In the western world, the domain of urban development and public health both initiated to deal with infectious disease and unsanitary situations in cites in the middle of the nineteenth century. However, because of professional specialization and bureaucratic fragmentation, the connection between urban development and health was almost lost in the twentieth century. Only in the twenty-first century, with the emergence of new urban health problems and health inequities, which not only cause high public expenditure and great economic loss, but also undermine social cohesion, it is realized the need to reconsider issues concerning urban development and health. Current research and practice on the connection is somewhat limited, mainly focusing on how to promote health through physical changes on built environment. However, implementing physical changes in living environments alone is not enough, and accompanying social and institutional changes are also needed. Space ought to be doubly understood from both the physical and social dimension. The objective of the thesis is to refocus urban development back to its health concern roots, to raise health consciousness in urban governance processes, and to develop innovative implications for health-oriented urban policies. In order to achieve the objective, it questions whether urban development agencies and public health agencies along with communities can redefine the spatial and social networks to improve the health of people and place. If so, what the conditions for success and which constraints undermine the future? The question is addressed through theory development and case study. Based on a comprehensive understanding of health and a relative view of spaces, the thesis goes through the theories of social innovation in territorial development and develops theoretical framework. Based on the theoretical framework, the thesis selects Trieste as the case study, which is advanced in its de-institutionalization movement in psychiatric hospital and area-based health policies. The case study is analyzed from different spatial levels (nation, region, city, and neighborhood), time periods (history and status quo), and different agendas (spatial, social, cultural, and political). Based on the case study conclusions, it modifies the theoretical framework and develop innovative policy implications for health cantered urban governance and urban planning. Ultimately, the thesis draws the key lessons from the case study and provides some innovative implications on urban governance and policies for responding the institutional challenges and adverse health outcomes caused by contemporary practice. It suggests that in order to promote health and reduce health inequities, urban planning should move from physical determinism to a socio-spatial approach, which considers both physical and social characteristics of places, and from professionalization and specialization of health care to the development of inter-agency cooperation networks and participatory approach.
Nel mondo occidentale, il dominio dello sviluppo urbano e della salute pubblica, sia avviato a che fare con malattie infettive e le situazioni antigieniche in cita a metà del XIX secolo. Tuttavia, a causa della specializzazione professionale e la frammentazione burocratica, la connessione tra lo sviluppo urbano e la salute era quasi persa nel ventesimo secolo. Solo nel XXI secolo, con l'emergere di nuovi problemi di salute urbani e le disuguaglianze di salute, che non solo causano alta spesa pubblica e grande perdita economica, ma anche di minare la coesione sociale, ci si rende conto della necessità di riconsiderare le questioni relative allo sviluppo urbano e salute. La ricerca attuale e la pratica sulla connessione è piuttosto limitata, concentrandosi principalmente su come promuovere la salute attraverso i cambiamenti fisici dell'ambiente costruito. Tuttavia, l'implementazione cambiamenti fisici in ambienti di vita sola non è sufficiente, e che accompagnano i cambiamenti sociali e istituzionali sono necessari anche. Lo spazio deve essere capito dal doppiamente sia la dimensione fisica e sociale. L'obiettivo della tesi è di concentrare lo sviluppo urbano torna alle radici la sua preoccupazione per la salute, per aumentare la consapevolezza della salute nei processi di governance urbana, e di sviluppare le implicazioni innovative per le politiche urbane orientati alla salute. Al fine di raggiungere l'obiettivo, si chiede se le agenzie di sviluppo urbano e le agenzie di salute pubblica insieme con le comunità possono ridefinire le reti territoriali e sociali per migliorare la salute delle persone e del luogo. In caso affermativo, quali sono le condizioni per il successo e che vincoli minano il futuro? Il problema viene risolto attraverso lo sviluppo teoria e caso di studio. Sulla base di una comprensione globale di benessere e una vista rispetto degli spazi, la tesi passa attraverso le teorie di innovazione sociale per lo sviluppo territoriale e si sviluppa quadro teorico. Sulla base del quadro teorico, la tesi seleziona Trieste come caso di studio, che è evoluto nella sua de-istituzionalizzazione movimento in ospedale psichiatrico e la zona a base di politiche sanitarie. Il caso di studio viene analizzato da diversi livelli spaziali (nazione, regione, città, e di quartiere), periodi di tempo (la storia e lo status quo), e ordini del giorno diversi (spaziale, sociale, culturale e politica). In base alle conclusioni dello studio di caso, modifica il quadro teorico e di sviluppare le implicazioni politiche innovative per la salute galoppo governance urbana e la pianificazione urbana. In definitiva, la tesi trae le lezioni chiave del caso di studio e fornisce alcune implicazioni innovative in materia di governance urbana e politiche per rispondere alle sfide istituzionali e gli esiti negativi per la salute derivanti dalla pratica contemporanea. Essa suggerisce che, al fine di promuovere la salute e ridurre le disuguaglianze di salute, la pianificazione urbana dovrebbe passare dal determinismo fisico a un approccio socio-spaziale, che considera sia le caratteristiche fisiche e sociali dei luoghi, e di professionalizzazione e specializzazione delle cure sanitarie per lo sviluppo di inter di agenzie di reti di cooperazione e l'approccio partecipativo.
Space for health : socially innovative ways to bridge urban development and health. Case study of Trieste, Italy
LIU, YU
Abstract
In the western world, the domain of urban development and public health both initiated to deal with infectious disease and unsanitary situations in cites in the middle of the nineteenth century. However, because of professional specialization and bureaucratic fragmentation, the connection between urban development and health was almost lost in the twentieth century. Only in the twenty-first century, with the emergence of new urban health problems and health inequities, which not only cause high public expenditure and great economic loss, but also undermine social cohesion, it is realized the need to reconsider issues concerning urban development and health. Current research and practice on the connection is somewhat limited, mainly focusing on how to promote health through physical changes on built environment. However, implementing physical changes in living environments alone is not enough, and accompanying social and institutional changes are also needed. Space ought to be doubly understood from both the physical and social dimension. The objective of the thesis is to refocus urban development back to its health concern roots, to raise health consciousness in urban governance processes, and to develop innovative implications for health-oriented urban policies. In order to achieve the objective, it questions whether urban development agencies and public health agencies along with communities can redefine the spatial and social networks to improve the health of people and place. If so, what the conditions for success and which constraints undermine the future? The question is addressed through theory development and case study. Based on a comprehensive understanding of health and a relative view of spaces, the thesis goes through the theories of social innovation in territorial development and develops theoretical framework. Based on the theoretical framework, the thesis selects Trieste as the case study, which is advanced in its de-institutionalization movement in psychiatric hospital and area-based health policies. The case study is analyzed from different spatial levels (nation, region, city, and neighborhood), time periods (history and status quo), and different agendas (spatial, social, cultural, and political). Based on the case study conclusions, it modifies the theoretical framework and develop innovative policy implications for health cantered urban governance and urban planning. Ultimately, the thesis draws the key lessons from the case study and provides some innovative implications on urban governance and policies for responding the institutional challenges and adverse health outcomes caused by contemporary practice. It suggests that in order to promote health and reduce health inequities, urban planning should move from physical determinism to a socio-spatial approach, which considers both physical and social characteristics of places, and from professionalization and specialization of health care to the development of inter-agency cooperation networks and participatory approach.File | Dimensione | Formato | |
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https://hdl.handle.net/10589/74401