City-level interventions: projects

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Complete Streets (extract) 

Complete Street policies balance people’s needs and safety across all forms of transportation, including walking, biking, public transit and cars. From street lighting to bike lanes to crosswalks, these policies ensure that all residents have safe, convenient ways of getting around and staying active – regardless of their age or ability.

Complete Streets policies allow city residents to safely walk, bike, drive or take public transit around their community. They keep buses and trains running on time, reduce traffic congestion, and make sure kids have safe routes to school. Done right, these policies have a range of benefits for cities, from community safety to connectedness, improved health to reduced stress and economic well-being.

Complete Streets encourage an active lifestyle by creating opportunities to integrate exercise into daily activities, thereby helping to reduce the risk of obesity and its associated health problems, which include diabetes, heart disease, high blood pressure, high cholesterols, as well as certain cancers, stroke, asthma, and depression. Some study show walkability improvements are associated with lower body mass indexes (BMIs) among children.

Click here to read about the full projects! 

Amsterdam Healthy Weight Programme (extract)

Priority areas:

  1. No longer an unhealthy growth environment for children in Amsterdam
  2. Staying normative and acting even more firmly on that
  3. The Amsterdam Health Weight Programme (AHWP) as a (inter)national standard
  4. Refinement of the (implementation of the) programme itself.

The mission and strategy of the AHWP are in the motto:
Mission, the ideal scenario:
For all of Amsterdam’s children’s to have a healthy weight in 2033
and
No child in Amsterdam will have an unhealthy upbringing

Vision:
A healthy weight is a collective responsibility and the healthy choice is the normal choice

Strategy:
Healthier behaviour in a healthier environment
Removing unhealthy factors from children’s living environment

Click here to learn more about rhe Amsterdam Healthy Weight Programme! 

Eat Well Be Active (extract)

The aim of the strategy is to increase the proportion of South Australians who eat a healthy diet, undertake regular physical activity and maintain healthy weight.

What does the strategy set out to achieve?

  • Mobilise the community to take action to promote healthy eating and physical activity, and publicly recognise achievements.
  • Ensure the places where we live, learn, work, eat, play and shop make it easy for children and adults to be active and eat a healthy diet, including breastfeeding.
  • Implement policies to improve the built, social and natural environments that support South Australians to eat well and be active.
  • Provide information, programs, and services to assist people throughout life to be more active, eat a healthy diet and maintain a healthy weight, with particular attention to those most in need.
  • Ensure that we have in place supports such as strong partnerships, leadership, good communication and workforce planning as well as evaluation and good governance.

Click here to learn more about the Eat Well Be Active Strategy for South Australia 2011-2016. 

The APPLE Project (extract)

Purpose of the APPLE Project:
Prevent excessive weight gain in 5-12 year old children by enhancing opportunities for healthy eating and non-curricular physical activity.

The APPLE project was designed to concentrate on approaches that would not involve an increased workload for teachers, but use the schools as a physical base for community interventions. The main intervention in both years was the provision of community activity coordinators attached to each intervention school. The main role was to encourage all children to be a little more physically active every day by increasing the variety and opportunities for physical activity beyond that which was currently provided in each school. They were used to increase non-curricular activity at recess, lunchtimes, and after school, with a particular focus on less traditional sports and more lifestyle-based activities such as outdoor games, household chores, gardening, beach hikes, and children’s games from different countries.

Click here to learn about the APPLE Project. 

Shape Up Somerville (extract)

Shape Up Somerville builds healthy, equitable communities in Somerville through interdisciplinary partnerships, programming, and policies related to food systems and active living. Shape Up Somerville is international recognised for this work. We are completing a comprehensive food system assessment to guide future food access work and strengthening physical activity partnerships.

Shape Up Somerville began in 2002 as a CDC-funded research study led by Somerville community members, Tufts University, Somerville Schools and Cambridge Health Alliance, with the goal of preventing obesity in 1st through 3rd graders through environmental changes. The researchers found that environmental changes like adding bike lanes, helping restaurants offer healthier options, and updating school lunches made a difference in preventing childhood obesity. Following the 3-year study, Shape Up Somerville was adopted by the City of Somerville and with generous multi-year grant funding, we have been able to expand our efforts to a city-wide focus.

Today, Shape Up Somerville works with a wide variety of local organisations and municipal departments continue improving the city’s culture of health. For example, Shape Up Somerville and the Cambridge Health Alliance are currently leading the charge to complete a city-wide food system assessment: a study of where people get food, how they get there, and what barriers there are to having enough health-promoting food. With this information, Shape Up Somerville and our local partners can work together to fill those gaps and break down those barriers.

Click here to learn more about Shape Up Somerville. 

Healthy Cities Network (extract)

WHO Healthy Cities is a global movement working to put health high on the social, economic and political agenda of city governments. For 30 years the WHO European Healthy Cities Network has brought together some 100 flagship cities and approximately 30 national networks. The flagship cities interact directly with WHO/Europe, while the national networks bring together cities in a given Member State. In both cases, WHO provides political, strategic and technical support as well as capacity-building. Together the flagship cities and national networks cover some 1400 municipalities. Their shared goal is to engage local governments in political commitment, institutional change, capacity-building, partnership-based planning and innovation.     

A healthy city is defined by a process, not an outcome:

  • A healthy city is not one that has achieved a particular health status.
  • It is conscious of health and striving to improve it. Thus any city can be a healthy city, regardless of its current health status.
  • The requirements are: a commitment to health and a process and structure to achieve it.
  • A healthy city is one that continually creates and improves its physical and social environments and expands the community resources that enable people to mutually support each other in performing all the functions of life and developing to their maximum potential.
  • WHO/Europe recommends a basic model for a healthy city.

The WHO European Healthy Cities Network has six strategic goals:

  1. to promote policies and action for health and sustainable development at the local level and across the WHO European Region, with an emphasis on the determinants of health, people living in poverty and the needs of vulnerable groups;
  2. to strengthen the national standing of Healthy Cities in the context of policies for health development, public health and urban regeneration with emphasis on national–local cooperation;
  3. to generate policy and practice expertise, good evidence, knowledge and methods that can be used to promote health in all cities in the Region;
  4. to promote solidarity, cooperation and working links between European cities and networks and with cities and networks participating in the Healthy Cities movement;
  5. to play an active role in advocating for health at the European and global levels through partnerships with other agencies concerned with urban issues and networks of local authorities; and
  6. to increase the accessibility of the WHO European Network to all Member States in the European Region.

Key documents to the Healthy Cities Network:

London Obesity Programme (extract)

The Mayor’s London Obesity Programme, originally funded for three years in 2013 (MD 1151), represents the Mayor’s contribution to a whole-system approach to reducing obesity in the capital. The programme includes the Mayor’s Healthy Schools London (HSL) programme as well as specialist public health input into pan-London transport and spatial planning strategies.

Healthy Schools London

  • The HSL programme aims to contribute to reducing levels of childhood overweight obesity in London from current levels of 37% of 10-11 year olds to 25% of 10-11 year olds by 2025.
  • The HSL programme is based on a proven methodology by which schools can become healthier place for children to spend time. This means:
    • The food available in school becomes healthier and more attractive
    • Children learn more about healthy eating and where food comes from
    • Children have more opportunities to be active at school and on the way to school
    • Children take this knowledge home to their families and siblings
    • Inactive school children (and their parents) are made active through increased PE and increase walking and cycling to schools
    • Schools foster holistic health to better support healthy weight

Healthier Environment

  • The London Obesity Programme supports a healthier environment for Londoners through the integration of public health in pan-London transport and spatial planning strategies
  • The programme provides specialist resource to enable delivery of the following:
    • Influencing planning guidance to enable boroughs to make health enhancing planning decisions.
    • Ensuring that plans from developers make the most of their potential to improve the health of Londoners – by providing expert public health advice and scrutiny of major planning applications.
    • Working closely with TfL, using public health expertise to ensure that TfL’s strategies and investments explicitly support Londoners to be more physically active.
    • Working with the environment team to ensure that the delivery of the Mayor’s commitment on Air Quality explicitly supports health outcomes of Londoners – by offering public health advice to delivery partners and working as a conduit to the borough based teams.
    • Tracking of London’s data on active travel levels against comparators from other World Cities.

Click here to learn more about the London Obesity Programme. 

Healthy Schools London (extract)

We all want to help London’s children stay healthy and happy as they grow up. In this context, what happens at school every day is really important.
Schools can help children lead a healthy lifestyle directly – to make healthy food choices at lunchtime, to be active at and on the way to school. More widely, schools can help children learn about their health, and develop their motivation and self respect to make healthy choices.
The benefits go beyond health. We know that when children are healthy and happy at school, they can achieve more.
So many schools in London are already doing great work to support their pupils to be healthier. Healthy Schools London is a new programme that will help schools to go further, and get more schools involved.
With our award scheme sponsored by the Mayor of London, we will recognise and celebrate schools that are making a difference for their pupils. By working together with our colleagues in London’s boroughs, we want to build a programme that schools are proud to be part of, and helps London’s children to be healthy, happy and achieve.
Taking part in Healthy Schools and working successfully for the tiered awards will enable schools to directly support the health and wellbeing of their pupils and staff.

An evaluation of the national programme on which HSL is based showed the following tangible outcomes:

  • Increased amount of opportunities that children and young people have to be physically active in and out of schools.
  • Increased participation of children and young people in physical activity in and out of school
  • Improved links between schools and communities that promote physical activity
  • Increased school meal uptake including free school meals
  • Improved children and young people’s access to healthy packed lunches and snacks throughout the school day.

The benefits go beyond health. Participating schools have also reported reduced incidence of bullying, improved behaviour and improved attendance. Headteachers have also said that they found the Healthy Schools Programme helpful as a general school improvement tool.

Key documents & resources:

Cities Changing Diabetes (extract)

Cities Changing Diabetes is a partnership programme initiated by Novo Nordisk in response to the urgent challenge caused by the dramatic rise of urban diabetes.

The world is rapidly urbanising, changing not just where we live, but the way we live. Today, the way cities are designed, built and run risks fuelling the health challenges of their citizens. Urban environments are already home to two-thirds of people with diabetes. This makes cities the front line in the fight against type 2 diabetes – and where we must take action to hold back the alarming rise of the condition. In 2014, three global partners, Steno Diabetes Center Copenhagen, University College London and Novo Nordisk, launched the Cities Changing Diabetes programme to accelerate the global fight against urban diabetes. Today, the programme has established local partnerships in 15 cities to address the social factors and cultural determinants that can increase type 2 diabetes vulnerability among certain people living in cities.

The Cities Changing Diabetes programme is currently active in 17 cities, representing more than 130 million citizens, at different stages of development. Each city contributes through its partnerships to establish a new knowledge base of the social factors and cultural determinants that make some people vulnerable to the development of type 2 diabetes and its complications in their city. The work in the study cities acts as a platform for the programme to grow globally. It provides a basis for connecting and understanding the challenge of urban diabetes, and for enabling and inspiring many more cities to join in the global fight against urban diabetes.

Key documents:​​​​​​

Partnership for Healthy Cities (extract)

Partnership for Healthy Cities is a prestigious global network of cities committed to saving lives by preventing noncommunicable diseases (NCDs) and injuries. Supported by Bloomberg Philanthropies in partnership with the World Health Organization and Vital Strategies, this initiative will enable cities around the world to deliver a high-impact policy or programmatic intervention to reduce NCD risk factors in their communities.

The Partnership for Healthy Cities is a network of 54 cities around the world.

The Partnership formally launched on 16 May 2017. Membership now stands at 54 cities, spanning from Cape Town to London, San Francisco to Ho Chi Minh City. Bloomberg Philanthropies, WHO and Vital Strategies are providing these cities with expert technical assistance, as needed; a $100,000 seed grant to support their activities; and communication support to bring visibility to the cities, to their Mayors and to cutting edge work in NCD and injury prevention.

Each city receives support to implement one of ten proven interventions to prevent noncommunicable diseases and injuries:

  • Create a smoke-free city
  • Ban tobacco advertising
  • Reduce sugar drink consumption
  • Healthy food for all
  • Create livable streets
  • Cleaner fuels for cleaner indoor air
  • Reduce drink driving
  • Reduce speeding
  • Increase seat-belt and helmet use
  • Monitor NCD risk factors

Specifically, cities that selected the Healthy Food for All intervention include:

  • Ouagadougou (Burkina Faso)
  • Bogotá (Colombia)
  • Cali (Colombia)
  • Medellín (Colombia)
  • Quito (Ecuador)
  • Lima (Peru)
  • Montevideo (Uruguay)

Cities that have selected to reduce sugar drink consumption include:

  • Quezon City (Philippines)
  • Cape Town (South Africa)
  • Seoul (South Korea)

Key documents: 

VIASANO (translated extract)

The VIASANO programme is currently present in 19 cities and communities around Belgium

Childhood obesity has become a major public health challenge in most developed countries as well as in developing countries. 60% of children will be overweight by adulthood. Overweight and obesity lead to a considerable increase in risks of non-communicable diseases such as cardiovascular diseases or diabetes, and decreased life expectancy. Given that treatment remains difficult, prevention is fundamental. To achieve it, it is essential to act on the global environment of the child and help families acquire healthy lifestyle habits, favouring a balanced nutrition and regular physical activity.

Methodology

The principle of the methodology of the VIASANO programme is to mobilise all local actors that gravitate around the family: schools, school restaurants, associations, sports clubs, play areas, after-schools programmes, health professionals, commercials… to help them modify their lifestyle and their environment in a profound and lasting manner.

VIASANO is based on official scientific recommendations and encourages families to adopt a balanced nutrition, as well as daily physical activity. Through macro-changes at the heart of professional practices, VIASANO aims to facilitate the adoption of new lifestyle routines and to stimulate individual and collective choices that favour health.

To allow families to modify, slowly their behaviours, VIASANO adopts the following philosophy:

  • The non-stigmatisation of people, behaviours and foods.
  • The acknowledgment of modern lifestyle behaviours
  • A positive, progressive and concrete approach focused on the enjoyment of eating, moving and partnership.

Results

VIASANO programme is evaluated on two levels:

  • Evolution of children’s BMI
  • Evaluation of mobilisation at the local level

Thao-Salud Infantil (translated extract)

The Thao-Salud Infantial programme is a childhood obesity prevention project developed in Spain in 2006 with the objectuive to halt the progression of childhood obesity, based on the experience of the EPODE programme initiated in France in 2004.

What is the Thao programme?

Thao-Salud Infantil is a childhood obesity prevention programme which aims to promote healthy lifestyles in the children population aged 0-12 years and their families. It is a programme based on community that is applied in municipalities, through the mobilisation of different local actors, from local authorities, educational centres, sport centres, markets, etc. to reach families.

The objective is to revert the growth tendency of childhood obesity through the promotion of healthy lifestyles in children aged 0-12 years within the community environment. It aims to influence the most important determinants of childhood obesity, through the promotion of a healthy and diverse nutrition, the promotion of regular physical activity, the stimulation of adequate resting habits and intervene in a transversal manner on psychological and emotion factors and social and family relations.

The municipal intervention is based on three axes: Actions, Evaluation and Communication

What makes Thao-Salud Infantil unique?

  • Municipal leadership
  • Transversality
  • Flexibility and creativity
  • Lifecourse approach
  • Network
  • Scientific support
  • Communication