Principles and strategies of effective community participation

A framework is offered for understanding the conceptual basisand the strategic implications of community participation, inachieving Health for All goals. Special focus is given to themeaning, settings and levels of participation in official decision-makingstructures and at the community level. Questions such ‘howis participation facilitated?’, ‘who participates?’and ‘what are the benefits and obstacles to participation?’are geared primarily towards the needs of individuals who functionat the city level and expect practical strategic advice andguidance. The structure of the 1989 WHO Healthy Cities Symposiumwhich was devoted to community action was based on the frameworkand conceptual approach of this paper.     

Alcohol control and urban livelihoods in developing countries: can public health aspirations and development goals be reconciled?

This commentary explores how household economic necessity and the public health aspirations set out in the WHO’s global strategy to reduce the harmful use of alcohol might be reconciled in the context of alcohol control in developing countries. The ‘ambiguity’ of alcohol’s role in social and economic development is clear, but, as yet, little progress has been made on how best to integrate alcohol control within development policies in low- and middle-income countries. Without this holistic thinking, alcohol control efforts are likely to be thwarted by liquor’s allure as an accessible micro-enterprise opportunity. Similarly, developmental efforts will be undermined by the severity of alcohol-related harms that now disproportionately affect middle-income countries. Drawing on the example of South Africa, this short commentary explores the complexities of controlling the supply of alcohol when its sale represents a major livelihood strategy amid conditions of high unemployment and constrained access to formal employment markets. The policy preference for closing illegal bars or shebeens in South Africa does not address the ‘causes of the causes’ of why people drink, and therefore why its sale continues to be an attractive livelihood choice. It also does little to provide alternative leisure or employment opportunities, which ultimately threatens the longer term sustainability of policy. We need to better appreciate why selling alcohol is a seductive business opportunity and the potential consequences of this for realising public health aspirations.     

Investigating the mental health implications of urban environments with neuroscientific methods and mobile technologies: A systematic literature review

Urbanization is an ongoing global process that is influencing and shaping individual mental health and well-being. This paper aims to provide an overview of the current literature containing state-of-the-art neuroscientific and mobile technologies that have been used to investigate the mental health implications of urban environments. Searches for peer-reviewed primary research articles were conducted in PubMed and SCOPUS, returning 33,443 papers; 90 empirical articles published from 1981 to 2021 were included in the final synthesis. Central findings suggest virtual reality and mobile electroencephalography to be the most commonly used methods, and demanding mood, affect, and health phenomena or states to be the most common concepts of study in both physical built settings and natural urban spaces. Recommendations for both future practice and study noting particular opportunities for future methodological contributions are discussed.     

淮海经济区城市居民生命质量与健康影响因素的研究

目的了解淮海经济区城市居民生命质量状况受到哪些因素的影响,以期提高该地区城市居民健康水平。方法采用世界卫生组织编写的生存质量测定简表（即WHOQOL-BREF）为主要内容的调查问卷对淮海经济区经济水平较好的2个城市（徐州和淮安）和经济水平较差的3个城市（连云港、宿迁和枣庄）1 000名居民（每城市随机调查200名居民）进行调查。结果不同经济水平城市的居民生命质量得分比较,差异均无统计学意义（P〉0.05）;对居民生命质量产生影响的因素主要为学历、婚姻、有无慢性病、吸烟、饮酒和体育运动。在生理、心理、社会关系、环境领域中生理领域受到最广泛的因素影响。结论体育运动是最重要的促进健康的手段,学历和婚姻是健康的重要保护因素,吸烟、饮酒等行为仅影响生理健康。     

Physical inactivity and its predictors among adolescents in Saudi Arabia: A cross-sectional comparison between cities with and without a Healthy Cities Program

Objectives:To estimate the prevalence of insufficient physical activity and excessive screen time among adolescents living in cities participating in the Healthy Cities Program (HCP) and cities not running the program in the Qassim region of Saudi Arabia.Methods:We surveyed 1133 adolescents from the Qassim region using systematic random sampling between April and September 2017. Multivariable logistic regression analyses were conducted to investigate the predictors of insufficient levels of PA and excessive screen time.Results:The prevalence of <60 minutes of moderate- to vigorous-intensity physical activity/day was 82.4% and <3 days of vigorous intensity physical activity/week among adolescents was 59%. There was no significant association between living in healthy cities (HCPs) and insufficient levels of physical activity. The odds of excessive screen time were higher in HCPs than in cities not running the program (NHCPs) (OR: 1.49). The odds of insufficient daily PA (OR: 2.19) are higher among girls than boys. Increasing age is positively associated with insufficient weekly PA (OR: 1.19). The prevalence of excessive recreational screen time is 84.6% with higher odds in HCPs than in NHCPs (OR: 1.51).Conclusion:Our findings report a lack of evidence of any impact of the HCP on adolescents’ physical activity behaviors. This outcome warrants a further in-depth evaluation of the process and outcomes of the HCP in Saudi Arabia.     

北京市城区中老年社区居民慢性病相关危险因素分析

目的了解北京市城区社区居民中老年高血压、冠心病、糖尿病3种慢性病的相关危险因素,为早期防病、治病提供临床依据。方法对北京城区4866名中老年居民进行常规检查,采用多因素logistic回归分析分别探讨3种慢性疾病的相关危险因素,并分析患慢性病组与正常人群组伴随疾病情况。结果年龄、三酰甘油、糖尿病、体质指数（BMI）与高血压呈正相关;年龄、高血压、糖尿病与冠心病呈正相关;性别、年龄、三酰甘油、高血压与糖尿病呈正相关;各种慢性病患者的伴随疾病患病率均较正常组高（P〈0.05）。结论年龄增加、高三酰甘油、高BMI是中老年社区居民高血压、冠心病、糖尿病的相关危险因素,应在社区居民中倡导科学的生活方式和正确的饮食观,加强体育锻炼,保持身心健康。     

北京城区院前救治的道路交通损伤特点分析

目的:描述北京急救中心2004年1月1日至2010年12月31日救治城区道路交通损伤的现状,总结其社会学特点,并初步探讨其可能的改善方法.方法:所有数据来源于北京市统计局和北京急救中心病案室,在收集后者数据时检索并录入2004年1月1日至2010年12月31日共7年期间由北京急救中心参与救治的道路交通损伤病例,应用Excel 2007、SPSS 17.0进行方差分析及卡方检验.结果:共收集符合准入标准的完整病例19 550例,道路交通伤的年发病率约为120人/10万人,死亡率约为4.97人/10万人,其中男性(11 737,60.04％)明显多于女性(7 813,39.96％),平均年龄(38.76±16.84)岁.各年龄组交通伤均多发于每年的10月份,日间多于夜间,以中午前、后最多,但不同年龄患者交通损伤发生的每日时间分布特点不同.受伤者多为行人(7 588,38.81％)和骑自行车者(3 790,19.39％),发生部位多在头面(8 343,42.68％)和下肢(6 828,34.93％),损伤程度以中等损伤为主(11 718,59.94％),造成损伤的一方多为小型汽车(11 490,58.77％).结论:防治道路交通损伤,需要针对不同人群、不同时段和不同交通方式,采用不同的管理方法和规范化的院前救治.     

发展社区卫生服务,振兴城市初级卫生保健

20世纪的50年代和60年代,中国的初级卫生保健工作处于世界领先地位。但是,自从80年代在卫生领域引入市场机制之后,中国初级卫生保健赖以生存的基础设施发生了戏剧性的变化。政府投入在卫生费用中所占的比重急速下滑,同时,卫生机构所承受的财务风险日益加大,卫生服务的重点越来越倾向于医院和技术,越来越多地依靠患者付费,就卫生服务可及性而言,公平性越来越差。在这种背景下,中国政府于1997年启动了城市社区卫生改革,试图重振初级卫生保健,扭转以医院为主导的卫生服务体系。发展以社区卫生服务中心和全科医生为特征的社区卫生服务体系成为中国城市卫生改革的政策重点之一。本文分析了中国城市社区卫生服务改革重点实现的目标,评价了该项改革所取得的成就和面临的问题与挑战。     

鲁南五市疟疾联防区2003～2007年疟疾疫情分析

目的分析鲁南五市疟疾联防区疟疾发病特点及流行规律，为疟防后期监测及制定防治对策提供依据。方法对鲁南五市疾病预防控制中心上报的当地感染、输入性疟疾或疑似病例进行登记和确诊，并逐一进行流行病学调查和资料的整理、统计与分析。结果鲁南五市2005～2007年疟疾病例呈明显上升趋势，发病例数比2004年分别上升293％、586％和686％，以枣庄、济宁和菏泽增多最明显。疟疾病例以间日疟和新发病例为主，既高度分散又相对集中，且当地感染病例明显增加。男性高于女性，以农民和民工发病最多。结论鲁南五卞联防区的疟疾疫情呈上升趋势，尤其靠近江苏、安徽和河南的市县为今后疟疾防治工作的重点地区。加强联防和流动人口管理，提高各级疟防人员的专业水平是今后工作的主要任务。     

中国18省市自治区城市高中生性行为现况分析

目的了解中国高中生性行为现状,为制定适宜的性教育策略提供依据。方法采取无记名自填问卷方式,按照分层整群抽样方法,对18个省、市、自治区110954名高中生进行中国青少年健康危险行为问卷调查。结果我国高中生性行为的报告率为4.4%,男、女生分别为6.9%和2.1%(P<0.01);职业中学学生性行为的报告率高于重点高中和普通高中学生(P值均<0.01);西部地区高中生性行为的报告率高于东部和中部地区高中生,地区之间差异有统计学意义(P值均<0.01)。Logistic回归分析发现,年级增加、看过色情书刊、影像制品、长期不与父母同住、生活在西部地区是高中生发生性行为的危险因素;在普通/重点中学就学、自感学习成绩好是高中生发生性行为的保护因素。结论对高年级高中生尤其是职业中学学生进行适当、科学、系统的性教育十分必要。