Intersectoral governance for health – experience of Healthy Cities The role of cities and municipaliWHO acknowledges this challenge ties in health promotion, designing and since almost 25 years supports healthy settings and creating conhealth development in the cities with ditions for well-being is growing Healthy Cities programme. The overall as the urbanisation is speeding up. motto and philosophy of Healthy CitToday 80% of European population ies is ‘’Health is everybody’s business’’, lives in the cities and it is the cities which means that the efforts for health who need to tackle current public development and health promotion health challenges. Most of the Euromust not be a responsibility of health pean countries have national health sector only. Healthy Cities promotes programmes, however, in order to Health in all Local Policies, which calls Ms Johanna Reiman, Executive Director, was a ensure their successful implementafor common actions of various city speaker at the workshop ‘How to meet the demographic tion, local action is needed. Moreodepartments: from sport to cultural, challenge; the ageing society’ held during the UBC ver, the new legislations in all Nordic from social to transport. Partnership General Conference in Liepāja in October 2011. countries, already followed by othfor health allows for better health govers, e.g. Latvia, oblige the municipalities to take more responsibility ernance and better well-being of city inhabitants. for health promotion. Besides intersectoral cooperation, Healthy Cities calls for strong Budget limitations, competing priorities and changing political environment in municipalities might create the constraints for development of sustainable societies. On the other hand, as a result of progressing decentralisation and recent law changes, municipalities are growing in power – and this is their time to use it! With the new responsibilities in their hands, local authorities enter new fields of activities previously reserved only for national governments. Cities seem to be an attractive place to live in, but empirical studies conducted during 1990s revealed that city population suffers more often than others from e.g. tuberculosis, cardiovascular diseases, cancer, poor mental health, or obesity. The environmental, economic and societal conditions in specific urban areas influence – positively or negatively – the health status of individuals. Health care sector has limited capacity to improve the health and wellbeing of populations and close cooperation with other sectors is needed!
political commitment on the local level. Local governments are engaged through capacity building programmes, institutional change and partnership-based strategic planning. Thanks to this, Healthy Cities have the potential to provide essential public health leadership, to create preconditions for healthier living and participatory governance. Over 220 cities from the Baltic Sea Region are Healthy Cities, many of them are also UBC members. Baltic Region Healthy Cities Association, based in Turku, Finland, is WHO Collaborating Centre for Healthy Cities and Urban Health in the Baltic Region since 2002.
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Karolina Mackiewicz karolina.mackiewicz@marebalticum.org
Institutional support for the elderly in Kaunas Just as in other EU Member States Lithuanian population consists of an increasing part of elderly people of 60 years old and over. The EU directives and policy encourage the Member States including Lithuania by financing local initiatives to increase the number of institutions which provide non-stationary social services, day centres, and self-dependent life homes. There are two budget institutions belonging to Kaunas: Kaunas Panemune Elderly People Home (Kauno Panemunės senelių namai) and Kaunas House of Generations (Kauno kartų namai). The institutions provide stationary and non-stationary social care 28
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services for elderly people. They also integrate elderly people day centres which aim to assure Kaunas citizens with non-stationary social care services creating the conditions for elderly people to keep active consistent social life in their natural environment. The Day centres serve as a social meeting place to share ones problems, hobbies and ideas. The visitors may join the excursions to theatres, museums and churches. A lot of attention is paid to the health care and promotion of healthy lifestyle through the practice of exercises, yoga, northern walking, group meetings of psychotherapy and psychological help. The day centre is like a small community which receives everyone in need to share hardships and joy and where everyone can expect to receive help and understanding. The visitors communicate with each other warmly, make new friends and keep in touch even beyond the walls of the centres.
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Jūratė Putnienė jurate.putniene@kaunas.lt