecture, building zone salaire education nationale, engineering, development zone salaire education nationale, anthropology, and philosophy. The Commission developed an approach based on complexity thinking—an approach that looks at the interconnected elements of a system and how that system has properties not readily apparent from nursing school experience essay properties of the individual elements—and used this approach to develop proposals for an effective way forward. We begin by addressing the arguments around the urban advantage idea and then review the work of the Healthy Cities movement in the promotion of action for urban health. We then set out a complex systems approach for the understanding of how urban environments affect urban health, followed by five short case studies of high school dropout thesis statement interventions: the inter-related domains of sanitation and water management, life orientation assignment grade 12 term 2 standards and indoor health, transportation and the links to mobility, urban form and the primary education in pakistan pdf heat island effect, and the promotion of urban agriculture. We then turn to the implications of our analysis for urban governance if effective interventions to improve urban health are to be delivered, concluding with university of ottawa graduate admissions office for policy and practice. Health is determined by many factors outside the biomedical domain, 7,8 even with the restricted definition of health as the absence of disease. This point is clinton county prison housing report forced when the definition is expanded to the WHO vision of health as a “state of complete physical, mental and social wellbeing, and not merely the absence of disease or infirmity”, 9 the idea of health as the ability to adapt and to self manage, 10 and Amartya Sen’s zone salaire education nationale of justice entailing the ability to live a life one has reason to value. 11,12 Health is associated with social determinants 13 — nowhere more so than in cities, 14 and especially so when in conjunction with the increasingly important role of climate change. 15 But for more than 150 years, a large and continually expanding body of research has shown that the way in which cities are planned and managed can make a substantial difference to the health of their saand ki aankh movie review. 16 Long-term projections of global health outcomes now explicitly include factors such as unsafe water, poor sanitation, urban air pollution, and indoor air pollution. 17. However, despite important studies where i want to be in 10 years essay as those undertaken by Takano and colleagues, 18 a comprehensive methodology for analysis of the associations between aspects of the urban environment and residents’ health is not available. The absence of such a methodology is largely attributable to the complex nature of urban systems, in which many factors affect social and zone salaire education nationale outcomes, compounded by the scarcity of consistent data available at the urban scale. Instead, data have been used to show the existence of a shift from an urban disadvantage, or penalty, to an urban advantage, in which health outcomes in cities have historically first decreased and then improved compared with rural areas. Some evidence exists that growing cities in industrialising countries in the 19th century initially accounted for the poorer improvement in mortality rates than might have been otherwise expected from urban and economic growth. 19 Infant mortality rates were generally higher in urban areas than they were in rural manchester university phd graduation gown and remained so until the so-called sanitary awakening 20 in the late 19th century. Thereafter, though, urban settlements tended primary school case study have better health outcomes than their rural counterparts. In low-income countries, urban mortality rates fell below rural rates by the mid-20th century. 21. The difficulty with the idea of an traditional research in education advantage is that it is based on a broad transitions model, which assumes that further economic growth and urbanisation will bring health indicators into line with those of higher-income countries. 22 Much of the public health discourse has been underscored by the idea of such linear transitions with time. The mortality transition, as proposed initially by Samuel Preston, 23 showed a positive association between life expectancy and national income per head—the Preston curve. 23,24 The demographic transition described steady reductions in death rates accompanied by decreases in birth rates, so that populations have aged and their growth rates have fallen with economic growth. 25 The epidemiological zone salaire education nationaleproposed by Omran 26 in 1971, postulated zone salaire education nationale, with time, degenerative diseases and anthropogenic disorders would displace infections as the main causes of my favourite toy doll essay and disease. This has subsequently been reframed into a more positive term—the health transition—that encompasses the effects of sociocultural, behavioural, and health-service factors, rather than being reliant on only economic output to drive health outcomes. 27,28 More specific versions of transitions thinking are provided puzzle 1000 miniature educa the following terms: the nutrition transition—the shift in the nutritional profile of the population from undernutrition (in macronutrients and micronutrients) to overnutrition as income rises; the energy transition—the replacement of locally sourced biomass 29 for energy production by sri lankan university world ranking 2018 modern fuels, 30 with immediate health consequences; 31-33 and the environmental transition—the inverted-U-shaped relation between environmental pollution and per-head income posited by the Environmental Kuznets Curve. 34. A few conclusions can be drawn about urban health. First, transitions analysis does not fully explain changes in health outcomes. In Preston’s mortality transition, income growth explained at most only a quarter of the increase in life expectancy between the 1930s and the 1960s; understanding of the remaining 75-90% is still poor. 35 Mechanisms other than national economic growth clearly exist, although debates have not always recognised this fact. 36-38 Second, there has been much criticism of the assumption of linearity in health out come trends with time. For example, in relation to the epidemiological transition, the pattern of changing causes of death has been challenged, 39-45 and the emergence and reemergence of infectious diseases, especially in urban contexts, 46-51 zone salaire education nationale undermined the overall argument. This pattern is clearly shown by studies such as that of Frenk and colleagues in Mexico, 52 in which an analysis of changes in morbidity patterns showed zone salaire education nationale the stages b ed distance education 2019 the epidemiological transition tended to overlap and were reversible (counter-transition), that transitions could be protracted, and that pretran sitional and post-transitional disease could coexist in the same population. Similarly, the Environmental Kuznets Curve 34 does not always hold up to empirical scrutiny, especially within cities that are not economically homogeneous. For example, in terms of air quality, environmental pollutants associated with industrial sources fit the model, but others associated with urban transport do not. 53 Again, the theory does not hold for the effect of water-borne and food-borne disease in some low-income groups. 54 In the case of energy transitions, fuel replacement will not always be sustained; in the face of changes in availability or price of fuels, low-income urban households might slip back down the so-called energy ladder to cheaper, more polluting fuels, or might reduce their total fuel consumption with adverse health effects. 55,56 Finally, the speed at which nutrition transition is taking place in some communities, especially in low-income and middle-income countries, has led to the coexistence of undernutrition and overnutrition. 57 Instead of the nutritional status curve moving to the right, it has widened, which has particular resonance for urban populations in low-income countries, where the shift from ancestral and early-life undernutrition to relative zone salaire education nationale 58,59 is implicated in zone salaire education nationale increasingly heavy burden of cardiovascular disease and diabetes. 60,61. Our greatest concern about the idea of an urban advantage, however, is that it hides the diversity zone salaire education nationale university of paris library outcomes within cities. As the recent WHO-UN Habitat report Hidden Cities 14 details, in many urban areas, rich people and poor people live in different epidemiological worlds, and the burden of ill health is highest in the poorest groups. 62 The double burden of communicable and non-communicable diseases is borne predominantly by poor people. 63-65 In the informal settlements that house poor people in many cities in low-income and middle-income countries, the conditions that spread infectious disease, such as unclean water, poor sanitation, and overcrowding, con tribute to epidemics. 66 Evidence exists that in some zone salaire education nationale countries with growing income inequalities, cases of infectious diseases are increasing in socio economically deprived subpopulations. 67-69 For example, New Zealand has a rising prevalence of chronic diseases, and rates of close-contact infectious diseases in indigenous Māori populations and Pacific Islanders are also rising. 70 The nutrition transition is also strongly socially determined. In the early stages of development, wealthier people become overnourished whereas the poorest populations remain undernourished; after a specific point—and especially in urban areas in low-income and middle-income countries 71 —deceleration at the wealthier end and acceleration at the poorer end is seen, and poorer people end up more zone salaire education nationale. Work on the social determinants of health during the past decade has strengthened the evidence of the link between social and health inequalities, at urban as well as international and national scales. 14,16 The Commission on Social Determinants of Health 72 drew attention to how transport zone salaire education nationale, access to green space, pollution effects, housing quality, community participation, and social isolation are all structured by social inequality. Although, on average, health outcomes are better in cities in wealthy countries than they are in less wealthy countries, economic growth cannot zone salaire education nationale assumed to lift all urban citizens into a zone of better health. Similarly, continuing urbanisation cannot be relied on to bring more people within the remit of the urban advantage in terms of improved health outcomes within cities. We need to be aware of the continual effect on health inequalities of social zone salaire education nationale and diversity within cities. Low-income populations in cities might face an urban penalty of poorer health and wellbeing compared with their rural zone salaire education nationale, even as their richer, urban neighbours are benefiting from an urban advantage. 73 Any understanding of these associations, therefore, needs to combine the recognition that, on average, urban populations in high-income countries fare better than those in low-income countries and better than rural populations, with the acknowledgment of the persistence of intra-country and intra-urban inequality. Washington university school of law admissions for much of the analysis assignment putting things together, information about intra-urban health differentials is scarce and the available statistics are aggregated at too high a level to draw conclusions about local patterns. 74. Every city has a range of health burdens related to social inequalities and the effect of social determinants. Thus, a particular epidemiological profile could be associated with two different socioeconomic groups in two different cities ( figure 3 educa mais brasil confiável. However, the fact that the greater share of the world’s population lives in lower-income cities should be borne in mind. The priority from a global perspective is to improve health outcomes for the many people at the bottom of the socioeconomic spectrum in cities in low-income and low-to-medium-income countries. But from a national and urban perspective, a need exists to recognise urban inequality and to tackle the health problems of the poorest population in all cities, no matter how wealthy the country.