Gezonde stadsgezichten : een studie naar gezondheidsverschillen en stedelijk gezondheidsbeleid

Abstract

Introduction - Poor city areas have been the target of urban renewal or anti poverty policies for decades. In the nineties, a new development has been added: health policy. In recent years, a colourful palette of local health initiatives has been created in cities. In some cases, the projects are directed to groups such as migrants or the elderly, and in other cases they have a more general orientation. They may be concerned with a concrete service, such as ’health guides’ in the neighbourhood, or a joint effort on the part of social institutions aimed at bundling resources. One project may make itself visible in the form of an actual building in the area, while another project may manifest itself as an initiative for healthy recipes in the neighbourhood supermarket. The first project involves mainly professionals, whereas the other would seem to revolve around volunteers. A wide variety of diverse initiatives exists, which have in common that they are doing ’something’ in the area of health at a local or neighbourhood level. Health is viewed in a wide, all-embracing and positive way (’health is more than just the absence of sickness’); diverse disciplines strive to cooperate together; political leaders become involved in health promotion activities and the people directly involved are used as reference for policy. Participation by the public is considered to be important. The initiatives are primarily the work of public health services and are frequently inspired by the international Healthy Cities Project. This study has scrutinized such local health policy. The goal of this investigation was, first of all, to clarify the characteristics of local health projects in cities. Secondly, the study was to offer insight into the problem areas these projects set out to solve. The study also set out to demonstrate the intended and unintended effects of this policy, and finally it was the intention to take account of both emancipating and disciplining views of local health policy. For this purpose, a theoretical framework was developed. The study was based on the following problem statement: Is there an element of a new health policy in cities? If so, what are its characteristics? What problems does this policy set out to provide a solution to? To what extent have the objectives been achieved? What are the unintended effects of this policy?