The city as a healthy lifestyle cluster: connection of public health policy and health culture formation

Problem setting. The city is always a group identity, including a culture of health. Health is related to education, living conditions, work, leisure, and many other factors. Global megatrends confirm the relevance of public health development. At present, the public health structure in the field of domestic medicine is forming in Ukraine. A pandemic and a financial crisis are pushing the state and local communities more actively to build an appropriate system to protect the population.

Recent research and publications analysis. Foreign authors focus on the effectiveness of community-based health care spending, especially for the poorest. At the same time, analysts argue that mortality among children under the age of five is significantly decreasing in urban areas and, on the contrary, and is increasing among adult men. Other studies provide a robust, flexible forecasting platform for community management systems. Therefore, foreign authors point to the need for active involvement of municipalities in the field of public health. This is necessary to preserve lives and to inculcate all levels of urban governance and citizens of the health culture. At the same time, the tools of this managerial influence in cities are not yet fully disclosed in researchers' publications.

Highlighting previously unsettled parts of the general problem. Studying foreign experience of health care development in the context of forming a health culture in the city, as well as exploring the possibilities of implementing effective decision-making technologies in this field in Ukraine.

Paper main body. The experience of World Health Organization projects in the context of urban public health development is considered. In particular, one of WHO's Healthy Cities initiatives is interesting. The following six theses of the Copenhagen Consensus of Mayors underpin the priority directions of Stage VII: investing in people; urban environment design, support for active participation and partnerships in the interests of health and well-being; promoting the development of local communities and access to public goods and services; promoting peace and security through the formation of inclusive communities; protecting the planet from degradation, including through sustainable consumption and production.

Cities need to ensure that public policy, economic investment programs are interconnected, and make every effort to equitably distribute resources. In this way, public health policy tools will shape the city’s health culture as a multifaceted concept. The process of implementation of public health system in the regions of Ukraine, in particular in Sumy region is also considered on a specific example. So, Sumy Regional Center for Public Health was created as part of the All-Ukrainian Medical Reform in 2018. Regional program of public health support for 2020 – 2021 is approved.

The total amount of indicative financing under this program for the years 2020 – 2021 is 63 mln. UAH. The main activities and activities of the program for two years are: improvement of the material and technical base of health-care establishments involved in the public health system and provision of services related to HIV/AIDS, tuberculosis, drug addiction. However, due to the lack of implementation of the regional budget and the deterioration of the socio-economic situation in the region, the Sumy Regional Public Health Center has been reorganized recently to optimize the structures of the region council. This fact points to the actual phasing-out in the area of public health health reform. Only the coronavirus pandemic, which began in 2020 both in the world and in Ukraine, has intensified the activities of the state and regional authorities to partially strengthen and restore the public health system.

Conclusions of the research and prospects for further studies. Therefore, the impact of public policy in cities on the development of a health culture becomes an urgent task. Using this strategic thinking in European cities will give Ukraine the opportunity to develop its own public health policy. Therefore, further research in this area is extremely promising. Cities need to ensure that public policy, economic investment programs are interconnected, and make every effort to equitably distribute resources. In this way, public health policy tools will shape the city’s health culture as a multifaceted concept.