Healthy City Project in Korea-English

Healthy City Project in Korea:
History, present and future

October, 2022
Eun Woo Nam MPH, PhD
Professor, Department of Health Administration,

Head of Healthy City Research Center
Dean, Graduate School of Health Science,
Yonsei University
1
Wonju, South Korea
Contents
1. History of Korea's Healthy City Development
2. Wonju Healthy City
3. Wonju Healthy City - Strategy
4. Wonju Health City - Case study
5. Conclusion
2
• Introductory Stage (2004-2006)
• Developing Stage (2007-2009)
• Maturity Stage (2010-2020)
• Future Challenges for Healthy Cities (2021- )
3
01. Introductory Stage (2004-2006)
• Attended AFHC 1st Kuching (2004)

: Founding Member Cities: Seoul, Wonju, Busan and
Changwon in South Korea
• Establishment of the Korea Healthy Cities Partnership (2006)
: Seoul, Wonju, Changwon, Busan, etc.
4
02. Developing Stage (2007-2009)
• Attended the 2nd AFHC Global Conference in Suzhou, China
• Operated ‘Healthy Cities Forum’ of Ministry of Health and Welfare
• Publication of Healthy Cities Casebook
• Publication of Research Report on the Classification of Healthy Cities
(Ministry of Health and Welfare, Yonsei University)
5
03. Maturity Stage (2010-2020)

• AFHC 3rd Global Conference - Gangnam-gu, Seoul
• AFHC 7th Global Conference - Wonju City (2016)
• Development of Healthy City Certification System (Ministry of
Health and Welfare, Yonsei University) - not being implemented.
• Establishment of the 'Health Promotion Foundation' under the
Ministry of Health and Welfare and supporting healthy city projects.
6
04. Future Challenges for Healthy Cities (2021- )
• Strengthening the Healthy Cities Network in Korea

• Community revitalization and the Healthy Cities
• Enactment and operation of the Healthy Cities Act
• Introduction of Healthy City Certification System
• SDG Healthy Cities
7
2.1. Population: 350,000 (March 1st, 2022)

2.2. Map
8
2.3. Progress of the Healthy City Project
• Phase 1 (2004-2010)
• Phase 2 (2010-2020)
• Phase 3 (2021-2025)
9
(2012) 5th AFHC Global Conference – WHO Best Healthy City Case Award
Applied with "Healthy City is a Safe City" and won the Award
Applied with “Supporting Out-of-School Youth” and won the Award
Applied with “Creating a Gender-sensitive Healthy City” and won the Award
Wonju is the only Healthy City in Korea that won the

WHO Best Health City Case Award for the
6 times in a row! (2008-2018)
(2018) Mayor of the Wonju City Won Chang-Muk won a

special award from Director-General of the WHO Western
Pacific Region.
10
Won the prize four times for Healthy City Award from Western Pacific Alliance
for Healthy Cities(AFHC).
11
2.4. Phase 3 of the Healthy City Project (2021-2025)
12
01 수행체계도
Vision 2025
WHO WPRO
AFHC
Phase 1-2 Community Selection of Project Final selection Development of

Healthy City Need Core Tasks for Priority of Core Tasks implementation
Evaluation Assessment Healthy City Setting for Healthy City strategies
Investigating Final selection

Quantitative/ Priority setting Project
local residents; Selection of of core tasks
qualitative using BPRS development
advisory panels; core tasks for reflecting result
(Basic Priority using
evaluation government next five years of priority
Rating System) Logic Model
officials setting
13
02 평가방법 Vision 2025
Community
Phase 1-2 Selection of Projects development of
demand Core Healthy City
Healthy City core healthy city priority implementation
degree tasks selection
Evaluation promotion tasks selection strategies
survey
local residents; Final healthy Peojects
Quantitative/ Selection of BPRS Method:
advisory panel; city decelopment
qualitative projects for the Golden
government tasks using Logic
evaluation next five years Diamond
officials selection model
Quantitative
evaluation WHO healthy city
Urban Heart
Evaluation of healthy city indicators, analysis of causes of death,
Analysis of vulnerable areas in healthy cities, analysis of press release
WHO
Healthy City
Guideline
Qualitative
evaluation
Process evaluation by SPIRIT Checklist, survey on health city advisors
International Organization Awards, Health City Project Cost Analysis
14
Fig. Trend of population in Wonju

(2010-2020)
15
Fig. Demographic structure by age

16
Fig. Changes in birth rates per 1,000 population by year

17
Fig. Changes in ozone (O3) concentration by year

18
Fig. Changes in urban park area per person (m2) by year

19
Fig. Changes in road pavement rates by year

20
Fig. Changes in current smoking rates by year

21
Fig. Changes in high-risk drinking rates (standardization) by year

22
Fig. Changes in walking practice rates by year

23
Fig. Changes in obesity rates (self-reported) by year

24
Fig. Changes in stress recognition by year

25
Fig. Changes in lifetime prevalence of hypertension by year

26 (over 30 years of age)
Fig. Changes in the prevalence of diabetes by year

27 (over 30 years of age)
Fig. Changes in cancer screening rates by year

28
Healthy City Wonju Vision 2025 Plan

02 평가방법
Phase 1-2 Community Selection of development of
Projects prior- Core Healthy City
Healthy city Need core healthy city implementation
ity selection tasks selection
evaluation Assessment promotion tasks strategies
Local resi- Final healthy
quantitative/ dents; Selection of BPRS Method: Peojects decel-
city
quantitative advisory panel; projects for the Golden Dia- opment using
tasks selec-
evaluation government of- next five years mond Logic model
tion
ficials
Local residents survey Healthy city advisory committee Wonju City public officials
Respondents: Healthy city advisory Respondents: Wonju City public offi-

Respondents: Residents in Wonju committee cial (by department)
Survey period: April 6-20, 2021 Survey period: March 30, 2021 Survey Period: April 25-30, 2021
Targeted population: 1,110 people Targeted population: 10 people Targeted populatio: 100 people
Sampling: Randomized Population Surve contents: Healthy City Wonju 10- Survey Method: Google online survey
Stratification Extraction year project evaluation, Project direc-
Survey Method: Mobile Survey tion setting for the next five years
Survey Method: Google online survey
29
02 평가방법
Results of Healthy City
Advisory Commitee Online Survey Survey method: Google Online survey
Survey period: March 30-31, 2021
Reflection of healthy city projects in policies that are
Survey organizer: Healthy City Research Center, Yonsei Univ.
receiving political attention
1) Low sensitivity of local residents 3) Lack of projects related to housing/unemployment issues

2) Low efficiency of project compared to 4) Necessity of policies that reflect the needs of local residents
No
investment
Yes
1) Projects of ‘Jobs for Elderly’ and ‘Walking Road (Dulle-gil)’ are well implemented.
2) Environmental and health projects are well implemented.
Current problems of healthy city Directions for Healthy city Required Projects for Vision 2025
1) Mental health promotion for the elderly

1) Lack of communication between
and adolescents 1) Health promotion and prevention projects in
agencies/organizations;
2) Health city projects led by the needs of COVID-19 era
2) Blind spot of public welfare services
2) Embodiment of the COVID-19 vaccination
(e.g. elderly, disabled, etc.)
local residents system
3) Lack of publicity of healthy cities
3) Active communication between the 3) Home visits for elderly people with disabilities
(e.g. last update on the website: in 2018)
Healthy City and residents of Wonju 4) Health education for adolescents
4) Absence of healthy city projects for
4) Regular events with community groups 5) Life-cycle dietary education program
young population
5) Pet-friendly city
30
Vision 2025
02 평가방법
Community
Phase 1-2 Selection of Project development of
Healthy city core healthy city priority implementation
evaluation promotion tasks setting strategies
survey
quantitative/ Selection of
quantitative projects for the BPRS Method
evaluation next five years
Setting the priority of healthy city projects using Basic Priority Rating System (BPRS) method
BPRS BPRS method is a tool for objective measurement following a guideline for scoring each item.
Opinions of public officials will be collected using this tool.
Component
Health Prob- BPRS
Priority
lem Size of prob- Severity of Effectiveness (a+2b)*c
lem (a) problem (b) of project (c)
A
31
Vision 2025
02 평가방법
Community
Phase 1-2 Selection of Projects development of
Healthy city core tasks for priority implementation
evaluation healthy city selection strategies
survey
quantitative/ Selection of BPRS Method:
quantitative projects for Golden
evaluation next five years Diamond
Need Reflection of the needs of local residents, health city

Assessment advisors, and public officials Selection of
core tasks of
healthy city for
next five years
Development of sustainable Healthy City projects
Core Tasks
considering 7 core tasks
32
3. Wonju Healthy City - Strategies
Healthy City 2025 Vision, Objective and 4 Strategies
Vision Healthy city where citizens participate together
Objective
Building a Green Healthy City and Digital Health-Based
Health Promotion Infrastructure for Citizens
Digital Health and Risk-responsive Future-oriented

Green Healthy City
Healthy City Healthy City Healthy City
• Smart healthy • Healthy living area • Healthy city for

4
• Safe and healthy vulnerable
strate city • Narrow healthy life
gies city groups
gap
• Life-cycle health • Healthy city
• Big data used • Create natural
promotion governance/
city environment
• Crisis-responsive system
• Healing Tourist • Sustainale
health city healthy city
City Wonju
33
Strategy1 Digital Health and Healthy City
사진 사진
Smart healthy city Big data used city
Expansion of smart VR Building a Big Data DB for Healthy

sports facilities City Projects
Promoting Smart
Healthy Cities International medical device
certification advisory committee
Digital healthcare (Based on big data)
medical device city
34
Strategy 2 Healthy Green City
사진 사진 사진 사진
Narrow healthy life Create natural Healing Tourist City

Healthy living area
gap environment Wonju
Stop drinking projects’ Expansion of public Eco-friendly electronic
Attracting tourists
infra development transportation in vehicle support project
using KTX
Non-smoking projects’ rural areas
Construction of infra
infra development around Wonju stream Promotion of
Improvement of health
Healthy Healing Village
Creating a walking-friendly care services in
humanitarian environment rural areas Activation of
walking projects Construction of
‘Wind Road’ for tourism
Bicycle-friendly health city
Construction of green park
35
Strategy 3 Risk-responsive Healthy City
사진 사진 사진
Crisis-responsive health
Safe and healthy city Life-cycle health promotion city
Cultural activities and crime Infectious disease-responsive
Creation of a clean road prevention for youth health city
environment
Development of youth health Healthy blood vessels,
promotion projects healthy Wonju
Expansion of
transportation safety
Mental health crisis
facilities Climate change-responsive
management project
healthy city
Social prescribing programs
36
Strategy 4 Future-oriented healthy city
사진 사진 사진
Healthy city for the Governance and system Sustainable healthy city
vulnerable establishment
Strengthening job support for Establishment/Operation of
the elderly Healthy Cities Committee/ Higher Education Center for
Strengthening of Healthy Seniors
Improvement of health Cities Governance
inequality for the disabled
Sustainable healthy city
Expansion of dementia Establishment of Health environmental design
prevention programs Impact Assessment improvement project
Operating System
37
4. Wonju Healthy City project - Case study
Project 1. Healthy Tourism project
Current - Improved accessibility to Wonju by operating KTX trains at Manjong Station and Wonju Station
status and (58.3% increase in tourists compared to 2012)
objectives
- Development of a combined healthy city project by linking existing tourism courses and healthy city projects
Wonju city hall

Main contents Wonju Terminal
Expanding tourism contents of thematic

1 city tour buses (healthy healing villages)
- Dangu
Make linkages between existing thematic city tour buses and
Dong
healthy healing villages* and major tourist attractions
Wonju
train
station
*Healthy Healing Village is a place where citizens who
are tired of their daily lives can participate in program
such as gardening and wandering in the healing
forest. The Agricultural Technology Center is
Picture. City tour bus
responsible for this program. Healthy Healing
Village
38 Fig. City Tour Bus (Healthy

Healing Village) Route Map
(Example)
Project 2. Healthy Wind Road Construction Project
- Wonju's average number of days of heat waves (23 days) is higher than that of Gangwon-do (21 days in
Current
average).
status and
objectives - Creating a wind road park enables lowering the temperature of urban area and provides park environment to the
citizens of Wonju.
Main contents
1 Haengu Waterfront Park ~ Create healing forest and wind road
- Wonju City is planning and promoting the Chiaksan Wind Road Forest Project to
create a healing forest from Haenggu Waterfront Park to Bangok Station. The theme
of "Healthy Chiaksan Wind Road Experience Forest" was created in the healing
forest.
- The forest was created by benchmarking Sturkart, Germany, a world-class wind road
built city.
Fig. Chiaksan Wind Road
39
Fig. Wind Road Experience Fig. Wind Road Forest - Fig. Fine dust traffic light Fig. Wind Road Rest Hall
Tower Windmill
Project 3. Wonjucheon River Stream Revitalization Project

- Satisfaction of Wonju citizens with Wonjucheon was 67.0% (Yonsei Healthy City Research
Current Center, 2021).
status and - Among the demands for Wonjucheon facility, 'separation of bicycle roads and sidewalks’ was the
objectives highest.
Main contents
1 Installation and maintenance of bicycle-separated dual-purpose roads
- Separated roads are installed so that cyclists and pedestrians can pass
safely.
- A project to create a hydrophilic space along Wonjucheon is going on, and
elastic pavement of the walking trail is in progress. It is necessary to create Picture. Separation of bicycle road and sidewalk
and maintain bicycle roads and sidewalks separately while doing the elastic
pavement.
2 Installation of health city signs
- The environment along Wonjucheon was created to allow citizens

have access to the health information by installing health city signs.
40 Picture. A walking calorie sign in the park (A
case of Lake Park in Goyang, Gyeonggi-do)
Project 3. Wonjucheon River Stream Revitalization Project

3 Establishment of Health, Sports and Culture Zone
- A zone considering health and cultural themes was established along Wonjucheon Stream (Taejang-dong to Gaeun-
dong) for citizens.
- (Sports Zone): Basketball court, badminton court, inline skating court, gateball court, etc.
- (Art Zone): Graffiti, citizen artist, street performance, small theater.
- (Stroller Zone) No smoking in all areas

Bicycle curfew
Removing obstacles for stroller use
- (PET Zone) Green Space for pets

Installation of pet drinking fountain,
collection box for pets’ excrement
Renting pet muzzle and walking rope
Fig. Bird's-eye view of Wonju Stream Zone (example)
- Improve satisfaction of using Wonjucheon

Expected
results - Promote health and increase quality of life of the Wonjucheon users
41
- Re-establishment of the image of Healthy City Wonju
Project 4. Healthy City Landscape Development Project

- Wonju citizens' satisfaction with urban environment and design was found to be low.
Current
- It is necessary to improve the urban landscape environment to build and promote the image of a healthy
status and
objectives city
Wonju.
Main contents
1 Green Healthy City
- Green Healthy City creates a garden on the roof of the

buildings with green grass, and emphasizes the city
with a green atmosphere.
- Currently, it is necessary to conduct urban regeneration
Fig. Green Healthy City (Singapore's case)
(general neighborhood type) in four sites: Usan-dong,
Hakseong-dong, Bongsan-dong, and Jungang-dong.
Improvement of urban facilities and

2
environmental design
- Design and improve the aged urban structures and

environment to fit the health city.
- Create a bright urban atmosphere in construction sites using Fig. Example of construction site cover Fig. Mural
42
screen design to cover the sites.
Project 5. Improvement of Health and Medical Services in Rural Areas
- The healthy life practice rate of the elderly in Wonju (21.4%) is lower than the average of Gangwon-do
Current
(26.2%).
status and
objectives - Project objective is to alleviate the health gap in vulnerable areas by improving health care services in rural
areas in Wonju.
Main contents
1 Building health promotion health centers 2 Linking Health Promotion Health Center to Health Clinic
- Establishment and operation of a deliberation committee to convert - Additional manpower and facilities are organized in
to a health promotion-type health center. the existing health centers/health clinics to operate
- Preparation of facilities, equipment and vehicles programs of physical activities and health
- Implementation of customized health promotion services for promotion for the elderly.
residents
- Implementation of Medical function and Health Promotion projects:
Operation of Medical Team + Health Promotion Project Team
43 Fig. A case of operating a health

Fig. Health Promotion Health Center
promotion health clinic.
Project 6. Healthy Healing Village Development Project
- Wonju City has excellent ecological resources such as Chiak mountain, Baegun mountain, Seom river, and
Current
status and Namhan river, making the city suitable for creating a healthy healing village.
objectives
- Project objective is to create a healthy healing village by utilizing this environment to create jobs, revitalize
rural areas, and improve the quality of life of the citizens.
Main contents
1 Creating a Healthy Healing Village
- It is necessary to establish a comprehensive operation

plan that can be linked to the village by building a
Healing Agricultural Center.
- Support for various facilities such as installing a
healing rest area (convenience store, toilet, bench) as
a village and farm support project through the
government public offering project.
- In the health healing village, not only residents of rural
areas but also outside tourists experience daily
through various professional education programs.
Creating various healing villages such as urban-rural
44 Fig. Bird's eye view of Healthy Healing Village
exchange type, rest healing type, and exercise healing
Project 7. Social Prescribing project
- Wonju City is an aging society with 49,983 (15.23%) elderly people (aged 65 and older) and is expected to
Current sta-
enter to the super-aged society within 2030.
tus and ob-
jectives - A three-year pilot project of social prescribing has been implemented which was supported by Korea
Research Foundation (2019-2021).
Main contents
1 Implementation of Music Therapy (Music Storytelling) Program
- The music storytelling social prescribing program was developed based on music therapy and psychotherapy, and it is a
service registered at the Korean Intellectual Property Office in 2013.
- Since 2019, a pilot project has been implemented for the elderly living in Heungup-myeon, and it has been converted to
non-face-to-face during the COVID-19 era. The project is being promoted as 2022 subsidy support project of Wonju City.
Fig. Music Storytelling Program Fig. Social prescribing Fig. Non-face-to-face music storytelling program
implementation implementation manual implementation
45
Project 7. Social Prescribing project (Cont.)
2 Self-help group with village school teachers - 老老 care
- The elderly know well about each other and care for each
other. Older people who are able to live their daily lives can
take care of the other older people who have difficulties in
daily living.
- Programs: ➀ Making masks and soap to prevent COVID-19,
Fig. Village school teachers and Self-help Meeting –
➁ making dolls using socks, ➂ making healing songs for
villages, etc. 老老 care (Heungeop case)
3 Gardening in our community
- A "community garden" is created, and the senior citizens

made plans for gardening activities with other local residents
and volunteering students.
- The harvested crops were given as gifts to other elderly
people living alone, or sold at a flea market. The revenues
are planned to be donated to the elderly in the community. Fig. Gardening in our community (Heungeop case)
Expected
results - Contribute to successful aging by alleviating social loneliness and increasing social capital.
46 46
5. Conclusion
• In order to make Wonju citizens be healthy, it is necessary to consider
the ‘Social Determinants of Health’ presented by WHO.
• It is necessary to promote a comprehensive regional health policy that
considers
Health in All Policies.
• It is necessary to implement a five-year healthy city project in Wonju that the
stakeholders such as local governments, citizens, health care institutions, and
universities cooperate with each other.
• As part of these efforts, it is necessary to improve the health behavior of
citizens
that do not rely too much on medications. To achieve this, new trials such as
introduction of a social prescription system that actively utilize community
47 resources are needed.

Thank you.
• QnA
48

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Healthy City Project in Korea:

History, present and future

Professor, Department of Health Administration,

2. Wonju Healthy City

3. Wonju Healthy City - Strategy

4. Wonju Health City - Case study

• Introductory Stage (2004-2006)

• Developing Stage (2007-2009)

• Maturity Stage (2010-2020)

• Future Challenges for Healthy Cities (2021- )

01. Introductory Stage (2004-2006)

• Attended AFHC 1st Kuching (2004)

02. Developing Stage (2007-2009)

• Attended the 2nd AFHC Global Conference in Suzhou, China

• Operated ‘Healthy Cities Forum’ of Ministry of Health and Welfare

• Publication of Healthy Cities Casebook

• Publication of Research Report on the Classification of Healthy Cities

(Ministry of Health and Welfare, Yonsei University)

03. Maturity Stage (2010-2020)

• AFHC 7th Global Conference - Wonju City (2016)

• Development of Healthy City Certification System (Ministry of

Health and Welfare, Yonsei University) - not being implemented.

• Establishment of the 'Health Promotion Foundation' under the

Ministry of Health and Welfare and supporting healthy city projects.

04. Future Challenges for Healthy Cities (2021- )

• Strengthening the Healthy Cities Network in Korea

2.1. Population: 350,000 (March 1st, 2022)

2.3. Progress of the Healthy City Project

Wonju is the only Healthy City in Korea that won the

(2018) Mayor of the Wonju City Won Chang-Muk won a

2.4. Phase 3 of the Healthy City Project (2021-2025)

Phase 1-2 Community Selection of Project Final selection Development of

Investigating Final selection

02 평가방법 Vision 2025

Fig. Trend of population in Wonju

Fig. Demographic structure by age

Fig. Changes in birth rates per 1,000 population by year

Fig. Changes in ozone (O3) concentration by year

Fig. Changes in urban park area per person (m2) by year

Fig. Changes in road pavement rates by year

Fig. Changes in current smoking rates by year

Fig. Changes in high-risk drinking rates (standardization) by year

Fig. Changes in walking practice rates by year

Fig. Changes in obesity rates (self-reported) by year

Fig. Changes in stress recognition by year

Fig. Changes in lifetime prevalence of hypertension by year

Fig. Changes in the prevalence of diabetes by year

Fig. Changes in cancer screening rates by year

Healthy City Wonju Vision 2025 Plan

Respondents: Healthy city advisory Respondents: Wonju City public offi-

1) Low sensitivity of local residents 3) Lack of projects related to housing/unemployment issues

1) Mental health promotion for the elderly

Need Reflection of the needs of local residents, health city

Vision Healthy city where citizens participate together

Digital Health and Risk-responsive Future-oriented

• Smart healthy • Healthy living area • Healthy city for

Strategy1 Digital Health and Healthy City

Smart healthy city Big data used city

Expansion of smart VR Building a Big Data DB for Healthy

Strategy 2 Healthy Green City

Narrow healthy life Create natural Healing Tourist City

Strategy 3 Risk-responsive Healthy City

Social prescribing programs