From Cardiff To Cuba: A Global Search For The Best “Cultures Of Health”
By Ben Schiller
10 August 2017
Photo courtesy of Emerging Innovation
Every Sunday in Bogota, Colombia, the streets close to cars and the community comes out to play. Between the hours of 7 a.m. and 2 p.m., 70 miles of roads become genuine public space, and up to 2 million people (a quarter of the city’s population) cycle, run, walk, take aerobics, play bike polo, dance, or just hang out. The “Ciclovia” is a Bogota institution dating back to the 1970s, and it’s been widely emulated elsewhere. Hundreds of cities, including about 120 in the U.S., have some version–though rarely on the same scale and with the same weekly frequency.
To the Robert Wood Johnson Foundation (RWJF), the U.S.’s largest foundation devoted to health, the Ciclovia is a good example of what it calls a “culture of health.” It’s a community intervention that promotes well-being outside the formal health system, and it has the effect of flattening the normal differences between people. The Ciclovia sees old and young, rich and poor, black and white, mix together in ways that don’t happen at other times, or in other places. “There’s a utilization of public space where people meet as relative equals, and that’s very different from other settings in society,” says Karabi Acharya, who leads the foundation’s program to identify culture of health models around the world.
When we think of health, we tend to think of hospitals, doctors, and insurance (or lack of it). RWJF is keen to expand the notion to something more encompassing and holistic. It argues that our health is determined by hundreds of disparate factors and that, to improve it, we need to open up the conversation. It’s not just a question of expanding medical access or making health care cheaper. It’s also how, as communities, we improve health together–how we make health a communal transaction as well as a personal and business transaction. Populations are well or sick, it argues, for dozens of reasons that fall under an umbrella of common responsibility, including the types of food available locally, whether there’s green space for exercise, if streets are cleaned, crime levels, street design, road safety, poverty, inequality, political coordination, and so on and so on.
As part of its “global ideas for U.S. solutions” program, which has now been running for about two years, the foundation has vetted and funded a variety of fascinating projects from around the world. Individually or as a group, they could serve as models for how to create a more robust culture of health in the United States.
One of these projects is Slum Dwellers International (SDI), a South-South group of organizations representing informal settlements inhabitants. It helps slum dwellers map their land, secure land tenure, improve economic opportunities, put in infrastructure, and boost environmental health, according to Jason Corburn, Professor of City & Regional Planning at the College of Environmental Design, who works with SDI in Nairobi, Kenya.
“These are community development organizations that are addressing core factors of well-being. They don’t consider themselves health workers but they are doing prevention work in public health upstream,” Corburn says.
Now Corburn is helping bring SDI’s community-building approaches, developed in those settlements, to Richmond and East Oakland, California.
“What all our work recognizes is that you can’t treat people in a healthcare center and then send them back into the communities that are making them unhealthy in the first place,” says Corburn.