Safer Streets, Longer Lives: Creating A Healthy Community

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A healthy community is much more than a town or region that boasts a low incidence of disease--it is a place where citizens feel safe walking at night, have confidence in their schools, and don't worry about the quality of the water their children drink.

Many cities around the globe have begun a journey toward this ideal by mobilizing stakeholders in all sectors of the community--school, church, business, law enforcement and medical leaders-- to take responsibility for overall community health. AIHA's three healthy communities partnerships in Slovakia, funded by the US Agency for International Development (USAID), are part of this movement.

Since 1995, AIHA's healthy community initiative has joined community leaders in Petrzalka, Turcianske Teplice, Banska Bystrica and Martin with US counterparts to address issues such as drug abuse prevention, environmental protection and prevention of cardiovascular disease. Following a six-step process tailored to their needs, partners have sought solutions to these problems through community assessment, planning and improvement methodologies, and have carried out numerous interventions that have made their cities safer and healthier places to live.

In the economically depressed, urban district of Petrzalka, for example, the local Aid to Children At Risk Foundation teamed up with community health professionals at Truman Medical Center in Kansas City, Missouri, to combat a sharp increase in teenage drug use. As a result of a community assessment completed by the partnership, foundation leaders began holding monthly drug forums where parents, children and other community members meet to discuss drug prevention and treatment strategies. Additionally, partners completed a groundbreaking survey of more than 800 12-to-18-year-olds, which provided a demographic portrait of Petrzalka's teen drug and alcohol use patterns and related risk factors.

Residents of the rural town of Turcianske Teplice drew on the expertise of partners at The MetroHealth System in Cleveland, Ohio, to initiate a fund-raising drive to purchase a badly needed ambulance, open a town Health Advisory and Education Center, and carry out a comprehensive survey on "family stress" to determine health and behavioral patterns that contribute to the breakdown of the family.

And in the nearby towns of Martin and Banska Bystrica, where a burgeoning elderly population is beginning to strain the health care system, community leaders are working to develop home care and hospice services as a cost-effective alternative to hospital care for the chronically ill. Partnered with The MetroHealth System, residents also are addressing the health and social problems of local youth, focusing on educating teens about the risks of smoking and creating better leisure activities and job opportunities for them.

Working within the same framework, these four partnerships created their own healthy communities by forming community-based coalitions to gather health-related data, surveying the community to pinpoint its most pressing needs, and analyzing data to determine appropriate and workable interventions. The interventions arrived at through this process can have a broad impact--for instance, Petrzalka's police chief and mayor regularly use the community's drug forums as a public platform to address their constituents.

But the healthy communities message--that cities and individuals can take action to make their local environments safer, cleaner and healthier--is not unique to Slovakia. Through the World Health Organization's Healthy Cities project, this idea has been taken up by more than 600 cities, in nations as diverse as Tunisia, Russia and Thailand. While focusing on the many urban health issues that arise from pollution and overcrowding, the WHO project, begun in 1988, has served to complement healthy communities initiatives worldwide, and has succeeded in redefining health in the eyes of many policymakers. Cities involved in the project are targeting issues that follow WHO's Health for All agenda, including improving access to health care, promoting healthy lifestyle change and reducing inequalities in health status.

AIHA's healthy communities initiative continues to reframe health as an issue that reaches beyond hospital walls. Creating a healthy community requires the participation of all segments of society, but it offers a special opportunity for health care professionals, who can draw on the support of colleagues and neighbors to forge new paths for promoting good health.

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