Experts from China and the United States exchanged ideas on healthy cities, integration of medicine and sports, and healthy housing at the "Healthy City and Public Health" Session of the 8th U.S.-China Health Summit.
David Siscovick, MS, Senior Scientist, the New York Academy of Medicine; Professor Emeritus of Medicine and Epidemiology, University of Washington, Seattle, USA
"Re-connecting Regional Planning and Health: The Fourth Regional Plan for Great Metropolitan of New York City"
In the United States, life expectancy per capita varies with different regions. Even the life expectancy of residents in neighboring communities is different from each other, indicating the importance of scientific regional planning for the health of residents. We have published a report on how to integrate health into urban regional planning.
Our suggestions are mainly divided into four categories:
1. To reshape transportation and expand the transportation system. There are too many cars in New York. In the next 20-25 years of planning, we have a crucial goal, which is, 80% of the urban street space should be used for walking, cycling and public transportation by 2040. One of the big problems that New York City faces is that there are many private cars occupying the street space, causing traffic jams. At the same time, we have to the street environment. The subway system in New York exists for more than 100 years. We want to make infrastructure like the subway system more modern, and reduce the dangers caused by exposure to heat and noise pollution.
2. To build a healthy community, including providing affordable housing and healthy housing, so that all communities can benefit from it. The road section that has adversely affected the health of the community should be demolished and transformed into a boulevard.
3. To create a healthier environment to cope with climate change. We have noticed that in 2012, hurricane Sandy caused huge losses to the United States. We must make efforts to build cities that can cope with natural disasters.
4. To incorporate health into decision-making standards.
GUO Jianjun, Director of the Institute of Science, State Sports General Administration
"Prospect of Sports Medicine in Government Urban Health GUO Jianjun, Director of the Institute of Science, State Sports General Administration"
Health is inseparable from exercise. This is because medical care alone cannot deal with the challenges of chronic diseases. There is plenty of successful experience in physical exercise prescription in chronic diseases. It works very well. However, many problems cannot be solved by sports or medical care alone. Therefore, it is necessary to combine sports with medicine, this is what I’m going to talk about, the integration of sports and medicine.
For instance, patients with chronic diseases want to do exercise in the gym, but they dare not to exercise unless a doctor is present. However, it will be counted as illegal practice if doctors go to the gym to provide instruction.
So who is going to instruct scientific physical exercise? We must integrate sports with medicine and cultivate talents in this filed. Sports medicine has been incorporated into various medical treatment fields, such as heart disease, respiratory disease, diabetes, geriatric rehabilitation, nutrition, child care, disabled people, Chinese medicine, etc. We have introduced corresponding sports instructions for all kinds of people. Concerning infants and children, when raising children, we must let them exercise rather than letting parents hold them in turn, depriving them of the opportunity to exercise, which will affect their growth and development. Similarly, the elderly cannot keep healthy only through eating and drinking. Their health is also inseparable from sports. Disabled people need sports instructions and sports venues as well.
The Department of Respiration of Beijing Guang'anmen Hospital provided 4-month scientific exercise instructions integrated with sports-and-medicine for 100 patients with chronic heart disease. The patients’ condition was alleviated to varying degrees as the times of their hospitalization decreased significantly. Their medical expenses lowered by more than 60% and their compliance rate reached 100%. It suffices to illustrate the benefits of the integration of sports and medicine to residents’ health.
Health must include scientific exercise literacy. At present, there is only a half among the 66 health literacy rules in our country, which is very abnormal. The development and popularization of health literacy requires the integration of sports and medicine, along with joint efforts of various parties. We must let the people know that it is better to rely on exercise than to take medicine, and scientific exercise instruction is particularly necessary.
WANG Na, Mayor, Wenchuan County, Sichuan Province
"Wenchuan Practice under the Health for All Principle"
On September 27, 2018, we released the “Panda Index” at the International Giant Panda Festival. Divided into “Health Index” and “Happiness Index”, this index is used to measure the level of social development, the improvement of people's life quality and the overall level of the improvement of subjective well-being in Wenchuan.
The Wenchuan Health Index evaluation score is 91.76, indicating that Wenchuan County's overall health level is relatively high, especially for mental health and physical health; besides, health management services have been continuously improved and management and services are equipped with a relatively good level. In 2017, the average score of overall well-being of residents in Wenchuan County was 89.87, of which the average score of social happiness of residents was 92.32. In a survey studying 8 aspects of social well-being, answers above the median value accounted for over 90%; answers of and above satisfaction accounted for more than 70%, indicating that the overall well-being of residents in Wenchuan County is high, and Wenchuan County's post-disaster reconstruction work and psychological relief work have achieved remarkable results.
ZENG Yan, Chief Architect, National Residential and Environmental Engineering Research Center
"Health from an Urban Architect’s Perspective"
Each person spends an average of 50%-60% of the time indoors. The indoor environment has various impacts and risks on health. American studies have shown that a good building environment can increase creativity by up to 12.5%, and vice versa by up to 17%. Japanese studies have suggested that controlling room temperature can reduce the incidence of diseases such as diabetes, heart disease, cerebrovascular disease, and hypertension.
Since 2002, China has carried out 60 pilot projects in 42 cities, covering all climate characteristic regions in China. From megacities to county-level cities, from high-end residence to affordable housing, each pilot project has research on targeted health topics, including barrier-free technology in residential areas, privacy research, kitchen and bathroom exhaust system research, acoustic environmental noise control research, and floor sound insulation. Based on the research results, we put forward key points of design for healthy housing design and the evaluation criteria of healthy housing from the perspective of regulatory agencies, including space comfort, fresh air, water quality and hygiene, quiet environment, good lighting and health promotion. However, there is still a lack of standards for the construction, management and customer terminals of healthy housing in China, which needs to be continuously improved in the future work.