European city leaders pledge to involve health and health equity in all local policies

Climate stability and social justice: in the Zagreb Declaration for Healthy Cities, European city leaders pledge to involve health and health equity in all local policies

Copenhagen and Zagreb, 18 October 2008

Mayors and other municipal political and health leaders from across the WHO European Region and beyond gathered in Zagreb, Croatia this week to work out a five-year plan to involve their citizens in bringing health and health equity into all city policies. The 2008 International Healthy Cities Conference adopted the Zagreb Declaration for Healthy Cities, which commits all participating cities to action for health that goes beyond high-quality, accessible health care to encompass disease prevention, health promotion and systematic action on inequality in health, the risk factors for noncommunicable diseases and injuries, and the social, economic and environmental determinants of health.

Today, 72% of Europeans live in cities. This is projected to rise to 80–90% by 2020. “Cities have much more influence today on people’s socioeconomic and cultural reality than ever before,” notes Dr Marc Danzon, WHO Regional Director for Europe. “The Healthy Cities movement has developed around the assumption that city governments and local partners have the legitimacy and the strategic advantage to be both advocates and custodians of their citizens’ health. They can complement and reinforce national and international plans to promote health and prevent disease and disability.”

Originally established at a European conference in Zagreb in 1988 to help local governments find solutions to health problems in urban areas, Healthy Cities has grown into a major global movement. In the European Region alone, the WHO European Healthy Cities Network has 79 member cities, and national and subnational Healthy Cities networks involve more than 1000 cities and towns in 25 countries. More than 600 participants from more than 35 countries attended the 2008 Healthy Cities Conference in Zagreb.

The Healthy Cities approach to engagement has been inclusive. Any city can be a healthy city, regardless of its current health status. What is required is a commitment to health and a process and structure to achieve it. A healthy city continually improves the physical and social environments and expands the community resources that enable people to support each other in performing all the functions of life and in realizing their potential.

“During the past 20 years, healthy cities have served as a unique multicentre public health laboratory,” says Dr Agis D. Tsouros, Unit Head, Noncommunicable Diseases and Environment, Division of Health Programmes, WHO Regional Office for Europe. “This living laboratory takes account of and responds to emerging public health threats and their implications for the urban environment. Cities work together and support each other in finding solutions for tough challenges, such as urban violence, support for older people and people with disabilities, HIV, avian influenza, inactive lifestyles, the obesity epidemic and, most recently, heat-waves and climate change.”

The Zagreb Conference heard from Professor Sir Michael Marmot, Chair of the WHO Commission on Social Determinants of Health; the Commission’s recent report calls for action to reduce “social injustice that is killing people on a grand scale”(1).

The inclusion of health and equity in health in all local policies was selected as the overarching goal for the next five years (Phase V, 2009–2013) of the WHO European Healthy Cities Network. The plan calls for assessing the health impact of all policies and action plans of the public, corporate and voluntary sectors, and boldly using civic leadership to catalyse action to improve living, social, economic and environmental circumstances that may harm physical and mental health and well-being.

“We are proud to have been selected to host this important gathering”, says Mr Milan Bandi?, Mayor of Zagreb. “The Conference has offered a unique meeting point and platform for urban and city leaders and practitioners, as well as networks, agencies and institutions that are concerned with health, sustainability, equity, urban development and community empowerment. It has provided Zagreb with an opportunity to share some the progressive health work we have been doing and learn about the effective approaches our sister cities are taking.”

For more information, contact:

Technical information:
Dr Agis Tsouros
Unit Head, Noncommunicable Diseases and Environment WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark
Tel.: +45 39 17 13 91, mobile: +4523 39 14 84
Fax: +45 39 17 18 80;

Dr Zvonimir Sostar
Head of Office for Health, Labour, Social Welfare and Veterans, City of Zagreb
Trg Stejepana Radica 1, HR-10000 Zagreb, Croatia
Mobile: +385 91 61 01239, +385 1 610 1239

Press information:
Ms Liuba Negru
Press and Media Relations Officer
WHO Regional Office for Europe
Scherfigsvej 8, DK-2100 Copenhagen Ø, Denmark
Mobile: +37 258 509 081, +45 20 45 92 74

Mr Damir Jugo, Senior Consultant
Millenium promocija
Planinska 2, HR-10000 Zagreb, Croatia
Mobile: +00385 91 466 9695, +00385 1 555 0458