Introduction to Healthy City and Healthy School

There is a paradigm shift of public health intervention from addressing the devastating effects of the living and working conditions on population health to the modification of health risk behaviours and build up the personal, cognitive and social skills which determine the ability of the individuals to gain access to, understand and make use of the information to promote and maintain good health. In many countries, there is a well-structured health care system to address diseases and illnesses but there is NO system addressing health particularly on promotion of positive health. Healthy Setting is a value based approach which has the ability of translation into language to fit the context of the particular setting. It can balance the long term community development with short term goals, and combining the top-down management with bottom up engagement and empowerment. The concept of Healthy Setting is evolution from Ottawa Charter for Healthy by building healthy public policy, re-orientation of health services, strengthening community actions, building up personal health skills and health advocacy. Setting approach does not only recognise the contextual issue but also argues for investment in social systems in which people spend their daily lives.

Healthy setting aims to improve health literacy of the community. It needs to shift from experts telling people what to do, to an approach that equips people with knowledge and skills to make their own decision. Healthy setting helps to build up a social culture and norm for health. The positive culture for health would facilitate higher level of health literacy within the communities leading to a collective deeper understanding of social, environmental, organizational and political factors that impact on health. Community members are likely to be more empowered to engage in debates around local health issues, and more enabled to collaborate with others in advocating for change at community and government level.

People live in a risk society, with increasing ecological and socioeconomic risks (e.g., increasing health inequalities) and with increasing individualization. There has been increasing emphasis to study the importance of socio-political and economic determinants of health. An ecological model of health promotion is needed with complex interaction of environmental, organisational, and personal factors. Apart from evidence-based medicine, it is obvious that we need contextual evidence to enhance quality health care, and only healthy setting research can provide this evidence. This research will have to be interdisciplinary, involving such disciplines as psychology, sociology, and anthropology, and will make use of qualitative research methods.

The Declaration of Alliance for Healthy Cities 2014 in Hong Kong has called for Healthy Cities development as overarching framework for other healthy setting initiatives such as Health Promoting Schools, Health Promoting Workplaces, Healthy Villages, Health Promoting Hospitals and Health Care Organisations, Health Promoting Universities to create synergy in health. This web site ‘Healthy City and Healthy School Clinic’ aims to share more knowledge and wisdom in this area.

Professor Albert Lee
MB BB (Med. Deg.-London), LLB (Hons-London), LLM (District-Arb & DR), MPH, M. Res & Prof. Study in Ed (Bristol), MD (Higher Res. Deg.-CUHK), FRACGP (Aus), FRCP (London & Ireland), FFPH (UK), FHKAM(FamMed), US Nat. Acad. Med. (Foreign Associate), FCIArb
Clinical Professor in Public Health and Primary Care
Consultant in Family Medicine