Urban health guidelines implementation: evidence and practice

Issue

Urban planning plays a crucial role in healthy lifestyle promotion, impacting physical activity and non-communicable diseases prevalence. National and regional strategies rely on an integrated approach. Under the chapter of collective prevention and public health, the new LEA (Assistance Essential Levels) include evaluating land-use plans (PGT in Italy) with a preventive assessment on the relationship between health and urban environment.

Description of the problem

The Italian Ministry of Health and the Lombardy Region with Polytechnic University of Milan proposed good practices for health impact evaluation of urban and environmental interventions of regeneration and redevelopment. After bibliographic research, on-site and on-field training, community practice and experts' evaluation, a multicriterial tool was built. A set of indicators (7 macro-areas) was selected to measure the propensity of urban plans to promote health. In 2020 the new guidelines were introduced in the administrative process of health impact assessment for receptors and of quinquennial PGT re-evaluation.

Results

The Health Protection Agency of the Po Valley (provinces of Cremona and Mantova, in Northern Italy) was asked to produce 344 judgements on civil buildings during 2020. Among them, 12 opinions referred to partial variations of PGT in 12 different municipalities. No comprehensive urban plan evaluation was requested in 2020.

Lessons

PGT evaluation through the proposed tool allows estimating the capacity to control population risk factors and promote a context organized to satisfy social needs and improve quality of life. In the rural context of small municipalities of Cremona and Mantova, an encountered limitation was the small size of urban centres. Thus, applying strategies conceived for metropolitan areas was challenging. A contextual evaluation of bordering municipalities urban plans would be desirable to promote bigger-scale interventions about transports, soil use and emission sources.

Key messages

Applying urban health good practices to land-use plan evaluation in rural areas with small municipalities poses some issues due to reduced interventions scale. It would be helpful to promote the simultaneous evaluation of bordering municipalities' urban plans so as to suggest integrated health interventions on a larger scale.

The GABAergic control of prolactin release is not affected by insulin-dependent diabetes mellitus: evidence from studies with sodium valproate

In order to evaluate the influence of the GABAergic system in the regulation of PRL secretion in patients with IDDM, serum PRL levels were measured in 7 diabetics and in 7 normal men with sodium valproate (400 mg per os), a drug capable of increasing cerebral GABA concentrations. A significant decrease of serum PRL concentrations was observed between 30 and 120 min after sodium valproate administration in both control and diabetic subjects. The time course and magnitude of the sodium valproate effect were similar in all subjects. These data confirm the inhibitory control of the GABAergic system on PRL secretion in man as evidenced by the GABAergic drug sodium valproate. It is suggested that this system is not altered in diabetic patients.