Perspectives on urban mobility in promoting physical activity in the context of commuting in Brazil / Perspectivas sobre mobilidade urbana na promoção da atividade física no contexto dos deslocamentos no Brasil

Despite Brazil's important advances in regulatory aspects related to city planning, the disorder-ly growth of Brazilian cities makes it difficult to implement changes that would result in greater opportunities for the active commuting of the population. This essay was designed to reflect on opportunities for improvement in the urban environment to promote physical activity in the context of commuting in Brazil. From this perspective, the study identified policies that promote orderly growth and support active commuting in cities. It also suggested the use of indicators to evaluate and monitor development, with a particular emphasis on active commuting. Furthermore, it is essential to adapt and improve the urban planning process to meet the needs of Brazilian municipalities and foster closer collaboration with civil society. Thus, it will be possible to verify the changes in the urban environment and their impact on the active commuting, promoting the development of healthy and sustainable cities

Apesar do Brasil apresentar importante avanço em aspectos regulatórios relacionados ao planejamento das cidades, o crescimento desordenado das cidades brasileiras dificulta a realização de mudanças que reflitam em maiores oportunidades no deslocamento ativo da população. Este ensaio foi elaborado com objetivo de refletir sobre as oportunidades para melhorias no ambiente urbano para a promoção da atividade física no contexto do deslocamento no Brasil. Nessa perspectiva, o estudo identificou políticas que permitem o crescimento ordenado e favoreça o deslocamento ativo nas cidades, além de sugerir o uso de indicadores para avaliação e monitoramento do desenvolvimento, com especial foco no deslocamento ativo. Ademais, é imprescindível que o processo de planejamento urbano seja adaptado e aprimorado considerando as necessidades dos municípios brasileiros e com aproximação da sociedade civil. Assim, será possível verificar as modificações no ambiente urbano e seu impacto no deslocamento ativo da população, estimulando a criação de cidades saudáveis e sustentáveis

Pressupostos epistemológicos das cidades amigas das pessoas idosas: revisão de escopo / Presupuestos epistemológicos de las ciudades amigables con las personas mayores: revisión de alcance / Epistemological assumptions of age-friendly cities: a scoping review

Resumo Objetivo Identificar os conceitos e perspectivas teóricas que fundamentam os estudos sobre Cidade Amiga da Pessoa Idosa. Métodos Revisão de escopo utilizando seis bancos de dados para identificar estudos publicados em revistas indexadas entre 2007 e 2021 usando as palavras-chave 'age-friendly' OR 'age friendly' OR 'cidade amiga'. Resultados Foram encontrados 2.975 estudos que após aplicação de critérios de exclusão resultaram em 227. Observou-se ampla variação no conceito do termo, porém muitos autores o fizeram replicando a OMS, sendo que em 59,5% dos estudos não houve menção de nenhuma perspectiva teórica. A teoria ecológica foi o referencial mais frequente (26%), sendo o termo usado como um equivalente a envelhecimento ativo. Autores de quatro países respondem pela maioria dos artigos (61%). Conclusão É necessário articular o conceito de Cidade Amiga da Pessoa Idosa com uma abordagem teórica e cultural para compreender mais profundamente as perspectivas do urbano e do social sob a lógica do envelhecimento populacional principalmente para a América Latina. A análise teórica nestes estudos e na gerontologia favorecerão discussões mais críticas sobre o envelhecimento, o idadismo e a crescente desigualdade social em curso.

Resumen Objetivo Identificar los conceptos y perspectivas teóricas que fundamentan los estudios sobre Cuidades Amigables con las Personas Mayores. Métodos Revisión de alcance utilizando seis bancos de datos para identificar estudios publicados en revistas indexadas entre 2007 y 2021, con las palabras clave 'age-friendly' OR 'age friendly' OR 'ciudad amigable'. Resultados Se encontraron 2975 estudios que, luego de aplicar los criterios de exclusión, quedaron 227. Se observó una amplia variación del concepto del término, aunque muchos autores replicaron a la OMS. En el 59,5 % de los estudios no se mencionó ninguna perspectiva teórica. La teoría ecológica fue la referencia más frecuente (26 %), y el término se usó como un equivalente al envejecimiento activo. La mayoría de los artículos (61 %) son de autores de cuatro países. Conclusión Es necesario unir el concepto de Cuidades Amigables con las Personas Mayores con un enfoque teórico y cultural para comprender más profundamente las perspectivas de lo urbano y lo social de acuerdo con la lógica del envejecimiento poblacional, principalmente en América Latina. El análisis teórico en estos estudios y en la gerontología permitirán discusiones más críticas sobre el envejecimiento, el edadismo y la creciente desigualdad social en curso.

Abstract Objective To identify the concepts and theoretical perspectives that underlie studies on age-friendly city. Methods This is a scoping review using six databases to identify studies published in indexed journals between 2007 and 2021 using the keywords 'age-friendly' OR 'age friendly' OR 'cidade amiga'. Results A total of 2,975 studies were found, which, after applying the exclusion criteria, resulted in 227. There was wide variation in the concept of the term, but many authors did so by replicating the WHO, and in 59.5% of studies there was no mention of any theoretical perspective. The ecological theory was the most frequent reference (26%), the term being used as an equivalent to active aging. Authors from four countries account for most articles (61%). Conclusion It is necessary to articulate the concept of age-friendly city with a theoretical and cultural approach to understand more deeply the urban and social perspectives under the logic of population aging, mainly for Latin America. Theoretical analysis in these studies and in gerontology will favor more critical discussions about aging, ageism and the growing social inequality in progress.

Mobilidade urbana e determinação social da saúde, uma reflexão / Urban mobility and social determination of health, a reflection

Resumo Compreender as relações entre mobilidade urbana e o processo saúde-doença requer perceber que a mobilidade urbana está diretamente relacionada ao tipo de cidade e sociedade onde ela ocorre. Assim, as diferentes condições de mobilidade nas cidades, um fenômeno subjacente à qualidade física e social do espaço urbano, pode implicar em iniquidades em saúde, em especial em países do capitalismo periférico. No Brasil, o modelo de mobilidade associado à precariedade da infraestrutura para pedestres e ciclistas, às longas distâncias a serem percorrida, ao tempo de viagem e à insuficiência e falta de qualidade dos sistemas coletivos de transporte, potencializa os efeitos deletérios sobre a saúde humana. Isso nos permite inferir sobre a mobilidade urbana como uma determinação social da saúde. Este ensaio busca lançar reflexões acerca da mobilidade urbana para além de um utilitarismo positivista a partir de um devir de justiça social alicerçado pela Promoção da Saúde e tendo como estratégia principal o fortalecimento das intersetorialidades.

Abstract Understanding the relationships between urban mobility and the health-disease process requires realizing that urban mobility is directly related to the type of city and society where it occurs. Thus, the different mobility conditions in cities, a phenomenon underlying the physical and social quality of urban space, may imply health inequities, especially in peripheral capitalist countries. In Brazil, the mobility model associated with precarious infrastructure for pedestrians and cyclists, long distances to be travelled, travel times, and the insufficiency and low quality of collective transport systems potentiates the deleterious effects on human health. This leads us to infer on urban mobility as a social determinant of health. This essay seeks to launch reflections on urban mobility beyond a positivist utilitarianism from a development of social justice based on Health Promotion and having as main strategy the strengthening of intersectorialities.

Active commuting among workers in the Southern of Brazil: a comparative analysis between 2006 and 2016 / Deslocamento ativo entre trabalhadores da região Sul do Brasil: uma análise comparativa entre 2006 e 2016

Abstract This article aims to compare the prevalence of active commuting to work in adults in the Southern region of Brazil between 2006 and 2016 according to sociodemographic and labor characteristics. The data from the Brazilian System for the Surveillance of Risk and Protection Factors for Chronic Diseases - VIGITEL were compared in 2006 and 2016 (≥18 years). Active commuting to work, sex, age group, education and job characteristics were collected by telephone survey and transportation in the cities of Florianópolis, Curitiba and Porto Alegre, using absolute and relative frequencies with their respective 95% confidence intervals. Active commuting increased significantly in 2016 compared to 2006. Florianópolis had the highest prevalence in the two years analyzed. In all capitals, there was a significant increase in the prevalence of the outcome, mainly for women, with secondary education and only in Florianópolis for men, with low schooling. The prevalence has also increased for job characteristics in all capitals. Active commuting to work increased significantly among adults living in southern Brazil, with emphasis on Florianópolis. Expanding interventions in this context is a necessity in Brazil.

Resumo O objetivo deste artigo é comparar a prevalência de deslocamento ativo para o trabalho em adultos na região Sul do Brasil entre 2006 e 2016 de acordo com características sociodemográficas e laborais. Os dados do Sistema Brasileiro de Vigilância de Fatores de Risco e Proteção para Doenças Crônicas (VIGITEL) foram comparados em 2006 e 2016 (≥18 anos). Deslocamento ativo para o trabalho, sexo, faixa etária, escolaridade e características laborais foram coletados por inquérito telefônico e analisados nas cidades de Florianópolis, Curitiba e Porto Alegre, utilizando as frequências absolutas e relativas com seus respectivos intervalos de confiança de 95%. O deslocamento ativo aumentou significativamente em 2016 em relação a 2006. Florianópolis apresentou as maiores prevalências nos dois anos analisados. Em todas as capitais houve aumento significativo na prevalência do desfecho, principalmente para mulheres, com ensino médio e apenas em Florianópolis para homens, com baixa escolaridade. A prevalência também aumentou para características laborais em todas as capitais. O deslocamento ativo para o trabalho aumentou expressamente entre os adultos que vivem no Sul do Brasil, com destaque para Florianópolis. Ampliar intervenções nesse contexto é uma necessidade no Brasil.

Influence of built environment on circulatory disease mortality: A case study of 17 cities in China / 环境与职业医学

Background In view of circulatory diseases, most previous studies focused on the impacts of air pollution and meteorological factors, while ignoring the influence of built environment. Objective To investigate and quantify the impact of built environment on circulatory diseases in China. Methods Circulatory disease mortality data and built environment data (including urban greenery coverage, urban land use, urban land use mix, urban road facilities and urban medical facilities) of 17 cities in China from 2000 to 2019 were collected. Multiple linear regression was used to analyze which built environment elements had significant influence on circulatory diseases, and to quantify their effects. Furthermore, the changes of built environment indicators on circulatory disease mortality were evaluated under different levels of urban economic development and various air quality. Results The built environment affected the mortality of circulatory diseases during the study period (P<0.05). Urban green space and commercial land area were negatively correlated with circulatory disease mortality, and regression coefficients were −0.550 and −0.280, respectively (P<0.05). On the contrary, the increase of urban road area, residential land ratio, and the degree of land use mix were positively associated with circulatory disease mortality, and their regression coefficients were 0.322, 0.283, and 0.176, respectively (P<0.05). When the level of urban economic development was low, the impact of commercial land use ratio on circulatory diseases was stronger, and the regression coefficient was −0.476 (P<0.05). When urban air pollution worsened, the impacts of per capita green coverage area and per capita urban road area on the disease were more prominent, and the regression coefficients were −0.528 and 0.372, respectively (P<0.05). Conclusion There is a significant correlation between urban built environment and mortality of circulatory diseases. To be specific, circulatory disease mortality has a negative correlation with per capita green coverage area and commercial land use ratio, and a positive correlation with per capita urban road area, residential land ratio and degree of land use mix.

Healthy City construction survey among residents living in Hangzhou City / 预防医学

Objective@#To investigate the awareness of and participation in Healthy City construction among residents in Hangzhou City, so as to provide insights into promotion of participation in Healthy City construction.@*Methods@#Residents at ages of 15 to 75 years were sampled using the multi-stage stratified random sampling method, from 30 townships in Jianggan, Xiaoshan and Tonglu counties of Hangzhou City from November 2019 to July 2020, and a questionnaire survey of 10 representative projects pertaining to Healthy City construction in Hangzhou City was performed to investigate the awareness of and participation in Healthy City construction.@*Results@#A total of 5 559 questionnaires were allocated, and 5 211 valid questionnaires were recovered, with an effective recovery rate of 93.74%. The respondents had a mean age of ( 43.82±17.25 ) years, and included 2 280 males ( 43.75% ) and 2 931 females ( 56.25% ). The overall standardized awareness and participation rates of Healthy City construction were 81.73% and 48.58% among the respondents. The projects with the three highest awareness included healthy environment improvements ( 92.67% ), travelling by public transportation ( 92.22% ) and tobacco control action ( 91.04% ), while the projects with the three lowest awareness included chronic disease management ( 75.57% ), maternal and child healthcare ( 72.73% ) and “Healthy Cell” Program ( 45.56% ). The projects with the three highest participation rates included travelling by public transportation ( 74.59% ), healthy environment improvements ( 65.17% ), tobacco control action ( 61.52% ), while the projects with the three lowest participation rate included chronic disease management ( 35.92% ), “Healthy Cell” Program ( 34.96% ) and maternal and child healthcare ( 33.20% ).@*Conclusions@# The overall proportion of participation in Healthy City construction is low among residents in Hangzhou City, and notably, the awareness rate of and the proportion of participation in chronic disease management, maternal and child healthcare and “Healthy cell” Program are both low.

Cidade saudável: o diagnóstico do território urbano por meio dos determinantes sociais de saúde: o caso Maracanaú / Healthy city: the diagnosis of the urban territory through the social determinants of health: Maracanaú case

To understand the urban territory through the analysis of Social Determinants of Health (SDOH) as a prerequisite for structuring a Healthy City Project. This research was characterized as a documentary survey through the Laws, Master Plan and Management Reports of the City of Maracanaú and in the Government Health Information Notebooks. The analysis took place through the reading and identification of what was about the SDOH, using Content Analysis. The results brought two categories of analysis that structured a diagnosis of the area, mapping the weaknesses found with regard to the SDOH analyzed, such as: population growth, mortality rate, urban violence, among others. It is believed that the diagnosis of the area carried out through the SDOH made it possible to identify the intervention points that can be used for the preparation of a Healthy City Project.

Compreender o território urbano por meio da análise dos Determinantes Sociais de Saúde (DSSs) como pressupostos para a estruturação de uma Agenda de Cidade Saudável. Esta pesquisa se caracterizou como um levantamento documental por meio das leis, plano diretor e relatórios de gestão da cidade de Maracanaú e nos cadernos de informação em saúde do governo. A análise se deu pela leitura e identificação do que versava sobre os DSSs, utilizando-se a análise de conteúdo. Os resultados trouxeram duas categorias de análise que estruturaram um diagnóstico do território, mapeando as fragilidades encontradas no que diz respeito aos DSSs analisados como crescimento demográfico, taxa de mortalidade, violência urbana, dentre outros. Acredita-se que o diagnóstico do território realizado por meio dos DSSs possibilitou identificar os pontos interventivos que possam ser utilizados para a preparação de uma agenda de cidade saudável.

Da cidade dos afetos para a cidade saudável / From affection cities to the healthy cities

Resumo Trata-se de experimentações de pensar a produção de subjetividades na cidade por meio dos afetos entre os corpos (humano, arquitetural e territorial) para potencializar a promoção do bem-estar humano com melhoria da saúde pública. A Organização Mundial de Saúde aponta a saúde como "um estado de completo bem-estar físico, mental e social e não somente ausência de afecções e enfermidades". Desse modo, busca investigar cidades saudáveis relacionando ambiente construído e social com os sujeitos das cidades, enfocando as múltiplas e complexas particularidades da saúde no espaço em transformação e movimento. Para tanto, este estudo trata de três experiências de orientação desenvolvidas com trabalhos finais de graduação em Arquitetura e Urbanismo, utilizando a abordagem metodológica rizomática de Deleuze e Guattari, com a prática da deriva situacionista e experimentação da cartografia de afetos, que potencializaram intervenções em áreas do entorno de rios das cidades de Bragança Paulista e Presidente Prudente. Assim, por meio da tessitura da produção de afetos nas zonas de intensidades das multiplicidades, heterogeneidades e singularidades espaciais existentes permitiu vibrar todos que se aproximaram para engajarem em uma proposta espacial libertária nos microespaços de resistência, ativando-as, promovendo invisibilidades sociais e, dessa maneira, poder potencializar a cidade saudável.

Abstract Experiments of thinking the production of subjectivities in the city through the affects between the bodies (human, architectural and territorial) to enhance of human well-being with improvement of public health. The World Health Organization points to health as "a state of complete physical, mental and social well-being and not just the absence of illness and disease." This paper seeks to investigate healthy cities relating as a built and social environment with city subjects focusing on the multiple and complex health particularities in transformation and movement. Therefore, this study deals with three experience orientations developed with final undergraduate works in Architecture and Urbanism, using a rhizomatic methodological approach of Deleuze and Guattari, with the practice of situationist derive and experimentation of affections cartographies, to strengthen interventions in the side of rivers in Bragança Paulista and Presidente Prudente cities. Thus, through the process of the production of affects in the intensities zones, multiplicities, heterogeneities and singularities of space allowed to vibrate all who approached to engage in a libertarian spatial proposal in the microspaces of resistance, activating them, promoting social invisibilities and, in this way, empower the healthy city.

Evaluation of the construction status of a healthy city in central China based on the health index method / 公共卫生与预防医学

Objective To evaluate the construction status of a healthy city in central China, and clarify the weak links and construction results in the construction of a healthy city, and to provide a basis for the relevant government departments to issue policies. Methods Healthy city construction evaluation system in this city was established according to the National Healthy City Construction Evaluation System (2018) of the National Healthy City Evaluation Office Forty-two sets of health city construction index data in 2017-2018 were collected and analyzed. The single index was calculated according to the Guidance Manual for Filling in the Healthy City Evaluation Data, and the single index data was then standardized. The Delphi method was used to consult the weights of the three-level index. Finally, the sub-index and the total index of each dimension of the city's healthy city construction were calculated based on the health index method. Results The results of the 2017-2018 healthy city construction evaluation showed that 35 of the 42 indexes participated in the evaluation, and the total-indices of the two years were 77.71 and 79.95, respectively. The two-year sub-indices of the five dimensions of health service, health culture, health environment, healthy population, and healthy society were 17.17 and 18.32, 11.39 and 12.85, 19.21 and 17.94, 13.81 and 13.81, 16.12 and 17.04, respectively. Except for the decline in the health environment dimension, the other four sub-indices and the total healthy city index showed an upward trend year by year. In the past two years, the comprehensive proportions of the corresponding weight of the five dimensions sub-indices were 95.58% in health culture, 95.47% in health service, 73.99% in health environment, 73.27% in healthy society, and 69.52% in healthy people. Conclusion After the construction of national healthy city and the pilot construction of national healthy city, a city in central China achieved its first results in five dimensions of healthy city. In 2018, among the 35 indexes participated in the evaluation in this city, 30 were positive, and 26 were better than the national/ provincial target value. However, some construction indices were still far from the standard values. The development of the five dimensions was unbalanced, and there were weak links in different degrees.

Perspectives on governance for health and Healthy City development / 上海预防医学

The paper highlights the three key words:city, health and development.On the one hand, it is necessary to understand the city with systematic thinking, to focus on the health gap and health equity of different populations in the same city, and the continuous spectrum of health indicators or disease distribution in the same population.On the other hand, it is suggested to establish a "participatory governance" model in Healthy City development-government for health, to further promote the development of healthy cities.Finally, it briefly introduces the report of "Healthy City 2.0-Towards a Planet City" presented by Professor Hancock at the 23rd International Conference on Health Promotion of IUHPE, 2019 in New Zealand.

Perspectives on governance for health and Healthy City development / 上海预防医学

The paper highlights the three key words:city, health and development.On the one hand, it is necessary to understand the city with systematic thinking, to focus on the health gap and health equity of different populations in the same city, and the continuous spectrum of health indicators or disease distribution in the same population.On the other hand, it is suggested to establish a "participatory governance" model in Healthy City development-government for health, to further promote the development of healthy cities.Finally, it briefly introduces the report of "Healthy City 2.0-Towards a Planet City" presented by Professor Hancock at the 23rd International Conference on Health Promotion of IUHPE, 2019 in New Zealand.

Health literacy and healthy city satisfaction of residents in Ningbo / 预防医学

Objective@#To understand the health literacy and healthy city satisfaction of residents in Ningbo,and to provide a basis for further development of healthy city .@*Methods@#The permanent residents aged 15 years old and above in six urban districts of Ningbo were selected by stratified multi-stage sampling and probability-proportionate-to-size sampling method. The health literacy and healthy city satisfaction of residents were surveyed by a self-designed questionnaire. Multivariate linear regression model was used to analyze the correlation between health literacy and healthy city satisfaction .@*Results@#A total of 3 300 people were investigated and 3 035 valid questionnaires were returned,with an effective rate of 91.97%. The scores of health literacy were 22.67±4.83 in males and 23.04±3.13 in females;the scores of healthy city satisfaction were 3.30±0.32 in males and 3.31±0.33 in females;there were no statistically significant differences in the scores above between genders（P>0.05）. The scores of health literacy were 25.65±4.14 in the residents aged 35-44 years and 20.34±3.54 in the residents aged 15-34 years;the scores of healthy city satisfaction were 3.16±0.32 in the former and 3.45±0.31 in the latter;the former scored higher in health literacy but lower in healthy city satisfaction than the latter （both P<0.05）. The scores of health literacy were 23.80±3.90 in the married residents and 18.94±3.22 in the single,divorced or widowed ones;the scores of healthy city satisfaction were 3.35±0.33 in the former and 3.22±0.32 in the latter;the former scored higher both in health literacy and healthy city satisfaction than the latter （both P<0.05）. The results of multivariate linear regression analysis showed that the higher the scores of health literacy,the higher the scores of healthy city satisfaction （β'=0.028,P<0.05） .@*Conclusion@#Improving health literacy of residents could improve their satisfaction with healthy city construction.

Aproximación a la experiencia de personas viejas que viven solas en contextos precarios: Ciudad Bolívar, Bogotá-Colombia / Approach to the experience of older people living alone in precarious contexts: Ciudad Bolívar, Bogotá-Colombia

Resumen Este artículo presenta los resultados de una aproximación cualitativa de las condiciones percibidas de la ciudad por parte de adultos mayores, en un contexto urbano precario de Bogotá-Colombia. Para esta aproximación se usaron algunos dominios del modelo de Ciudades amigables con la vejez de la Organización Mundial de la Salud entre ellos: la habitación, la habitabilidad, el transporte, el soporte comunitario, las redes sociales, el apoyo, la participación social, la empleabilidad, el respeto y la inclusión social como centrales para evaluar desde la perspectiva de los sujetos hasta una ciudad amigable con la vejez y su percepción de salud. A partir de la aplicación de herramientas cualitativas en un contexto urbano se exploró en estos dominios específicos la interpretación y los recursos que los mayores tienen frente a la experiencia de vivir solo.

Abstract This article presents the results of a qualitative approximation of the city conditions perceived by older adults in a precarious urban context of Bogotá-Colombia. For this approach, some domains of the "Age-friendly Cities" models, by the World Health Organization, were used, such as: habitation, habitability, transportation, community support, social networks, support, social participation, employability, respect and social inclusion, all this considered central to evaluate from the perspective of the individuals to an age-friendly city and their perception of health. Based on the application of qualitative tools in an urban context, the interpretation and resources that older people have, compared to the experience of living alone, were explored in these specific domains.

Prevalence of active transportation among adults in Latin America and the Caribbean: a systematic review of population-based studies / Prevalencia del transporte activo en los adultos de América Latina y el Caribe: revisión sistemática de estudios poblacionales / Prevalência do deslocamento ativo em adultos na América Latina e Caribe: revisão sistemática de estudos populacionais

ABSTRACT Objective To describe the prevalence of "active" (self-propelled, human-powered) transportation in the Latin America and Caribbean (LAC) region over the past decade. Methods MEDLINE, Excerpta Medica (Embase), SportDiscus, Lilacs, MediCarib, Web of Science, OVID, CINAHL, Scopus, Google Scholar, National Transportation Library, and TRIS/TRID were searched for articles on active transportation published between January 2003 and December 2014 with (at least) a title and abstract in English, Portuguese, or Spanish. Research was included in the study if the two reviewing authors agreed it 1) was conducted in an adult sample (≥ 18 years old), 2) was designed to be representative of any LAC area, and 3) reported at least one measure of active transportation. Reference lists of included papers and retrieved reviews were also checked. A total of 129 key informants (87 scientific experts and 42 government authorities) were contacted to identify additional candidate publications. Two other authors extracted the data independently. Results A total of 10 459 unique records were found; the full texts of 143 were reviewed; and a total of 45 studies were included in the study, yielding estimates for 72 LAC settings, most of which were in Argentina, Brazil, and Colombia. No eligible studies were found for the years 2003-2004, resulting in a 10-year study time frame. Estimates were available for walking, cycling, or the combination of both, with a high degree of heterogeneity (heterogeneity index (I2) ≥ 99%). The median prevalence of active transportation (combining walking and cycling) was 12.0%, ranging from 5.1% (in Palmas, Brazil) to 58.9% (in Rio Claro, Brazil). Men cycled more than women in all regions for which information was available. The opposite was true for walking. Conclusions Prevalence of active transportation in LAC varied widely, with great heterogeneity and uneven distribution of studies across countries, indicating the need for efforts to build comprehensive surveillance systems with standardized, timely, and detailed estimates of active transportation in order to support policy planning and evaluation.

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RESUMO Objetivo Descrever a prevalência do "deslocamento ativo" (uso de modais de transporte autopropulsados e de propulsão humana) na região da América Latina e Caribe (ALC) na última década. Métodos Foi realizada uma busca nos bancos de dados MEDLINE, Excerpta Medica (Embase), SportDiscus, Lilacs, MediCarib, Web of Science, OVID, CINAHL, Scopus, Google Scholar, National Transportation Library e TRIS/TRID por artigos sobre deslocamento ativo publicados entre janeiro de 2003 e dezembro de 2014 com (pelo menos) título e resumo em inglês, espanhol ou português. Pesquisas foram incluídas no estudo se os dois autores da revisão concordaram que a pesquisa 1) havia sido realizada em uma amostra de adultos (≥ 18 anos de idade), 2) tinha o intuito de ser representativa de uma área da ALC e 3) relatava pelo menos uma medida de deslocamento ativo. As referências bibliográficas dos artigos e revisões incluídos também foram analisadas. Foram contatados 129 informantes-chave (87 peritos científicos e 42 autoridades de governo) para identificar possíveis publicações adicionais de interesse. Outros dois autores extraíram os dados de maneira independente. Resultados Foram encontrados 10 459 registros não duplicados; os textos completos de 143 foram examinados; e 45 foram incluídos na revisão, gerando estimativas para 72 regiões da ALC, a maioria na Argentina, Brasil e Colômbia. Não foi encontrado nenhum estudo dos anos 2003-2004 que atendesse os critérios de inclusão; portanto, o período de análise foi de 10 anos. Foram obtidas estimativas para caminhada, deslocamento com bicicleta ou a combinação de ambos os modais; con alto grau de heterogeneidade (índice de heterogeneidade (I2) ≥ 99%). A prevalência mediana de deslocamento ativo (combinação de caminhada e deslocamento com bicicleta) foi de 12,0%, variando de 5,1% (em Palmas, Brasil) a 58,9% (em Rio Claro, Brasil). Homens andaram de bicicleta mais do que as mulheres em todas as regiões para as quais havia informações disponíveis. Constatou-se o oposto em relação à caminhada. Conclusões A prevalência de deslocamento ativo variou muito na ALC, com grande heterogeneidade e distribuição desigual de estudos entre países. Isso indica necessidade de esforços para construir sistemas de vigilância integrais que proporcionem estimativas padronizadas, oportunas e detalhadas do deslocamento ativo para subsidiar a formulação e avaliação de políticas.

Construction methods of America,s health rankings and county health rankings: Implications for China / 中国卫生政策研究

This review summarised and compared the contents and methods of America,s Health Rankings (AHR)and the County Health Rankings(CHR)in the United States by using literature review.AHR and CHR are the currently widely used population health assessment index ranking systems in the United States,respectively,which provided an analysis of population health on a state-by-state basis and a county-by-county basis by evaluating a histori-cal and comprehensive set of health outcomes and health determinants data to determine the health benchmarks and state/county rankings.The selection criteria of each indicator take into account of reliability, availability, stability, and intervention.The determination of weights of each indicator took into considerations the literature review,a histori-cal perspective,weights used by other rankings,internal analyses of the variation in outcomes explained by each factor, and pragmatic issues involving communications and stakeholder engagement.By comparison, it was found that AHR and CHR have a higher level of accuracy in the classification as they are well -defined by population demographics and geography respectively.The evaluation of health cities and health villages and towns in China is more complicated. There are few studies on village and town health rankings systems.This article reviewed the evaluation methods of AHR and CHR with a view to providing a reference for research on the evaluation system of City Health Rankings and the Village and Town Health Rankings in China.

Política de promoção da saúde e planejamento urbano: articulações para o desenvolvimento da cidade saudável / Health promotion policy and urban planning: joint efforts for the development of healthy cities

Resumo A Politica Nacional de Promoção da Saúde (PNPS) define as estratégias para a construção de políticas públicas, intersetoriais, que contribuem para o desenvolvimento de cidades saudáveis. O planejamento urbano é uma ferramenta para a melhoria da qualidade de vida, colaborando na promoção da saúde. Tomando por referência estudos e ações de cooperação desenvolvidas pelo Laboratório de Investigações Urbanas (LABINUR/FEC-Unicamp), este artigo descreve aspectos relevantes da PNPS que têm interface com as políticas de Planejamento Urbano no Brasil. Identificou-se um crescimento de dispositivos interdisciplinares e intersetoriais com a nova PNPS, através da Portaria 2.446/14, tais como: mobilidade e acessibilidade; desenvolvimento seguro (saneamento, habitação, transporte); alimentação saudável com inclusão social e diminuição da pobreza (hortas urbanas); práticas corporais e atividades físicas com a melhoria dos espaços urbanos. Conclui-se que a participação social, a intersetorialidade e a contribuição da universidade são aspectos diferenciais para promoção das cidades saudáveis.

Abstract The National Health Promotion Policy (PNPS) defines strategies for devising inter-sectoral public policies that ensure the development of healthy cities. Urban planning constitutes a tool to improve the quality of life and enhance health promotion. Using the studies and cooperation actions conducted by the Urban Research Laboratory (LABINUR/FEC-Unicamp) as a reference, this article describes relevant aspects of the PNPS that have an interface with urban planning policies in Brazil. An increase in interdisciplinary and inter-sectoral measures related to the new PNPS after the passing of Ordinance 2.446/14 was identified, which include: mobility and accessibility; safe development (sanitation, housing and transport); healthy eating with social inclusion and reduction of poverty (community vegetable gardens); corporal activities and physical exercise and the enhancement of urban spaces. The conclusion drawn is that social participation, inter-sectoral activities and the role of the university are important aspects for the promotion of healthy cities.

Ciudades sostenibles y saludables: estrategias en busca de la calidad de vida / Healthy and sustainable cities: strategies in the search for quality of life / Cidades sustentáveis e saudáveis: estratégias visando qualidade de vida

Este artículo discute la relación que hay en los planteamientos del desarrollo sostenible y de las ciudades saludables como estrategias que surgen de la promoción de la salud. Para ello, la participación social e intersectorial hace de la gobernanza un requisito indispensable en la construcción de ciudades sostenibles y saludables que permitan lograr una mayor equidad en salud y a su vez una mejor calidad de vida de la población.

This paper discusses the relationship between the proposals of sustainable development and healthy cities as strategies arising from health promotion. To achieve this, social and inter-sect oral participation makes governance an essential requirement for the construction of sustainable and healthy cities that lead to more health equity and improve the quality of life of their populations.

Este artigo discute a relação entre as teorias de desenvolvimento sustentável e as de cidades saudáveis como estratégias originadas da promoção da saúde. A participação social e entre vários setores faz com que a governança seja um requisito necessário na construção de cidades sustentáveis e saudáveis, onde mais equidade na saúde e melhor qualidade de vida para a população sejam possíveis.

Socioeconomic and regional differences in active transportation in Brazil / Diferenças socioeconômicas e regionais na prática do deslocamento ativo no Brasil

ABSTRACT OBJECTIVE To present national estimates regarding walking or cycling for commuting in Brazil and in 10 metropolitan regions. METHODS By using data from the Health section of 2008's Pesquisa Nacional por Amostra de Domicílio (Brazil's National Household Sample Survey), we estimated how often employed people walk or cycle to work, disaggregating our results by sex, age range, education level, household monthly income per capita, urban or rural address, metropolitan regions, and macro-regions in Brazil. Furthermore, we estimated the distribution of this same frequency according to quintiles of household monthly income per capita in each metropolitan region of the country. RESULTS A third of the employed men and women walk or cycle from home to work in Brazil. For both sexes, this share decreases as income and education levels rise, and it is higher among younger individuals, especially among those living in rural areas and in the Northeast region of the country. Depending on the metropolitan region, the practice of active transportation is two to five times more frequent among low-income individuals than among high-income individuals. CONCLUSIONS Walking or cycling to work in Brazil is most frequent among low-income individuals and the ones living in less economically developed areas. Active transportation evaluation in Brazil provides important information for public health and urban mobility policy-making

RESUMO OBJETIVO Apresentar estimativas nacionais sobre o deslocamento a pé ou de bicicleta no trajeto casa-trabalho no Brasil e em 10 de suas regiões metropolitanas. MÉTODOS Utilizando dados do Suplemento sobre Saúde da Pesquisa Nacional por Amostra de Domicílios de 2008, estimamos a frequência de pessoas empregadas que se deslocam a pé ou de bicicleta no trajeto casa-trabalho estratificada por sexo, e segundo faixa etária, escolaridade, renda domiciliar per capita, residência em área urbana ou rural, regiões metropolitanas e macrorregiões do país. Adicionalmente, estimamos a distribuição da mesma frequência segundo quintos da distribuição da renda domiciliar per capita em cada região metropolitana. RESULTADOS Um terço dos homens e mulheres empregados desloca-se a pé ou de bicicleta de casa para o trabalho no Brasil. Em ambos os sexos, esta proporção diminui com o aumento da renda e da escolaridade e é maior entre os mais jovens, entre os que residem em área rural e naqueles residentes na região Nordeste. A depender da região metropolitana, a prática de deslocamento ativo entre os mais pobres é de duas a cinco vezes maior do que entre os mais ricos. CONCLUSÕES O deslocamento a pé ou de bicicleta para o trabalho no Brasil é mais frequente entre os mais pobres e entre pessoas que vivem em áreas e regiões economicamente menos desenvolvidas. A avaliação do deslocamento ativo no País traz informações importantes para a discussão de políticas públicas de mobilidade.

Resultados del estudio de percepciones de actores sociales sobre salud, promoción de la salud, participación social, y de planes municipales región central de occidente, Costa Rica - 2011 / Results of the study of perceptions of stakeholders on health, health promotion, social participation, and municipal plans central west, Costa Rica - 2011

La salud representa un derecho humano fundamental y se constituye a su vez en un componente indispensable para la vida. Además, es el resultado de la interacción de determinantes sociales, económicos, ambientales, espirituales, políticos; por consiguiente, debe abordarse desde un enfoque integral en el que se articulen esfuerzos individuales, colectivos e intersectoriales en procura de alcanzar propósitos comunes desde el enfoque de promoción de la salud. En este sentido, los gobiernos locales tienen un rol protagónico por ser los responsables de gestar políticas, impulsar la formulación e implementación de programas y proyectos de manera concertada. Por lo anterior, la Dirección Regional de Rectoría de la Salud Central de Occidente del Ministerio de Salud, realizó en el año 2011 un estudio de línea base a fin de dar respuesta a los siguientes interrogantes: ¿Cuáles son las percepciones sobre salud, promoción de la salud y participación social que tienen los actores sociales municipales y cuáles son las principales acciones en salud integradas en los planes estratégicos de alcaldías de las municipalidades que conforman la Región Central de Occidente, Costa Rica? El estudio fue de tipo descriptivo y exploratorio con enfoque cualitativo, que permitió el acercamiento a los actores sociales para obtener los datos mencionados y fuentes documentales de las municipalidades de la Región Central de Occidente. En este marco, el presente artículo recopila referentes teóricos-metodológicos utilizados, los principales hallazgos, las conclusiones y algunas recomendaciones generales derivadas del estudio. Los resultados obtenidos representan un insumo valioso para redefinir estrategias de negociación y abogacía así como procesos rectores que fomenten el posicionamiento del enfoque en el quehacer de los gobiernos locales y por ende, favorecer la construcción de una nueva cultura de salud desde una lógica positiva, proactiva e innovadora.

Health represents a fundamental human right and, at the same time, constitutes an indispensable component for life. In addition, it is the result of the interaction of social, economic, environmental, spiritual and political determinants; therefore, it must be addressed from an integral approach in where the individual, collective and cross-sectorial efforts are articulated in order to achieve common purposes from a promotion of health approach. In this sense, the local governments play a leading role because they are the responsible for developing policies, promoting the formulation and implementation of programs and projects on an agreed way. Therefore, the Regional Directorate of Health Rectory of the Central West of the Health Ministry conducted a baseline study in 2011 to provide answers to the following questions: What are the perceptions of health, health promotion and social participation that municipal stakeholders have and what are the main health actions integrated in their strategic mayor plans of the municipalities that constitute the Central West Region in Costa Rica? It was a descriptive and exploratory study with qualitative approach which enabled the approach to stakeholders to obtain the mentioned data and documentary sources of the municipalities in the Central West Region. In this context, this article collects theoretical-methodological referents, the main findings, conclusions and some general recommendations derived from the study. The obtained results definitely represent a valuable input to redefine negotiation and advocacy strategies as well as directing processes that encourage the positioning of the approach in the work of the local governments and therefore, promote the construction of a new culture of health from a positive, proactive and innovative logic.

Planos locais de promoção da saúde: intersetorialidade(s) construída(s) no território / Local health promotion plans: intersetoralities created in the territory

O artigo aponta para a importância de se considerar as especificidades dos espaços/territórios/locais de vida individual e coletiva na construção de ações de promoção da saúde e explora como essa abordagem tem consolidado conceitualmente o respeito às territorialidades e à territorialização das ações como um princípio e uma estratégia operacional da promoção da saúde. Com base na literatura selecionada, os autores discutem a necessidade de se vislumbrar o território vivido enquanto locus para operacionalizar intersetorialidade(s), dando voz às pessoas que ali vivem, desejam e resolvem seus problemas complexos, às redes sociais já existentes e àquelas emergentes. Apresentam ainda uma estratégia/método validado (Método Bambu) nacional e internacionalmente para elaboração de planos locais de promoção da saúde, o qual permite a priorização de ações mediante a escuta da população e dos gestores.

The article highlights the importance of considering the specificities of spaces/territories/ locations of individual and collective life in creating health promotion actions. It explores how this approach has conceptually consolidated respect for territoriality and territorial actions as a principle and an operational health promotion strategy. Based on the literature, the article also points to the need to envision the territory occupied as a locus to put intersetorialities into practice, giving a voice to people who live there, seek to and solve their complex problems, to existing and emerging social networks. It also presents a nationally and internationally validated strategy/method (Bamboo Method) for the development of local health promotion plans, which enables the prioritization of actions by listening to the people and to the managers.