2023-08-06 01:17:01
Public health Health also goes through neighborhoods
If we asked you, the reader, to list the things that influence your health, what would you answer? While you think about it, we dare to venture that on your list there will surely be issues such as your genetic heritage, your eating habits or the amount of exercise you habitually practice. However, beyond these individual factors, there is a series of external conditions that also have a direct impact on your chances of getting sick and that we often tend to ignore. How is the place where you live is one of them. Think about whether there are green spaces near your house and a pleasant area for walking or if, on the other hand, the sidewalks are narrow and the traffic is devilish all day. Because that is also important for your well-being. The characteristics of our neighbourhoods, the way in which our cities are designed directly affect our health, summarizes Carlos Doraone of the world experts who best knows the effects of this determinant of health.
As current president of the International Society for Urban Health (ISUH according to its acronym in English) and former Coordinator of Public Health and Environment of the World Health Organization (WHO), this Brazilian doctor recently participated in the Congress of the Spanish Society of General and Family Physicians, held in Granada, where, among other issues, he spoke of the importance of act locally to promote health and fight climate change, two factors that go hand in hand.
In many of our current cities there are factors that are harmful to our well-being -and also to the climate-, such as high levels of traffic, pollution, noise or lack of green areas, among others, points out Dora. But other city models are possible. Furthermore, well-designed and organized cities can be an engine to promote health. There are already many successful examples of this transformation, he points out. And he refers to initiatives, such as the commitment to cycling lanes carried out by cities such as Copenhagen (Denmark) or Amsterdam (Netherlands).
In the future, just as it now seems incredible to us that before it was possible to smoke in schools or in the doctor’s office, it will seem outrageous to everyone, somewhat crazy, that many of our cities are designed for cars and not for people, poses.
Dora denounces that from the 50s of the last century, the urban development of many cities became to serve cars, and not individuals. It was part of an economic strategy to develop the car industry and even involved buying tram companies and other collective means of transport to destroy them so that they could not be considered as an alternative for travel. That happened in many places, there are many examples without going any further in the United States; which has led to the existence of widely dispersed cities, with houses that are far from the place of work, school, library or hospital. In these types of cities it is mandatory to take the car for everything and that has an impact, says Dora.
First of all, in terms of contamination and health, appointment. We often think of air pollution as a negative factor for the environment. But it also has a very detrimental effect on the body, recalls the president of the ISUH. WHO estimates indicate that in 2019 outdoor air pollution caused 4.2 million premature deaths worldwide. Because its effects go far beyond the respiratory system. There is increasing evidence of its effects on the cardiovascular or neurological systems.
Breathing polluted air has a direct impact on the arteries that is very similar to that of hypertension or cholesterol. Pollution causes as many deaths a year in the world as tobacco and it has been shown that it can also influence the intellectual capacity of developing children, respiratory diseases and other disorders, emphasizes Dora, who recalls that traffic is one of the the main sources of pollution in cities.
Although the alternative of electric car As a way of solving the problem, for the Brazilian specialist, in reality, this model is not advisable either. We must not forget that continuing to dedicate cities to cars, even if they are electric, means, on the one hand, continuing to generate a very high carbon footprint, because producing this type of vehicle is also highly polluting. But it also means continuing to influence other problems that derive from this model of a city, centered on cars, such as the hoarding of public space or the lack of physical activity that they cause.
Cities for people, not for cars
It is necessary that the design of cities is designed for people and not for vehicles, continues the doctor, who speaks of denser, greener cities oriented towards public transport, in which access to essential services and socialization is easy.
One of the ways to do more compact cities it is to carry out a development aimed at creating density around points of communication junctions, where there are public means of transport, safe routes for bicycles and spaces designed for walking, he explains. It is very important to encourage people to incorporate physical activity into their day to day. Not everyone has the opportunity to go to the gym or dedicate part of their day to exercise. For this reason, it is important to be able to include routines in daily life, such as cycling or walking to work, which allow them to be active without spending specific time on sports, he points out. Immediately, the specialist adds that it is also essential that cities are designed taking into account people of different ages and conditions.
Many cities, today, are designed for healthy men, 70 kg, who mainly commute by carlaments the expert. However, the reality is that society is more diverse. Older people, children, people with different types of physical abilities must be taken into account. We cannot forget that people need spaces where they can rest if they walk slowly, where they can meet other people, where they can play if they are a child. This is fundamental, creating spaces for socialization. Impersonal cities without spaces for people to interact are very harmful. It is proven.
Throughout the conversation, there is a point on which Carlos Dora insists several times: the importance of cities being green, with parks, landscaped areas and trees in each neighborhood. There is a lot of evidence on the benefits of living near green areas. Whoever has a park near a waterfall has lower levels of stress hormones, such as cortisol, and has higher levels of dopamine and endorphins, related to well-being. There is a clear mental health benefit. And it is also important for children’s early development. Being in contact with nature is very important on many levels, also because it is a stimulus to walk or to do physical exercise in the open air.
Also, keep in mind that there is a lot of evidence that shows that green areas are one of the most efficient ways to reduce temperatures in the city. Heat waves in areas like the Mediterranean are going to continue. As people have internal temperature limits, there is much evidence that more deaths occur during heat waves. And it has been shown that green areas help combat this excess of temperatures, just as they help the absorption of water by the soil when there are floods. If there is only asphalt, pavement, the damage from a flood is much higher, because the water does not filter, it is not absorbed into the earth.
Transformation cores
Cities can be key to transforming the health of countries, maintains the doctor, especially considering that the number of people estimated to live in cities in the coming years is going to increase significantly. Cities are an opportunity for change, because the decisions that are made locally, depending on the characteristics of each municipality, have a direct impact. The city can provide solutions to improve pollution, analyzing and addressing local sources of pollution; optimizing the use of public transport, waste management or adaptation to changes caused by climate change, among other factors. There are even models to estimate how much you will gain in health if you invest in green or in the use of the bicycle, points out Dora, who adds that the evidence exists, what is lacking is the transfer of that knowledge for implementation.
Many times, those who make decisions are focused on a certain area and for urban design aimed at improving health, an intersectoral connection and a long-term vision are needed, thinking of the common good, points out the specialist. In this sense, he recalls that the movement and pressure of civil society to demand changes is essential.
It would be essential that older people get involved in this transformationDora muses. They are often people with authority, time to reflect and an interest in future generations, those of their children and grandchildren, having well-being. I believe that this part of the population is essential to rethink cities, so that they take the future of cities into their own hands. Cities that benefit the old also benefit the young. Getting involved in that change, I think, would be one of the gifts that they could leave to other generations. I think that the future may belong to the old, she concludes.
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