City Health

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. E. Didem EVCİ KİRAZ
Aydın Adnan Menderes Üniversitesi Tıp Fakültesi, Halk Sağlığı ABD, Çevre Sağlığı BD, Aydın, Türkiye
Article Language: TR
Şehirlerimizi Oluşturan İnsanlara Yatırım Yapmak Şehirler canlıdır.

İnsan sağlığından sorumlu olan tüm taraflar, şehri de canlı olarak kabul etmeli ve insana gösterdikleri özenin aynısını şehre de göstermelidirler. Yeşile yatırım yapma gibi klasik yaklaşımlardan arındırılmış, şehri oluşturan insanlara yatırım yapmaya odaklanmış bakış açılarına ihtiyaç vardır. Dünya Sağlık Örgütü (DSÖ) sağlıklı şehirler projesini başlatırken, şehir sağlığı konularını temel başlıkları ile sıralamış, her birini mesajlara dönüştürmüş ve sağlığı geliştirmek amaçlı bu mesajların doğru adrese gitmesini amaçlamıştı. Proje mesaj yollarını açtı, mesajlar yerine ulaştı. Ancak, beklentiler ve yarışlar da arttı.

Bir Süreç, Bin bir Hikâye

Tarihsel Bakışla Türkiye'de Halk Sağlığı kitabında da yazdığım 'Şehir Sağlığı' bölümünden bazı cümlelerle süreci özetlersek:

*1978 yılında yayınlanan 'Alma Ata Bildirisi' 'Şehir Sağlığı' kavramının temeline en önemli katkılardan birini yapmıştır.
*DSÖ 'Sağlıklı Şehirler Projesi'ni bir araç, bir anahtar olarak tanımlamıştır.
*Kopenhag'da DSÖ Avrupa Bölge Ofisi bünyesinde 'DSÖ Şehir Sağlığı Avrupa Merkezi'nin kurulması ile Sağlıklı Şehirler Projesi hız kazanmıştır (1998-2002).
*1999 yılında Türkiye'de Sağlık Bakanlığı tarafından 80 ile bir resmi yazı gönderilerek Belediyeler Sağlıklı Şehirler Projesi'ne davet edilmiştir.
*Türkiye'de Sağlıklı Şehirler Projesi için milad 2000 yılı olmuştur. DSÖ 2000 yılı sonuna kadar Türkiye'ye sekiz şehir kotası ayırmıştır.
*Sağlıklı Şehirler Projesi'nin yurtiçi koordinasyonu görevi Sağlık Bakanlığı Temel Sağlık Hizmetleri Genel Müdürlüğü'ne verilmiştir. Yurtdışı koordinasyonu görevi ise Sağlık Bakanlığı Dış İlişkiler Dairesi Başkanlığına verilmiştir. Daire Başkanı Bekir Metin tarafından süreç yönetilmiştir. 13 Haziran 2000 tarihinde Sağlık Bakanlığı tarafından Temel Sağlık Hizmetleri Genel Müdürlüğü bünyesinde, Dr. E. Didem Evci Kiraz 'Ulusal Sağlıklı Şehirler Ağı Koordinatörü' olarak atanmıştır.
*Bursa Büyükşehir Belediyesi'nin DSÖ'ye yaptığı adaylık başvurusu 5 Temmuz 2000 tarihinde kabul edilmiştir. Bursa, Türkiye'den DSÖ Avrupa Sağlıklı Şehirler Ağı'na ilk üye olan şehir olmuştur.
*DSÖ tarafından, Eylül 2003'den itibaren ağların akreditasyonuna başlanmıştır.
*Bu süreç Türkiye'de şehir sağlığı açısından önemlidir, 'Sağlıklı Kentler Birliği' kurulma süreci başlamıştır. .
*Ulusal ağa üye şehirlere birliğin kurucu üyesi olmaları için katılma çağrısı yapılmış, Çankaya Belediyesi koordinatörü Ethem Torunoğlu'nun ifadesi ile 'bu işin öznesi olan bir avuç Donkişot', Yalova (Yakup Bilgin Koçal-Metin Sabuncu), Van, Kadıköy (Selami Öztürk-Şule Onur), Afyon, Tepebaşı (Ahmet Ataç-Melih Savaş), Çankaya (Muzaffer Eryılmaz-Ethem Torunoğlu), Ürgüp (Bekir Ödemiş-Ömer Kıvanç), Ordu, Kırıkkale (Veli Korkmaz-Zühtü Bozdemir) ve Bursa (Hikmet ŞahinNalan Fidan) Büyükşehir Belediyeleri meclis kararı alarak Birliğin kurucu üyeleri olmuşlardır.
*Sağlıklı şehirler projesi artık bir proje olmaktan çıkmaya başlamıştır.
*2004 yılının sonunda, 22.12.2004 tarihli Resmî Gazete'de, Türkiye Sağlıklı Kentler Birliği'nin kuruluşu yayınlanmıştır.
*Türkiye Sağlıklı Kentler Birliği, kurulduğu tarihten itibaren, 2014 yılına kadar, Bursa Büyükşehir Belediyesinde görevli, Yüksek Şehir Plancısı ve Bursa sağlıklı şehirler projesi koordinatörlüğünü de yapmış olan Nalan Fidan'ın müdürlüğü ile hayatını devam ettirmiştir. Nalan Fidan, görevini 2014'de, hâlen Birlik Müdürü olan Şehir Plancısı Murat Ar'a devretmiştir.

Projelerin en tehlikeli yanı; eğer sürdürülebilirlikleri yoksa yok olmalarıdır. Sağlıklı şehirler projesi, şehir sağlığı müfredatının oluşmasını sağlayarak sürdürülebilirliği garantilemiştir. Aydın Adnan Menderes Üniversitesi Tıp Fakültesi'nde 2005 ve Aydın Sağlık Hizmetleri Meslek Yüksekokulu'nda 2010 yılından bu güne, 'Şehir Sağlığı' dersleri müfredata girmiştir. Özellikle Türkiye'de kurulan Sağlıklı Kentler Birliği yapılanması şehir sağlığı yaklaşımının büyük bir nüfusta yaygınlaşmasını sağlamıştır. Şu an sağlıkla ilgili eğitim vermeyen bir çok üniversite bölümünde şehir ve sağlık ilişkisi anlatılmaktadır.

İnsana Nasıl Yatırım Yaparsınız?
Sağlık, eğitim ve ekonomi üzerine inşa edilebilir. Ulaşım, istihdam, iletişim, sosyal destek mekanizmaları gibi bileşenlerle birlikte sağlık değerlendirildiğinde, bir toplumun sağlık ve refah düzeyi ortaya çıkar. İnsana yatırım, sağlığın sosyal belirleyicisi dediğimiz eğitim, ekonomi ve bu bileşenlere yatırım demektir. İnsanın yürüdüğü yol, nefes aldığı hava, içtiği su, beslendiği toprak, oyalandığı parklar, hayatını geçirdiği iş yerleri ve konutlar, kaybettiklerini ziyaret ettiği mezarlıklar, can dostları hayvanlarla birlikte oldukları alanlar, hepsi, yatırım bekler. Maliyetlidir, ama getirisi yüksektir. Getirisini izlemek için hastalık yükünü hesaplamak yerinde olur. En az sağlık sorununa neden olan, en az öldüren, en az sakat bırakan, en az iş güç kaybına neden olan politika değerli politikadır.

Bu Kitap Neden Yazıldı?

Türkiye Klinikleri'nin 'Şehir Sağlığı' kitabı, insana yatırım rehberi niteliğindedir. Bir başlangıç kitabıdır. Geliştirilmelidir. Ortak dilin oluşturulması için değerlidir. Birbirinden farklı başlıklardan oluşmakla birlikte, her birisi şehir sağlığının göstergeleridir. Sayısal veriler olmakla birlikte, nitel yaklaşımların daha yoğun olduğunu sizler de fark edeceksiniz. Sayılar bazen gerçekleri söylemez ve/veya farklı yorumlara neden olabilir. Şehri oluşturan değerler ise, ancak, nitel yaklaşımlarla anlatılabilir.

Hepimizden hepinize güzel okumalar dileriz.

Prof. Dr. E. Didem EVCİ KİRAZ
Editör
Investing in the People That Make Up Our Cities Cities are alive. All parties responsible for human health, live the city as well and they should show the same care to the city as they do to people. To green Investing in the people who make up the city, free from classical approaches such as investing focused perspectives are needed. World Health Organization (WHO) while starting the healthy cities project, it listed the city health issues with its main titles, turned each of them into messages and used these messages to promote health. It was aiming to get to the right address. The project opened the message paths, instead of messages reached. However, the expectations and the races also increased.

One Process, One Thousand and One Nights Stories

From the "City Health" section, which I also wrote in the book Public Health in Turkey with a Historical Perspective.

If we summarize the process in some sentences:

*The 'Alma Ata Declaration' published in 1978 is based on the concept of 'City Health' made one of the most important contributions.
*WHO defined the 'Healthy Cities Project' as a tool, a key.
*With the Establishment of 'WHO Urban Health Europe Center' within the WHO Regional Office for Europe in Copenhagen, the Healthy Cities Project gained momentum (1998-2002).
*In 1999, an official letter was sent to 80 provinces by the Ministry of Health in Turkey. Municipalities have been invited to the Healthy Cities Project.
*The milestone for the Healthy Cities Project in Turkey was 2000. WHO has allocated eight city quotas for Turkey until the end of 2000.
*The duty of national coordination of the Healthy Cities Project has been given to the Ministry of Health, General Directorate of Primary Health Care Services. International coordination task was given to the Department of International Relations of the Ministry of Health. The process was managed by the head of the department, Bekir Metin.
* On 13 June 2000, under the General Directorate of Primary Health Care Services, Ministry of Health, Dr. E. Didem Evci Kiraz has been appointed as the 'National Healthy Cities Network Coordinator'.
*Bursa Metropolitan Municipality's candidacy application to the WHO. Adopted on 5 July 2000. Bursa was the first city to become a member of the Healthy Cities Network.
*Networks have been accredited by WHO since September 2003.
*This process is important in terms of urban health in Turkey, the establishment of the 'Healthy Cities Union' has begun.
*Cities that are members of the national network were invited to participate in order to become the founding members of the association. In the words of Ethem Torunoğlu, Çankaya Municipality coordinator, 'The Turkish movement is the success of a small group of Don Quixote'. Yalova (Yakup Bilgin Koçal-Metin Sabuncu), Van, Kadıköy (Selami Öztürk-Şule Onur), Afyon, Tepebaşı (Ahmet Ataç-Melih Savaş), Çankaya (Muzaffer Eryılmaz-Ethem Torunoğlu), Ürgüp (Bekir Ödemiş-Ömer Kıvanç), Ordu, Kırıkkale (Veli Korkmaz-Zühtü Bozdemir) and Bursa (Hikmet Şahin-Nalan Fidan), the founding members of the association by taking the decision of the Metropolitan Municipalities council they have been.
*The healthy cities project is no longer a project. It is a life necessity.
*The establishment of the Turkish Healthy Cities Association was announced in the Resmî Gazete dated 22.12.2004.
*Turkish Healthy Cities Association has continued its life under the directorship of Nalan Fidan, who was a Senior City Planner and Bursa healthy cities project coordinator, who was working in Bursa Metropolitan Municipality, from the date of its establishment until 2014. Nalan Fidan handed over her duties to City Planner Murat Ar, who is still the Union Manager, in 2014.

The most dangerous aspect of the projects; if they are not sustainable, they will perish. Healthy.

The cities project has ensured its sustainability by creating a city health curriculum. Aydın Adnan Menderes University Faculty of Medicine in 2005 and Aydın In the Vocational School of Health Services since 2010, "City Health" courses are included in the curriculum. In particular, the Healthy Cities Association established in Turkey. Its restructuring has enabled the urban health approach to become widespread in a large population. In many university departments that do not currently provide health-related education, city and health relationship is taught as a lesson.

How Do You Invest in People?

Health can be built on education and the economy. When health is evaluated together with components such as transportation, employment, communication, social support mechanisms, the health and welfare level of a society emerges. Investing in people means investing in education, economy and these components, which we call the social determinants of health. The way people walk, the air they breathe, the water they drink, the land they eat, the parks where they spend their free time, the workplaces and residences where they spend their lives, the cemeteries they visit, the areas where they stay with their best friends and animals, all await investment. The investment is costly, but the return is high. To monitor its return, it would be appropriate to calculate the disease burden. The policy that causes the least health problems, kills the least, causes the least loss of function and ability, and causes the least loss of power is a valuable policy.

Why Was This Book Written?

The book of "City Health" of Türkiye Klinikleri is a guide to investment in people. It is a starter book. It should be developed. It is valuable for the creation of a common language. Although they consist of different titles, each of them is an indicator of city health. Although there are numerical data, you will also notice that qualitative approaches are more intense. Numbers sometimes do not tell the truth and/or may lead to different interpretations. The values that make up the city can only be explained with qualitative approaches.

We wish you all a good reading.

Prof. Dr. E. Didem EVCİ KİRAZ
Editor

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