城市卫生专题讨论会
城市卫生：科学现状
卡莉·伯克著
On Thursday, December 6th, the 波士顿大学公共卫生学院 (SPH), the 城市倡议, and the 耶鲁大学全球健康澳门威尼斯人注册网站研究所 co-hosted an 城市卫生专题讨论会 that examined the intersection of public health and urban development. 来自世界各地的30多名学者参加了由6个小组组成的系列会议，讨论了全球大规模城市化对公共卫生的影响。 一些发言者讨论了用于推进城市卫生学术澳门威尼斯人注册网站研究的方法，另一些发言者介绍了已经制定公共卫生政策的城市的案例澳门威尼斯人注册网站研究。 这一天充满了发人深省和引人入胜的讨论，出现了一些关键思想，成为未来城市卫生需要考虑的趋势。
The symposium commenced with a warm welcome from 桑德罗盔状突起物, SPH Dean and Professor, and 大卫Vlahov, the Associate Dean for 澳门威尼斯人注册网站研究 at the Yale School of Nursing and a Professor of Epidemiology at the Yale School of Public Health.
加利亚说：“有机会把来自世界各地的专家聚集在一起，了解城市，了解我们如何创造更健康的城市，这对我们来说真的是一个智力上的高点。”他把城市健康列为公共卫生学院的四个关键澳门威尼斯人注册网站研究领域之一。
Vlahov highlighted the fact that more people are living in cities now than ever before – by 2030, two-thirds of the world’s population will live in an urban setting.
“城市环境是无处不在的健康暴露，”弗拉霍夫说。 “城市塑造了我们吃什么、喝什么、呼吸什么、听到的噪音水平、运动量、社交网络、社区安全，以及许多其他对健康至关重要的因素。 我们如何在城市环境中创造健康将在很大程度上决定全球人口的健康程度。”
The panels varied in scope and discipline, with speakers covering a range of diverse topics, from approaches to urban health, to resources available, to 具体案例澳门威尼斯人注册网站研究 from cities around the world.
The final panel, entitled 城市的过去、现在和未来, was moderated by 凯瑟琳Lusk, the Executive Director of the IOC. 发言者讨论的主题包括移民、城市领导促进发展、区域规划以及健康和安全的空间。
Lusk opened the panel with a brief introduction to the IOC’s 梅尼诺市长调查, which interviews over 100 mayors across the U.S. each summer. The 2018 report will be published come January, but Lusk mentioned some prominent statistics from this past year’s Survey, including the fact that only 13% of mayors believe that their housing availability and affordability is well-matched to the needs of their residents, 70% of mayors support expansion of bike infrastructure, and 84% of mayors believe climate change is caused by human activities. 除其他问题外，绝大多数市长还非常关心社区内的贫困人口。
梅尼诺调查不仅揭示了全国城市空间市长的优先事项和关注点，而且还揭示了知识上的差距，Lusk解释说。
“[The Survey] is also a measure of misperceptions,” said Lusk. “It’s a measure of knowledge gaps and knowledge deficits.”
很少有市长理解的一个问题是建筑环境与歧视和种族主义之间的关系，也就是说，白人社区和有色人种社区的公园、社区、道路和交通之间的差异。 这种差异是城市环境中缺乏卫生知识的几个指标之一，也是公共卫生科学家和澳门威尼斯人注册网站研究人员迫切需要与决策者建立具体伙伴关系的一个指标。
She highlighted the “three legs to the stool” of a healthy, vibrant community, according to mayors with whom the IOC converses – physical infrastructure, economic infrastructure, and social infrastructure.
“[This panel] will focus on how we get levels of government working together, how we get government and community working together, and how collectively as allies in the public health community we can overcome some of the key challenges to implementation and impact,” finished Lusk.
The first to take the podium was 塞布丽娜Hermosilla, a 澳门威尼斯人注册网站研究 Scientist in the Global Mental Health Program at the Vagelos College of Physicians and Surgeons at Columbia University. Hermosilla谈到了国内和国际移民对城市发展的影响； 随着每周有300多万移民涌入城市，城市已成为跨文化影响和变革的多元化中心。 例如，迪拜和布鲁塞尔等城市的外国出生人口比例分别为83%和62%，这一比例在其他类似城市还在继续上升。
Hermosilla注意到移徙者目前面临的障碍以及如何将其转化为机会，例如缺乏获得医疗保健和其他有效服务的机会，这些服务必须在语言和文化上为移徙人口所接受。
Lastly, Hermosilla provided a multisectoral example of progress being made using the 约翰内斯堡移民健康论坛, a collection of NGOs, universities, and policymakers in Johannesburg, South Africa. 该论坛汇集了来自多个学科的学者、专业人士和领导人，以监测公共部门的移民歧视，将社区成员与政策制定者联系起来，并促进服务提供者与面向移民的非政府组织之间的合作。
“移民是城市空间的核心，”Hermosilla说。 “Migrant issues and challenges provide us a unique opportunity.”
Next to speak was 蕾妮Boynton-Jarrett, an Associate Professor of Pediatrics at the 波士顿大学 School of Medicine. 她的讨论主要集中在为儿童创造安全的生活和玩耍空间，到2030年，这一年龄组将占城市居民的大多数。
她比较和对比了公共卫生和城市规划作为学科领域的发展； 两者都是对类似问题的反应，比如控制疾病和感染的方法。 但这两个领域的工作后来发展得彼此平行，互不相干，互不一致。
“Some of the threats that rapid urbanization pose to population health exist because of this parallel evolution of fields that truly, if aligned and coordinated, could benefit to work toward the same goals,” said Boynton-Jarrett.
从历史上看，儿童在城市规划和设计中没有被认真考虑，他们经常被视为累赘而不是受益者。 对儿童的首要关注是严格的安全，这限制了儿童参与城市空间的方式。
此外，城市地区的差距和贫穷对处于整体发展阶段的儿童的影响尤其严重。 博因顿-贾勒特还强调，生活在贫民窟的女孩文盲、营养不良、早婚和早孕的风险更高。
But Boynton-Jarrett is hopeful for the future of children’s public health in urban spaces. Child-friendly cities are considerations that are now entering discourse surrounding urban planning and public health, a trend particularly exemplified at Habitat III, the United Nations Conference on Housing and Sustainable Urban Development, which included a commitment for children in the decision making-process.
“T在这里’s a renaissance around the importance and understanding of the impact of w在这里 you live, learn and play, the ecosystem w在这里in your health develops, has on your life course health outcomes, and it is motivating changes in our work,” she said.
博因顿-贾勒特最后敦促她的同事们考虑儿童在城市规划中的角色和声音，以及建筑和社会环境影响儿童福祉和发展的方式。
斯兹考伟克大卫, a Senior 澳门威尼斯人注册网站研究 Scientist at the New York Academy of Medicine and Professor Emeritus in Medicine and Epidemiology at the University of Washington, discussed his experience with the 区域规划协会 of metropolitan New York (RPA), an independent, nonprofit, nongovernmental planning agency for the tri-state area (New York, New Jersey, and Connecticut). 它的一些服务包括澳门威尼斯人注册网站研究和确定各地区面临的主要挑战，并提供潜在的解决方案，与政策制定者分享想法和计划，以及倡导实施。
2014年，西斯科维克搬到纽约，开始与城市规划者接触，在从事了一辈子的医学工作后，他尽可能多地了解了区域发展。
从1929年到1996年，RPA为三州地区起草并发布了三个区域规划。 第一个区域计划的重点是汽车，第二个区域计划，发表于1968年，重点是郊区化，第三个区域计划，发表于1996年，重点是交通相关的挑战。
The turn of the millennium brought issues like climate change and income inequality to the forefront of public discourse, and, following the recession of 2008 and Hurricane Sandy in 2012, the RPA began to consider launching a Fourth Regional Plan to address crumbling infrastructure, economic disparity, and vulnerability to natural disasters.
2012年，区域规划局概述了第四个区域规划的四个目标：
-创建一个动态的，以客户为导向的运输系统
——应对气候变化挑战
-让该地区的每个人都负担得起
-修复那些让我们失望的机构
然而，这些目标没有包括健康或公平。 但此后不久，RPA获得了一笔拨款，撰写了一篇澳门威尼斯人注册纽约城市健康的论文，其结果揭示了不同社区、县甚至州之间公共健康状况的巨大差异。 白皮书迫使RPA将公共卫生作为其第四个区域计划的关键问题，并根据四个指导价值重新设计了该计划：公平、繁荣、可持续性和健康。
“[This commitment] says a lot about the commitment of this organization – it’s not a health organization, it’s a planning organization committed to integrating health and equity into plans and into their assistance of government in making decisions with regard to investments,” Said Siscovick.
世界Tsouros 在结束这一天时，我呼吁通过伙伴关系和合作综合公共卫生背后的科学。 With over thirty years of experience at the World Health Organization, Tsouros currently serves as an International Advisor on Healthy Policy and Strategy at the WHO, after previously serving as the Director of the Global Healthy Cities initiative.
Tsouros在1988年职业生涯之初受命制定一个欧洲健康城市项目，当时城市公共卫生的概念尚未得到深入探讨。 Tsouros discovered very quickly that health policies were of major interest to city leaders – within one year, 200 cities had joined his healthy cities project, and the basis for the project quickly spread across the globe.
In 1998, Tsouros, along with Michael Marmot, released an influential 出版 exploring the social determinants of health that offered policy advice for city leaders regarding public health strategy. 尽管从那时起，公共卫生澳门威尼斯人注册网站研究投入了数百万美元，但Tsouros声称，学术界对变化的证据仍然是孤立的，在公共卫生领域的影响中传播，但从未到达那些有权实施政策的人手中。
“Today we are drowning in evidence, but still action is very limited,” said Tsouros.
因此，Tsouros重申了全天一致表达的一个主题：公共卫生是一个超越科学家和澳门威尼斯人注册网站研究人员的问题，必须被置于政治议程的前列。 推进公共卫生政策所必需的是为澳门威尼斯人注册行动创造合法性和承诺的政治声明。 启动澳门威尼斯人注册行动和政策实施的关键是全球伙伴关系，将科学转化为城市领导人和政策制定者可理解的内容，并将所有学科的倡导者联系起来。
“Modern approaches to address public health require whole-of-government approaches. The public health sector alone can’t do it,” said Tsouros. “Our agenda of social determinants and the determinants of health is an agenda that should be discussed in political party platforms. This kind of information should shape policies.”
总的来说，这次研讨会是一次精彩的一天，讨论了城市公共卫生的各种不同、有见地和有影响力的方法。 The issue was tackled from several different focal points – from education to incarceration, from the children to the elderly, from healthy foods to housing affordability, and everything in between. 在所有这些问题中出现了几个主题，包括建筑环境与社会和经济环境之间的联系，解决办法的多学科方法，以及将公共卫生澳门威尼斯人注册网站研究和成果与立法澳门威尼斯人注册行动和政策形成结合起来的重要性。
To see the full list of speakers at the event and watch a livestream recording of each panel, you can access the School of Public Health’s website 在这里.