Health Legacy Project of the World EXPO 2010 Shanghai, China

Fan WU M.D. Shanghai Municipal Center for Disease

Control and Prevention2010.4.8

Mass Gathering Events

Individuals come together for a collective purpose

Gathering in specific site(s) of variable size

Duration is usually hours to days

Types of Mass Gathering (MG)

Why do MGs have impacts on our city

Duration Population Food/Drinking Water

Disease outbreaks Requirement on city infrastructure

Safety Requirement on health system

EXPO is changing the city in the way of

Implications of MGs

The impacts may be Short term, long

term impact Direct and indirect

impact Visible and

invisible impact Positive and

negative impacts

Individual

Health service system

Health-related environment

2010 World Expo. Shanghai, China

2010 World Expo. Shanghai

Theme： Better City, Better Life

Sub-theme： Blending of diverse cultures in

the city Economic prosperity in the

city Innovations of science and

technology in the city Remodeling of communities in

the city Interactions between urban

and rural areas

Long duration: 1 May 2010 - 31 Oct 2010

Large scale: 242 countries and international

organizations Visitors:

70 million in total400,000 visitors/day 700,000-800,000 visitors/day on peak

2010 World Expo. Shanghai

West of Huangpu River: 0.9 km2

East of Huangpu River: 2.38 km2

Enclosed area: 3.28 km2

Measure relevant health indicators2009 2011

Potential Health Impacts of Expo 2010

HealthyEnvironments

Increase in green areas

Improve waste disposal/sanitation

Improve road safety

Improve air quality

Increase in smoke-free areas

<…more…>

Improvement of Health System

Improve public health emergency response

Improve capacity of emergency service

Quit smoking class

<…more…>

Health Policy/Legislation

Smoke free

Clean air

Safe drinking water/food

Healthy nutrition

<…more…>

Community & Individual Capacity

Increase in physical activity

Improved in nutrition

Reduce tobacco use

Reduced harmful use of alcohol

<…more…>

Promotion of health of host city populationAbsolute improvements

Relative (Equity gains,

gradients)

portfolio of actions

hp performance

action on local determinants

civil society partnerships

intersectoral commitments

hp financinguniversal coverage

healthy settings

specific laws & regulations

hp structuresprevention

contentpersonal

behaviourshealth & equity

impacts

developing hp capacity

strengthening health systems

individual & community

development & determinants

How to

monitor and measure of all

these changes and

impact?

portfolio of questions

After the Expo, will Shanghai be better able

to run sustainable

health promotion?

What is the prevention

component of the health

system? How is the system

more equitable?

How are communities empowered?

What improvements

in personal behaviours?

How are all

sectors of

government

and industry

improving

health?

developing hp capacity

strengthening health systems

individual & community

development & determinants

Experience from Beijing Olympic

games6 indicator categories, 56 indicators

Health status: e.g. Life satisfaction, ... Health behaviours: (knowledge and

practices) of people e.g. prevalence of smoking, …

Health environment: e.g. Number of days meeting standard of air quality, …

Health care system Health: medical and hospital services, e.g. medicine insurance coverage rate, …

Health service: e.g. emergence response time, …

Health-related cognition: e.g. The cognation of knowledge about health, …

Objectives of the project

Indicators To set up a group of indicators

measuring World Expo health impact

Monitoring To record all the changes due to

the World Expo 2010 Improving

To offer evidence for future development

Set up indicators Health status

Describe the epidemiologic situation: major health risks and major disease burdens

Define priority areas for this project Important health risks and disease burdens Link these to the effects of the World Expo 2010 Approved by advisory group

Define concepts to be measured within the domains of health impact

Define indicators, methodology, and equity dimension for each concept or sub-concept

2009 Measure relevant health indicators 2010

Potential Health Impacts of Expo 2010

Health StatusPromotion of health of Shanghai

PhysicalEnv

Improvement of Health System Policy

Literacy &Behavior

Social Env &Community Involvement

Health equity in different social groups

Concept Map

H Sys

Soc Env

Literacy

PhysEnv

Policy

H Status

WaterFood

SafetyDisease Control

AlcoholPhys Act

Tobacco

Domain

Environmental Health

Infectious Diseases

NCD

Areas of Priority

Example Concept MapArea: NCD Sub-area: Tobacco

Smoking CessationH Sys

Social Mobilisation for Tobacco-Free ShanghaiSoc Env

Knowledge attitudes & skills related to smoke-free living

Literacy

Smoke-free public places (enforcement of regulations)

PhysEnv

Smoke-free RegulationsPolicy

Smoking by Children & Ados Smoking by Adults

Health Status

Tobacco

Domain

NCD

Areas of Priority

Concepts Indicators Methods

Analyse service provision and use by agreed social groups

DocumentaryProcess recordsProcess records

GuidelinesTrainingUse of service

Smoking Cessation

H Sys

? ? Website activity

? Volunteer action

Social Mobilisation

Soc Env

Analyse by agreed social groups

SurveyKAP indicatorKnowledge attitudes and skills

Literacy

Enforcement by locality?

InspectionsComplianceSmoke-free public places

Phys Env

Regulations apply to all?

DocumentaryRecord of regulations

Smoke-free Regulations

Policy

SurveyCurrent daily smoking

Smoking by Adults

Analyse by agreed social groups

SurveyCurrent daily smoking

Smoking Child/Ados

H Status

Equity IssueMethodsIndicatorsConcepts

Tobacco Control

NCDDomain

Priority Areas Emergency

preparedness and response

Network construction ……

Infectious Disease Control

Disease Control: outbreak alert and response

Food safety Sexually Transmitted

Diseases ……

Injury Prevention Traffic injury ……

NCD Prevention and Control Tobacco Control Healthy Diet Physical Activity Harmful use of Alcohol ……

Environmental Health Drinking water safety ……

Principle of Indicator Selection

Change due to Expo Should change due to Expo Likely to change due to Expo Likely to have high impact during time of

Expo or after Evidence-based Measurable Available (Routinely collected) and

Authoritative Integrated

Domain Priority Area Sub-area Indicator

Health Status

NCD 1 3

Infectious Disease 1 1

Injury Prevention 1 1

Integrated indicator

1 3

Policy NCD 1 2

Finance investment

1 3

Phys Env Infectious Disease 2 2

Environmental Health

7 14

Overview of Indicators6 domains, and 66 indicators

To be continued…

Domain Priority Area Sub-area Indicator

Literacy&

behaviour

NCD 4 7

Infectious Disease 4 5

Injury Prevention 1 1

Env. Health 1 1

Integrated indicator 1 2

Soc Env NCD 3 3

Infectious Disease 1 1

Environmental Health

1 1

H Sys NCD 2 2

Infectious Disease 4 7

Integrated indicator 1 2

Emergency 2 5

…continued

Indicators for each domain

Health Status: mortality from traffic-related injuries resident satisfaction for normal life …….

Policy : non-smoking policy finance investment policy ……

Social environment : number of automatic condom vending

machines number of physical activity sites ……

Indicators for each domain

Physical environment: number of days meeting standard of air

quality coverage of Green area …

Health System: emergence response time number of hospitals offering cessation service …

Health literary and behaviors : cognation about AIDS prevention in high-risk

groups heavy drink rate …

Sub-area Indicator Data(before EXPO)

Public place

Good sanitation in public place

90%

Waste  Proportion of rubbish Treatment

76.9％

Air Proportion of days meeting standard of air quality

90.5%

Green land

Green land coverage 38%

House per-capita living space 16.5m2

Water Central treatment proportion of waste water

85%

Safety drinking water A new water resources

Domain: Physical Environment Area: Environmental Health

Further efforts Indicators improvement Data collection in difference

periods Long-term and slow effect Unpredictable effect

Multi-sectoral cooperation Sharing information

Data analyses and report

Photo http://flickr.com/photos/qifei_20/2716066817/sizes/l/

Thank You!