Healthy Cities are Attractive Cities

Last Wednesday I was in a workshop about the strategy to develop new infrastructure in the town of Opatija in Croatia. The town is an attractive resort by the gulf of Kvarner. It is historically known for its popularity as a seaside resort for the Austria-Hungarian empire before the first world war and the Austrian emperor Franz Joseph used to spend several months here annually during the winter season. Today Opatija is a summer and winter destination for visitors looking for a calm place with spa´s, traditional restaurants and comfortable belle époque hotels.

Gandhi on healthAs I was in the workshop, I was thinking about which attraction factors Opatija really has to be a natural destination for tourists, in competition with similar resorts around the Mediterranean, and naturally I was also thinking about which currently strong competitive elements can be enhanced in order to place Opatija in a sweet spot where other similar locations cannot so easily be.

The calmness of the place is one and should be preserved. Monaco, Biarritz, San Sebastian and other comparable places with similar historical belle époque hotels are all known as glamorous jet set destinations. This you will not find in Opatija. What you will find, naturally in this calm bay of Kvarner with healthy food in the restaurants and a calming pace, that is a location where stressed tourists from large cities may find a refuge to rest and relax and recover health during their holidays.

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What makes a city or town like Opatija healthy? It is a combination of factors, ranging from health and spa services to readily available healthcare to excellent public transport and parking spaces outside the city centres,  to access to clean sea and a commitment to improving access to green spaces.

Health tourism in Opatija

healthy_lifestyileHealth and wellness tourism has only recently begun to develop in Croatia and  Opatija´s hotels are popular among health and wellness visitors. The Wellness Centre in the town offers its guests a 25-meter swimming pool with all water effects, two Jacuzzis, a fitness facility, several kinds of saunas, over 10 different massages and numerous beauty treatments all in one place. It also includes a SPA relax zone where you can enjoy a barrel hot bath, Kneipp baths, Roman or Finnish sauna, aromarium, or simply relax in the relax zone offering a view of the beautiful Kvarner bay.

The Thalasso Wellness in Opatija is special for the seawater in the pools heated to the optimal temperature and the cosmetic treatments and other services are also based on the benefits of seawater. The most important thing in the centre’s offer is that, in addition to standards wellness programs, you can use medical programs closely related to the hospital’s specialty. In Hotel Ambassador, we find a new wellness and spa centre based on a combination of ancient Chinese fengshui philosophy and modern wellness programs.

One of the most outstanding Opatija highlight is the beach-side promenade, Lungo Mare, where you may choose to stroll for more than 12 km. This beautiful cobblestone walkway starts in Voslko and extends on to Opatija, Icici, Ika and Lovran. The construction of the promenade began in 1885 and completed in 1889 when Opatija was proclaimed a climatic health resorts.

Considering that Croatia is one of the countries that offer high quality health services at very affordable prices will be additional reason for health travel. Price of services, depending  on the content of the treatment or procedure, can be much cheaper than the same services and procedures in other Western European countries.

What do we mean with public health systems?

Healthy-LifeAfter the example of Opatija, let us step out a bit to look at the general picture of health care. The focus of public healthcare vary in different parts of the world depending upon the prevalent health problems. In the developing world where we in Bearing also work, sanitation problems and limited medical resources persist and infectious diseases are the most significant threat to public health.

In Nairobi for example, where we work with United Nations Habitat on the development of the Kenya Railway City concept, public health officials devote resources to establish sanitation systems and immunization programs to curb the spread of infectious diseases, and provide routine medical care to rural and isolated populations. In the district of the city where my hotel was located on last month´s visit, an Economics professor I met told me the sanitation system was grossly under dimensioned as the city district was initially planned for small houses and not the modern office and residence towers we find there now.

In industrialized nations sanitary food and water supplies and excellent medical resources reduce rates of infectious disease. Instead, accidents and diseases such as lung cancer, heart attacks, and strokes, and (not to be forgotten) the stress of modern work and city life are among the leading causes of death. In these areas, public health goals include education programs to teach people how to prevent accidents and lessen their risk for disease, and the maintenance of the excellent disease prevention systems already established.

Norwegian ratIn places with a high standard of health care, public health workers may engage in activities outside the scope of ordinary medical practice. These include inspecting and licensing restaurants, conducting rodent and insect control programs and checking the safety of housing, water, and food supplies.

Keep calm for healthy life styleIn assuring overall community health, public health officials also act as advocates for laws and regulations, such as drug licensing or product labelling requirements. These practices spread fast to developing economies, one of my young nieces was working on such a project in Thailand last year.

Most people think of public health as a sector of physicians and nurses, but a wide variety of other professionals work in public health, including veterinarians, sanitary engineers, microbiologists, laboratory technicians, statisticians, economists, administrators, attorneys, industrial safety and hygiene specialists, psychologists, sociologists, and educators, and they all collaborate to make our cities and other places healthy and attractive for residents and visitors.

An article on BBC travel recently compiled a number of lists in publications such as The Guardian and The Economist that rank the healthiest cities and countries around the world, to list five cities that have a history of investing in the behaviours and elements that ensure their citizens live as healthy a life as possible. There is no scientific truth in this list, it is just an interesting compilation of examples, but one can often learn more from qualitative examples than from ranking of quantitative data. All of the five cities are big cities by the sea.

Singapore

Singapore skylineSingaporeans experience both some of the world’s lowest infant mortality rates and the highest life expectancies: 84.07 years, number four in the world according to the CIA World Factbook. Ranked among the most efficient health care systems across the globe, up to 80% of residents use the public health system, which has a few different pricing tiers. The excellence of the system is well described in this paper on the Singapore Healthcare Story, written by the Brookings institute.

Overall, Singapore is one of the world’s cleanest cities where strict laws forbid everything from spitting to littering, and the government has successfully used incentives, pricing and congestion charging to reduce the amount of car traffic from its high point in the 1970s. The city’s comprehensive mass transit system, SMRT, carries more than two million passengers every day. Calling itself the Garden City, there are dozens of parks, gardens and mountain trails around the island. For cyclists, runners and walkers, the Park Connector Network comprises more than 200km of paths linking local parks and green spaces.

Tokyo

TokyoWith one of the most efficient public metro systems in the world, moving approximately three million people a day in the greater metropolitan area, Tokyo’s greenhouse gas emissions are lower than most other Asian cities. According to the World Bank, Tokyo’s CO2 per capita output is 4.89 tons, while Beijing’s is 10.8 tons and Singapore’s is 7.86 tons. In the wake of the 2011 tsunami, the Fukushima reactor disaster has caused concerns, but the government claims radiation levels are safe.

Ranked by the Guardian in 2012 as the second healthiest city in the world, life expectancy in the Japanese capital is one of the highest at 84.19 years. This is due to a number of factors, including investment in public health, strong family and community ties, the Japanese tradition of hygiene, and a common diet of rice, fresh fish and vegetables. Universal health insurance was also implemented in 1961, which cut down on the rate of childhood and infectious diseases.

Health standards in Tokyo are comparable to those found in other highly industrialized countries. Restaurants are most often impeccably clean, and the food is safe to eat and the water safe to drink everywhere. However noise and smog are persistent problems in the city. Electronic billboards report sound levels and air pollution indices. Air quality has improved in recent years and continues to improve.

Perth

PerthRanked in the top 10 for the Economist Intelligence Unit’s most liveable cities in 2013, Perth is also one of Australia’s healthiest cities. The EIU ranking is based on five criteria: stability, healthcare, education, infrastructure and culture and environment. And according to the magazine Australian Women’s Health, Perth is near the top of the list for healthy eating, mental wellbeing, life satisfaction and medical health. The public healthcare policy covers all medically necessary treatments at public clinics, consultation fees for general practitioners and some specialist doctors, as well as all tests and examinations required to diagnose and treat illnesses.

Between 1998 and 2009, the number of bicyclists in Perth increased by 450%, and Transperth, the city transit system, has installed bike shelters at many stations, so commuters who cycle to the train can lock up their wheels. The warm climate and nearby Indian Ocean beaches mean residents have access to many outdoor and sporting activities, and in October 2013, government health agencies launched the Public Open Space Tool to enable Perth residents to locate parks and facilities near them.

Copenhagen

CopenhagenThe Danish capital tops many global health lists for its bicycling culture and big drop in CO2 emissions over the last decade. Greenhouse gas emissions are down 20% since 2005, part of the government’s plan for the city to be the first carbon-neutral capital in the world by 2025. Every day 50% of Copenhageners commute to work or school by bike, and there are nearly 400km of bike lanes across the city.

The bicycling lane that crosses the Dronning Louises Bridge, connecting the lively Nørrebro neighbourhood to the city centre, is the busiest bike lane in the world, with 36,000 cyclists using it daily. Also heavily used is the Lange Bridge across the Inner Harbour.In the Islands Brygge area of Amager along the harbour front, the curving Gemini Residence is a former silo converted into apartment buildings. A bicycle and pedestrian bridge has also been built across the harbour, connecting the area with the residential district of Fisketorvet.

Denmark’s healthcare system is excellent and offers an abundance of medical facilities and services to all citizens. In the spirit of the welfare state, all residents indeed enjoy equal access to healthcare services. Specific services and health insurance schemes are organized by municipalities, while hospitals are run by one of the country’s five regions.

Monaco

monaco-viewMonaco is the most densely populated country in the world and has the highest life expectancy of 89.6 years. It also has the world’s highest concentration of millionaires and billionaires per capita, as we have written about previously. The great wealth concentrated in this city-state means citizens can afford top health care, ranked 13th in the world in 2000 by the World Health Organization.

Monaco has an excellent standard of compulsory state funded healthcare. Medical staff are extremely well trained and healthcare in Monaco is available to all citizens, registered long-term residents and those citizens from France and Italy who can prove that they have paid their healthcare contributions in one of these countries. The Prince Albert II of Monaco Foundation has launched a number of green initiatives, including carbon offsets for conferences held at Monaco hotels, and local government agencies use a fleet of electric smart cars.

Monaco is divided into four quarters: historic Monaco-Ville, glamorous Monte Carlo, portside La Condamine and the new district Fontvieille. Monaco-Ville is the old city, known as the Rock, the town’s ancient heart that contains the Prince’s Palace, home to the Grimaldi ruling family and the Cathédrale de Monaco. Across the port, Monte Carlo is where the famous casino is located, along with many residential apartment buildings and grand hotels. South of the Rock, Fontvieille is the newest part of town, built on land reclaimed from the sea and home to Louis II Stadium, where the AS Monaco Football Club plays, and the Monaco Heliport.

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