Background
The effect of environmental factors
Green spaces in the built environment
Green space management policies
Urban green spaces and health: Where health in all policies (HiAP) come into play
Research questions and objectives
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understand how the cities implement HiAP in order to take into account the health inequities thanks to the political decisions related to green spaces (Objective 1)
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describe and analyze the interventions produced and implemented within the cities on the green spaces from a geographical point of view, according to the socio-economic characteristics of cities and neighborhoods (Objective 2)
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analyze the use and the contribution of urban green spaces to health and well-being of the inhabitants (Objective 3).
Methods/design
Setting of the research
Study design
The sample
Research proceedings
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Work package A involves a baseline study to analyze the characteristics of the Healthy Cities Network.
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Work package B investigates objective 1: Understand how cities implement the approach of health in all the policies, in order to take into account the health inequities thanks to the political decisions related to green spaces,
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Work package C investigates objectives 2 and 3: Describe and analyze cities’ interventions produced and implemented on the green spaces from a geographical point of view, according to the socio-economic characteristics of the cities and neighborhoods and analyze the use and the contribution of urban green spaces to health and well-being of the inhabitants.
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Work package D involves cross-analysis of data and proposed recommendations.
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Work package A (QUANT): Baseline study: Healthy Cities network characteristics (N = 80 cities)
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Work package B (QUAL-quant): Characterization of the HiAP approach and governance and green space policies (N = 6)
Goal: • constitute a baseline database of each healthy city according to its socio-demographic, geographic, green spaces characteristics and characterize the HiAP approaches in the 80 cities • build city profiles according to its socio-demographic, geographic, green spaces characteristics and characterize the HiAP approaches in the 80 cities | |
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Dimensions analyzed | Methods and tools |
Elements of description of each city that will be used as context factors concerning the demographic situation and dynamics, socio-economic heterogeneity, urban segregation (a dissimilarity index will be constructed by an aggregation of different indicator: unemployment rate, worker’s rate, higher education rate and median income at infra-communal scales) | Web-based data collection using the national socio-demographic base (INSEE. Data will be analyzed with Excel software |
Information about urban green spaces (quantity, surface area, etc.) to appreciate the coverage of urban green spaces in each city (relevance of urban green space in the city, share of urban green space per inhabitant, etc.) | Web-based data collection using the national geographic and topographic base (IGN) and the participative Open Street Map data set will be used. Data will be analyzed with Excel software and mapped with Philcarto and ArcGis programs |
HiAP approaches will be studied according to the degree of maturity drawing on the works of Storm et al. [51] and to the extent to which they address health inequities and green spaces in policy making | Two different online surveys: one for the elected officials and the practitioners responsible for the cities’ heath issues, and the other for the officials in charge of green space management |
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Work package C (QUAL - QUANT) – Geographical characterization of green spaces and green spaces use (N = 6)
Goals: • Characterize the cities according to the HiAP process of each case: levels of governance implemented (internal, external) and the strategies related to health, policy making processes related to green spaces and urban planning (44,45) (WP B1).
• Identify policy action relating to green spaces and intentions in terms of health and reducing health inequities (WP B2)
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Dimensions analyzed | Methods and tools | |
WP B1
| Combining different frameworks of HiAP and SIH assessment: - identification of the governance tools and the authorities involved - characterization of HiAP strategies [33]: cooperation, damage limitation, win-win situations and health-centered decision making - characterization of intersectoral governance in terms of coordination and sustainability [53] - characterization of the strategies aimed at reducing health inequities by using the Gradient Equity Lens [54] which describes, for every stage policy making, the strategies impacting on health inequities. Here, strategies such as “proportionate universalism”, targeting vulnerable populations [55‐57] or intersectoral strategies will be particularly characterized. | • document collection and review
Documents will be collected from municipal websites and during on-site visits. A content analysis based on the dimensions of Gradient Equity Lens tool [58] will be conducted. The modes of governance identified in the documents will be analyzed according to the theoretical framework of Baum and al. [52] and according to coordination and durability dimensions [53]. • semi-structured interviews
In each selected city, we will identify municipal staff along with staff from other organizations including from the private sector who deal with health issues. This will be done through the French Healthy Cities Network using snowball sampling. Interviews will explore partnerships and collaboration on health issues, health inequities and green spaces policy and management i.e. accessibility, esthetics, amenities and/or maintenance. All the interviews will be recorded and transcribed. A content analysis [25] will be performed with the software N′ Vivo10 ©. |
WP B2
| We will analyze two major dimensions: policy and implementation relating to establishing new green spaces, spatial planning, redevelopment and use of green spaces with regard to health and reducing health inequities. We will focus on accessibility (distance, number, continuity, safety), esthetics (landscaping, perception) and features (infrastructure...) and will draw on the theoretical model by Roué Le Gall [59]. We will furthermore analyze the mechanisms behind policy action on health inequities. This will enable us to clearly demonstrate the logical model of the policy action. | • a documentation review: urban plans (municipal town planning documents) and green spaces intervention plans will be already collected in work package C. • semi-structured interviews, on-site visits and participatory meetings. The logical model will be built and validated during these meetings. |
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Work package D: Case study synthesis and transferability
Goal: • Study spatial and geographical characteristics of the urban green spaces. This analysis will enable us to answer the following questions: what, where, how are urban green spaces distributed, managed and organized? Are there marked differences across the 6 cities in the type, location, distribution and nature of their green spaces? How can cities be characterized by their green spaces? (WP C1).
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Dimensions analyzed | Methods and tools | |
WP C1
| analyze the spatial distribution of green spaces in the city, the amenities, and the appropriateness with the social and demographic characteristics of cities and districts, their accessibility, configurations, nature and surface: - Size, topography (steeps slopes for example) and type (child recreation parks...) - availability (walkable travel times, signposts, number of entrances, number of bus stops existing within 200 m of a green space, etc.) - Location (spatial concentration vs. equitable spatial distribution of GS in towns for example) and neighborhood types (e.g. are they located in poor or rich districts, young or old populations?) - Broader context (are cities and their GS located near large national parks, the sea, mountains … or in a very dense and mineral area?) | Urban green spaces will be chosen in each of the six cities in order to ensure data representativity and comparability. These spaces will be identified by green space managers and municipal health departments as representing some form of strategy to reduce health inequities. Once these spaces have been identified, quantitative and qualitative data will be used for mapping and analysis: - IGN (BD-Topo base) and Open Street Map data to appraise the coverage of urban green space in each city (relevance of urban green space in the city, share of urban green space per inhabitant …). We will also measure the potential availability of urban green spaces potential availability using road network data and urban public network data - IGN (BD-Topo base) and Open Street Map data to appraise the location of each city and its green spaces in relation to important, or significant, natural places such as mountains, sea, and preserved national parks - Qualitative study results from observation in situ. Field data will be necessary for analyzing the urban green space type and topography, accessibility (number of entrances), etc. Finally, collected geographical data will be integrated into and processed by a geographical information system (SIG). The data will be used according to traditional spatial analysis methods at different scales (city, districts, and neighborhoods). |
Goal: • Observe physical features of green spaces and describe the use and non-use of urban green spaces identified by green space managers and municipal health departments as representing some form of strategy to reduce health inequities (WP C2)
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Dimensions analyzed | Methods and tools | |
WP C2
| For each city: seasonal use green spaces, (the main criteria for attractiveness), leisure use, surroundings, amenities, etc. This work package will complete the geographical data and help to characterize the use, esthetics and management of each urban green space selected. This will serve to enable different cities to share practices and enhance their innovation. For researchers, this will be an observational phase with knowledge transfer in mind | A qualitative study will combine observation in situ and interviews with green space users or non-users, and stakeholders involved in urban green space management and maintenance. - Observations: An observer will make observations in each selected city, at 4 different times per year in the different green spaces identified by the mapping (objective 2). We will explore items in order to characterize green space environments including: esthetics, equipment, leisure amenities, location, neighborhood, and users. - User and non-user interviews: Through on-site meetings with users and non-users living next to green spaces, interviews with residents could be planned in order to learn how they view the green space. Together, the interviews and observation periods at different times of the year will enable us to identify routine and occasional uses of public green spaces. - Stakeholder interviews: For each city, we will interview some key stakeholders of green space interventions (politics, NGOs, spatial planners, citizen committees, local organizations …) in order to better understand local green space policy, use and management. Finally, this study will also include on-site visits with practitioners from the selected cities. For each city observations will be completed by on-site visits with different stakeholders and policy makers concerned by the study. |
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for similar “green space” types and urban context but different “modes of governance”, which mode of governance seems to favor wellbeing and tackle the health inequities
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for similar “modes of governance” but different “green space” types and urban context, which configuration of green spaces seems to favor wellbeing and tackle health inequities.
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Contextual factors: socio-demographic situation and dynamics, position of the city in the French Healthy Cities Network, location of the city in relation to important or significant natural places such as mountains, sea, and preserved national parks,
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socio-economic characteristics: the socio-economic heterogeneity and urban segregation,
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the HiAP approach’s degree of maturity,
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green space characteristics: size, nature, context and accessibility.
Type of production | To whom? (targeted audience) | Why? (Specific objectives) | How? (Strategies of KT) | With whom? (stakeholders) | What context? | Indicators of achievement |
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Diffusion to scientific peers | ||||||
1 – Oral communication and/or poster | Peers, community of research | Inform: present the results of the research and improve the approach Disseminate: the results - on the protocol - on the results Communicate: data on evidence-based intervention concerning the reduction of health inequities at a local level | Less interactive strategy: oral presentation; poster or power point Interactive strategy During oral communication – exchange with the scientific community | Team of research Team of the French network of healthy cities | National congress: SFSP International congress: EUPHA, IUHPE Seminar: Health and environment Academic value and scientific credibility Scientific value of the project | Number of communication oral or not/in France and at international |
2 – Scientific papers | Peers, community of research | Disseminate: the results - on the protocol - on the results | Less interactive strategy Publication on peer-reviewed papers | Team of research | Impact factor of publication Number of published articles | |
3 – Research seminars | Peers, community of research | Exchange on methodology and results Improve research protocols | Interactive and structured strategy Exchanges with the scientific community and written production Less interactive strategy Dissemination of the minutes | Team of research | Scientific enhancement Close-up seminar Workshop– EUPHA, IUHPE | Seminar y/n Number of publications |
4- Final research report | Peers, community of research Funders | Endorse accountability Justify the funds Disseminate results and knowledge | Less interactive strategy Disseminations to and beyond the institutions of the stakeholders of the project | Team of research | Scientific value of the project | Fund use and justification Accountability Number of publications |
Type of production | To whom? (targeted audience) | Why? (Specific objectives) | How? (Strategies of KT) | With whom? (Stakeholders) | What context? | Indicators of achievement |
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Diffusion to practitioners | ||||||
5- Case study presentation | Selected cities, elected officials | Inform: present the results of the research and improve the approach Disseminate: the results - on the protocol - on the results Highlight the participation of cities | Short-term interactive strategy: exchanges decision-makers and elected officials Less interactive strategy Web-diffusion of the minutes | Network team Research team | Feedback information on results and interaction | Number of presentation |
6 –Site visits | Selected cities | Exchange on practices between the ejected-official and stakeholders Disseminate innovation on green spaces, urban planning and governance Reinforce team-building | Less interactive strategy Individual case study giving to the selected cities Public dissemination of the final report | Network team: leader Research team (assist) | Feedback information on results and interaction Part of the research protocol | Number pf visits/number of participants |
7- Publication of a practical guide by the French network of healthy cities and the EHESP | French Network of Healthy Cities Other French municipalities European network of Health cities | Exchange on practices between the ejected-official and stakeholders Disseminate innovation on green spaces, urban planning and governance | Less interactive strategy Dissemination of the guide and free access on the French Network of healthy cities web-site | Members of the board of the French Network of Healthy Cities Network team Research team | Document for dissemination to general public | Number of practical guide published and disseminated Number of downloads |
8-Seminar French Network of Healthy Cities /Ehesp | Elected official, decision-makers Researchers on public health | Exchange on practices between the ejected-official and stakeholders Disseminate innovation on green spaces, urban planning and governance | Short-term interactive strategy exchange between participants during the seminar Continuous but less interactive strategy Creation of a short movie (5 min) about health and urban planning – available on line | Members of the board of the French Network of Healthy Cities Network team Research team | Communication through the French network of healthy cities and the other municipalities Improvement of knowledge about interventions on health inequities | Number of participants Number of papers Number of web-visits |
9- Briefing notes HiAP/EV/Paysage | Elected official, decision-makers, practitioners Other French municipalities European network of Health cities | Disseminate innovation on green spaces, urban planning and governance | Continuous but less interactive strategy – briefing notes available for all, researchers and practitioners | Team project | Innovation on KT support | Number of downloading |