The Bulgarian Five Cities Study

There is a growing recognition that a purely biomedical approach to health is often insufficient and is an expression of a certain reductionism that prevents a systematic understanding of the determinants of human health in social and even planetary terms. The modification of the environment is a tool with great potential to prevent diseases or reduce the risk of their occurrence, to treat them more effectively and quickly, to lower the risk of complications and to help the sick person adapt to their life, while taking into account the social, political, economic and cultural aspects of the transactions between the person and his environment, as well as between members of society.

Appropriately planned and designed urban living environments should enable and actively support active travel in daily life, while reducing exposure to stressors such as air pollution and noise, promoting contact with nature, and contributing to building individual and community resilience to adverse influences. A systems approach to a comprehensive transformation of the urban environment is needed, alongside campaigns targeting individual knowledge, attitudes and the societal norm as a whole.