Health and greening the city; new visions for health promoters.

okyo is one of the world's great new metropolitan areas; when I first visited it, it reminded me powerfully of Fritz Lang's prescient classic Metropolis. Space is at an absolute premium and conducting the normal routines of everyday life can seem like a major challenge. The contemporary public health issues are mostly to be found there. Fortunately for Tokyo and its citizens, Takehito Takano and his group at the Graduate School of Tokyo Medical and Dental University are well on the case and have been for over 10 years. Working within the framework of the WHO Healthy Cities initiative,[1] they have thrown light on pressing problems in novel and lateral ways. This group is really " out of the box " , while grounded in the classic epidemiological methods. Their latest offering is a cohort study of elderly Tokyo citizens to establish whether having ready access to green space affects longevity. In summary it seems to, and the factors of walkable green streets and spaces near the residence and that of having a positive attitude to one's own community both came out with positive predictive values for survival over the following five years. The implications of this, and of this genre of work for the reinvigoration of town planning and its connections to public health are obvious (Liverpool, where I am writing this piece from, had not only the first full time city medical officer in William Henry Duncan but also the first university department of town planning, and this was no coincidence). However, we must remind ourselves that to the biomedical strand of public health and the environmental strand of town planning we also need the behav-ioural and political strand when considering these kinds of questions. Throwing green space at people may well not work unless they have some sense of ownership power and control, hence the significance of the finding relating to citizen's attitude to their community. Professor Takano visited Liverpool in the late 1980s to study William Henry Duncan's legacy when he was embarking on his Healthy Cities research programme. William Henry would have been more than proud at the results. T he paper from Takano et al, 1 outlines how the presence of a " green and pleasant land " has meaning even within an urban sprawl. Here, just perceiving that your neighbourhood is both green and pleasant was associated with increased longevity in older people. …