1. URBACT II Building Healthy Communities 1 st Steering Group Meeting Brussels, 9-10 June 2008 An overview

2. Health … Unravelling health and its links with everyday life is a complex and taxing challenge. Is there a limit to understanding health issues? Where do the boundaries lie? At what point does a health problem become a social problem? An economic problem? The more closely the issue of health is examined, the more complicated and multifaceted it becomes… (from the Urb Health Workshop held in Torino, in November 2007)

3. Health and the City In 2007 Urb Health, a thematic network of the URBACT I phase ended. During the last trans-national meeting, policy-makers, professionals, researchers, members of NGOs and EU institutions - among the others - discussed of the needs and challenges that cities are facing as regards health and quality of life. They recognized that : health in cities is related to quality of life; healthy cities are places where attention is paid to equality, lifestyles, diversity and the interrelations among the different levels of government involved, not least the EU level; more efforts should be made to tackle this issue and a specific attention should be paid to the implementation of actions/projects/programmes that aims to create healthy communities.

4. The vast majority of the population (nearly 80%) in Europe lives in cities. Any development strategy that does not take into account the urban dimension is outdated. As stated in the Leipzig Charter (2007): All dimensions of sustainable development should be taken into account at the same time and with the same weight. These include economic prosperity, social balance and a healthy environment. At the same time attention should be paid to cultural and health aspects. The focus on the urban dimension

5. Health inequalities in cities tend to become more evident and important, thus affecting the degree of quality of life and the general economic conditions. Health inequalities, besides, are becoming more and more concentrated in terms of physical parts of the cities and … in terms of specific groups of the population. Lifestyles are heavily influenced by socio-economic factors that produces health inequalities (in terms of equal access to health services, of availability of the same services, of target focused services). Health inequalities in cities

6. There is a clear link between lifestyle and health, since there are links among health, poverty, socio- economic context and social capital. Yet lifestyle is influenced by health determinants which shape the (lack of) choices available to everyone in everyday life. The wider social, cultural, political and economic environment in which people live need to be changed, so that healthy choices can become the easiest choices. Health and lifestyle

7. Health is important for the wellbeing of individuals and of the society as a whole. In the case of urban areas, this social importance of health is directly linked to the importance of health as a key factor for economic growth, as recognized in the Community Health Strategy Together for Health: A Strategic Approach for the EU 2008-2013. There is a direct link between health and competitiveness in cities and this link is related to territorial cohesion, whose objective is to achieve a more balanced development by reducing existing disparities, avoiding territorial imbalances, and by making both sectoral policies with significant spatial impacts and regional policy more coherent (Territorial Agenda, 2007). Competitiveness + Cohesion = Health

8. There is a limited awareness of the contributions that a healthy urban policy can make to tackle the issue of an equal and balanced development. This limited awareness is mostly due to three weaknesses: - health policies are often developed without explicit and effective connections to other urban policies; - there is not a widespread culture of assessment of the impact of urban policies on health and viceversa; - there is an objective difficulty in linking needs and priorities in the health sphere that refers to different institutional levels. A challenge

9. To answer to the challenge, BHC has been designed around three main themes. The themes are: 1. The use of the Health Impact Assessment and the definition of a set of urban health indicators; 2. The implementation of policies and actions for an active and healthy ageing; 3. The definition of policies for healthy places with an healthy environment. A strategy

10. There is, besides, a transversal issue that regards the capacity to use the Structural Funds in designing actions to develop health gains. This issue is fundamental, since it refers to the role of the Managing Authorities in co-designing development strategies for cities in which health (both in the medical and in the quality of life sense) becomes a key factor. A transversal issue

11. Definition of a new framework for sustainable policies in cities Consolidation of a cooperative methodology among public and private actors at different territorial levels Introduction of the health factor in development programmes in cities and regions The stakes

12. Good luck and thank you! Marco Santangelo BHC Lead Expert marco.santangelo@gmail.com