5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |1 | Urban Health Equity Assessment and Response Tool – Urban HEART Urban Health Equity Assessment and Response Tool – Urban HEART Megumi Kano, DrPH WHO Centre for Health Development

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |2 | Overview 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 WHO Campaign Year for Urbanization and Health

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |3 | WHO Kobe Centre and Urban Health Equity WHO lead for initiatives on urban health equity 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

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |4 | Programme Areas Urbanization and Health Equity Health Governance Climate Change and Emergency Preparedness Health Equity Impact Assessment Urban HEART

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |5 | What is Urban HEART? User-friendly guide to identify health inequities and develop an action plan Assessment component Response component National government Target audiences Mayors, local authorities

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |6 | 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

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |7 | Six Steps of Urban HEART STEP 1 Build inter- sectoral team STEP 1 Build inter- sectoral team STEP 2 Define local indicators STEP 2 Define local indicators STEP 3 Data collection STEP 3 Data collection STEP 4 Data analysis STEP 4 Data analysis STEP 5 Identify responses STEP 5 Identify responses STEP 6 Prioritize relevant responses STEP 6 Prioritize relevant responses

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |8 | Urban HEART Core Indicators

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April |9 | Health Equity Assessment

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

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April | Health Equity Response Example 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 Strategy A: Urban planning Strategy A: Urban planning Strategy B: Primary health care Strategy B: Primary health care Strategy C: Health equity focus Strategy C: Health equity focus Strategy D: Local agenda Strategy D: Local agenda Strategy E: National agenda Strategy E: National agenda Prioritize an issue based on Assessment Designate tobacco-free areas in the community Create a smoke-free city Put tobacco control higher on the national agenda

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April | Prioritizing Responses UnfeasibleFeasible Acceptable by affected communities Achievable within a timeframe Likely to reduce inequity Complies with national priorities Unlikely to be cost-effective Insufficient local resources

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

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April | Air Quality Assessment Ulaanbaatar, Mongolia District %+ 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%

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April | Safe Water and Solid Waste Removal Guarulhos, Brazil Access to Safe WaterSolid Waste Removal Services Coverage

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April | Social Gradient in Access to Sanitation Jakarta, Indonesia

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

5 th International Academic Conference on Environmental and Occupational Medicine Dujiangyan, Chengdu, People’s Republic of China, 7-10 April | 2010 WHO Campaign Urbanization and Health 7 April - World Health Day Global Report – “Hidden Cities” November - Global Forum