module specification

 This module studies health in cities. The word ‘cities’ here is broadly taken as any human settlement classified as ‘urban’. The future of human settlement is predominantly ‘urban’. The United Nations Urban Observatory data shows that more than 50% of the world’s population already resides in urban / city settings. It is projected that by 2025 at least 60% of the world’s population will be residing in cities. In most developed countries today, at least 80% of the population resides in cities. Thus, most of the work in public health will be done in cities. It is therefore imperative to have an in-depth understanding of how cities influence human health to be more effective in promoting and improving population health around the world. The module uses a multidisciplinary approach to study the influence of ‘place’, wider determinants of health, and the changing urban environment on the health of residents in cities and city neighbourhoods.

The module aims to: -

• Examine the notions of ‘health crisis’, ‘health disadvantage’ and ‘health advantage’ in cities by using reference material from selected global / world cities that include London
• Understand the significance for health and healthcare of London's and other global cities' "world city" status
• Grasp the impact of ‘place’, wider determinants of health and the urban environment on the health of city dwellers around the world
• Engage critically with public health materials regarding the health of city dwellers, including policy formulation process in relation to shifting agendas towards health improvement in city settings
• Create an understanding of the differences in health, health policy and healthcare systems between cities in the developed and developing world against a backdrop of contemporary urbanisation, globalisation and sustainable development goals
• Provide students with an opportunity to develop skills to get to grips with specific public health issues in relation to specific population groups in given cities
• Critically analyse the influence of international and national policies, including the New Urban Agenda and sustainable development goals on health promotion and improvement within urban settings.

 The module will engage with theoretical concepts and principles of health in urban settings. In addition, it will look at practical aspects of managing health resources, developing primary and public health, health planning and promotion, and ways of mitigating and accommodating globalisation, migration and diversity in urban settings. It demonstrates practical problems and strategies by extensively drawing real examples from both the developed and developing world, enhancing students’ global consciousness.

The module covers the following areas: -

1. The principles, concepts, theory, context and controversy of health in city settings LO1, LO2, LO3
2. Health data frameworks in city settings LO, LO2
3. The determinants of health and health inequalities in city settings LO1, LO2
4. The organisation and delivery of healthcare services and health resources in cities LO2, LO3
5. Interventions and strategies to promote and improve health in city settings LO2, LO3, LO4
6. Paradigm shifts of future healthy cities and the influence of planning, globalisation and sustainable development on health in the cities LO2, LO3, LO4

The module teaching is based on weekly lectures and seminar classes, where specific group-work exercises have been developed to provide students with an opportunity to examined in more detail some of the main conceptual and methodological issues covered in lectures.

The approach to teaching is based on facilitating the application of concepts, methods and principles to practice-related contexts, and students’ integration of learning in relation to real world scenarios. This approach to teaching aims to develop students’ ability to think critically about data and evidence, and to draw appropriate inferences in accordance with the stated learning outcomes.

The above teaching methods will be complemented by students’ independent study on the module. Students will be required to read, on a weekly basis, recommended chapters in the core textbook, or to access other relevant educational material.

The module will be using WebLearn - guidance will be given during the module about how to best use this. It is designed to support students learning providing access to wider reading and resources to help to prepare for each session e.g. websites, policy documents and articles and or to revise and deepen knowledge after sessions e.g. lecture notes. Students are encouraged to use other learning resources such as the Library and the CELT and WebLearn.

 On completion of this module students will be able to:

1. Demonstrate a systematic understanding of, and critique the evidence for and in relation to, the notion of urban health crisis, the impact of ‘place’, and the wider determinants of health on Londoners and other city dwellers
2. Demonstrate a comparative understanding of the problems of health and health service planning in London and other cities
3. Identify and analyse the outstanding factors and changes that are creating differences in health, health policy and healthcare systems between cities in the developed and developing world against a background of urbanisation, globalisation and sustainable development goals
4. Critically engagement in the process of formulating policy in relation to shifting agendas towards health improvement in city settings

 There are two scheduled summative assessments on this module. The module is passes on the aggregate score of the two assessments

The first assessment is an oral presentation (20 minutes) of a health profile analysis of a local authority within London or another chosen city. The analysis will describe key health issues of the health profile and seek to provide an explanation of the key factors influencing health outcomes in the chosen borough or city. Students will critique efforts made in the local authority / city to address the key health issue/s. Students will pay special attention to health inequalities and factors that explain them in relation to particular population groups. Students who prefer to look at health profiles within London or New York should choose a specific patch or borough. The presentation will also have to use broader public health reporting materials about health in the local authority /city to support the analysis. It will indicate how the urban context of the local authority / city influences the health issue/s discussed in the analysis. It will also have to consider how current policy and legislation present opportunities and problems for the local authority / city to address the key health issue/s. This will be considered in light of attempts to develop a strategic approach to improve health within the London borough or city chosen.

The second assessment is a 4000 word report of an evidence-informed initiative to improve health and healthcare for a particular population group in a London borough or any other chosen city. Students should the approach of developing an evidence-informed campaign and advocacy report to convince commissioners to take up the health issue. Therefore, students should choose health issues that are of great concern in causing health inequalities among population groups within London boroughs or other cities. They should pay special attention to health inequalities affecting the population group and key factors that explain them. Thus, the work should focus on a specific health issue in relation to a population group; seeking to highlight the key factors and impact of the health issue on the population group and what the borough or city health commissioners can do differently from current interventions to improve health and healthcare for the population group. Students who prefer to study health issues among population groups within London or New York should choose a specific patch or borough.

 Key reading:
Corburn J (2009) Toward the healthy city: people, places, and the politics of urban planning. Cambridge, Mass.: MIT Press.
Galea S and Vlahov D (eds) (2005) Handbook of Urban Health: Populations, Methods and Practice. New York: Springer
Rydin Y, Bleahu A, Davies M, Dávila JD, Friel S, De Grandis D, Groce N, Hallal PC, Hamilton I,Howden-Chapman P, Lai KM, Lim CJ, Martins J, Osrin D, Ridley I, Scott I, Taylor M, Wilkinson P, and Wilson J (2012) Shaping cities for health: complexity and the planning of urban environments in the 21st century. In Lancet 2012; 379: 2079–108.
World Health Organization and UN HABITAT (2016) Global Report on Urban Health: equitable, healthier cities for sustainable development. Geneva: WHO.

Additional reading:
ACT (2010) ACT Strategic Plan for Positive Ageing 2010-2014: Towards an Age-Friendly City. Canberra (Australia): ACT Government. 
Corburn J (2013) Healthy city planning: from neighbourhood to national health equity. Abingdon: Routledge.
Gibbons M C, Bali R K and Wickramasinghe N (2010) Urban health knowledge management. New York; London: Springer.
Le Grand, Julian (2001) Health in the city. In: Marinker, Marshall, (ed.) Medicine and humanity. King's Fund:  London, UK; pp. 125‐139.
Libman K, Freudenberg N, O’Keefe E. (2010) A Tale of Two ObesCities: Comparing responses to childhood obesity in London and New York City. New York and London: City University of New York and London Metropolitan University Childhood Obesity Collaborative.
London Health Commission (2002, 2003, 2004, 2005, 2006/7) Health in London. London: Greater London Authority.
London Health Commission (2010) Mayor's Health Inequalities Strategy. London: Greater London Authority.
Manley D, van Ham M, Bailey N, Simpson L, and Maclennam D (2013) (eds) Neighbourhood effects or neighbourhood based problems? : a policy context. New York: Springer.
Mckintosh M (2005) London – the World in One City: An Analysis of 2001 Census Results. London: Greater London Authority.
Napier AD, Nolan JJ, Bagger M, Hesseldal L and Volkmann AM (2017) Study Protocol for the Cities Changing Diabetes Programme: a global mixed methods approach. In BMJ Open 2017;7 (12):e015240. doi:10.1136/ bmjopen-2016-015240. Available Online.
Prasad A, Gray CB, Ross A, and Kano M (2016) Metrics in Urban Health: Current Developments and Future Prospects. In Annual Review of Public Health 2016.37:113-133. Available Online; PDF
Rothenberg R, Stauber C, Weaver S, Dai D, Prasad A and Kano M (2015) Urban Health Indicators and Indices—current status. In BMC Public Health (2015) 15:494. Available Online
Whitman S, Shah A M and Benjamins, M (2011) Urban health: combating disparities with local data. New York: Oxford University Press.

Journals
Cities and Health, Online
Globalization and Health, Open Access
Health and Place Journal, Available Online
Implementation Science Journal, Available Online
Journal of Urban Health by New York Academy of Medicine; New York: Springer.
Journal of Public Health Policy 
Urban Health and Development Bulletin; Tygerberg: National Urbanisation and Health
Research Programme of the Medical Research Council. Available on LMU Library
Women's Health & Urban Life - an international and interdisciplinary journal; Toronto: Dept. of Sociology, University of Toronto, 2002-