Recently I attended a local community poverty relief seminar and heard grassroots views illustrating the close connection between a healthy city and happiness in life.
Among the participants was an unemployed widow with diabetes who needs to spend HK$7,000 ($892) a month on life-sustaining medication. Another was a single mother of two who moved from a subdivided flat to a 100-square-foot (9.3-square-meter) unit so her children could have a decent desk for online classes without having to be squeezed together on the same bed. Her new rent is an immense financial burden, and she now has mental illness. These two cases are vivid examples of how residents’ happiness and the construction of healthy cities are intertwined.
The Department of Health (DH) in 2007 published “Building Healthy Cities: Guidelines for Implementing a Healthy Cities Project in Hong Kong”, which references the World Health Organization’s guidelines. The Healthy Cities project’s seven principal elements seek to improve citizens’ health and quality of life and encourage substantial community participation through multidisciplinary coordination among government departments.
If the seven guidelines are considered key performance indicators, how many guideline policies were enacted by the Hong Kong Special Administrative Region government in the past two decades? What is the efficacy of building a healthy city? There is much room for improvement from a results-oriented perspective.
The WHO defines health as “a state of complete physical, mental and social well-being”. In other words, the government ought to be concerned about both the physical health and happiness of citizens, or their well-being when promoting the construction of a healthy city.
Let me provide a brief overview of Hong Kong’s implementation of the Healthy Cities project. The Healthy Cities movement was officially launched by the WHO in 1986 and adopts the principles laid out in the Ottawa Charter for Health Promotion. Hong Kong’s first Healthy Cities project was initiated in 1997 with a seminar titled “Building Healthy Cities in the HKSAR”, organized by the DH in 2005. The publication of “Building Healthy Cities: Guidelines for Implementing a Healthy Cities Project in Hong Kong” was released in 2007, the same year that the China Hong Kong Chapter of the Alliance for Healthy Cities in the Western Pacific Region was established. After an initial flurry of activity, the Healthy Cities project stalled in Hong Kong for more than a decade until 2019, when Hong Kong joined the Partnership for Healthy Cities. Fourteen interventions identified in the Partnership for Healthy Cities included having a smoke-free city, curbing drunken driving, and preventing opioid-associated overdose deaths. Each participating city committed to one of them. It was delightful to see the HKSAR government’s contribution to building healthy cities when it finally pledged to conduct a new citywide population health survey (PHS) in 2020 to strengthen the government’s information base on population health, in line with evidence-based health policies.
Well-being is an all-around concept. Enhancing residents’ well-being should serve as the guiding principle in the policymaking process of all bureaus to create synergistic effects and realize the goal of building healthy cities
On top of the Partnership for Healthy Cities’ 14 interventions, the WHO issued a new set of guidelines for actualizing healthy cities in 2020. The guidelines’ nine new action domains are more panoramic and comprehensive than the previous 14 interventions, but relevant information cannot be found on government websites, and it remains unclear whether the authorities are aware of the updates.
The nine new domains include:
1. Planning for urban preparedness, readiness and response in public health emergencies by optimizing transportation planning.
2. Increasing access to all green spaces for social interaction that are supportive of health and healthy choices.
3. Continuously improving the quality of and access to local health and social services.
4. Strengthening local public health services and capacity to deal with health-related emergencies. (The COVID-19 pandemic over the past two years was a litmus test of the government’s competency in handling the ongoing public health crisis).
5. Promoting a health-in-all-policies approach and improving city governance by:
i) using residents’ health and happiness as guiding principles when enacting local policies in all bureaus, and
ii) ensuring policy coherence that is conducive to health and fostering related synergies.
6. Mapping out the social landscape via regular PHS to:
i) acquire information on residents’ physical and mental health for further review on the progress of building healthy cities in Hong Kong; and
ii) strategically devote resources to different areas.
7. Enhancing public participation by forging local partnerships for health with attention to the needs of the vulnerable and socially disadvantaged.
8. Allocating resources wisely by:
i) investing in population-based and community-based disease prevention programs to improve hygiene; and
ii) prioritizing the most in-need after considering all citizens.
9. Minimizing health inequalities among various social classes.
The fifth, eighth and ninth elements are particularly important as they align with President Xi Jinping’s remarks: “The people’s aspiration for a better life is what we are striving for”; “The biggest aspiration of Hong Kong people is to lead a better life, in which they will have more decent housing, more opportunities for starting their own businesses, have better education for their children, and better care in their twilight years. We should actively respond to such aspirations”; and “It should make sure that all citizens in Hong Kong share more fully and fairly in the fruits of development.” These elements also reflect the public’s shared vision. Taken together, these all underline the importance of building healthy cities.
Well-being is an all-around concept. Enhancing residents’ well-being should serve as the guiding principle in the policymaking process of all bureaus to create synergistic effects and realize the goal of building healthy cities.
Healthy cities are not built overnight. It is hoped that the HKSAR government “should be pragmatic”, as President Xi remarked, and swiftly review relevant guidelines to expedite the Healthy Cities project so the public can share the fruits of society and lead happy, blissful lives.
The author is a Legislative Council member.
The views do not necessarily reflect those of China Daily.