‘Social, innovative and smart cities are happy and resilient’: insights from the WHO EURO 2014 International Healthy Cities Conference

This paper provides a brief overview of, and elaborates on, some of the presentations, discussions and conclusions from Day 4 of the ‘WHO EURO 2014 International Healthy Cities Conference: Health and the City - Urban Living in the 21st Century’, held in Athens, Greece on 25 October 2014. The Internet of Things (IoT) is made of sensors and other components that connect our version of the world made of atoms, i.e., humans/our bodies, our devices, vehicles, roads, buildings, plants, animals, etc., with a mirror digital version made of bits. This enables cities and regions to be self-aware and dynamically reconfigurable in real- or near-real-time, based on changes that are continuously monitored and captured by sensors, similar to the way the internal biological systems of a living being operate and respond to their environment (homeostasis). Data collected by various IoT sensors and processed via appropriate analytics can also help predict the immediate future with reasonable accuracy, which enables better planned responses and mitigation actions. Cities and regions can thus become more adaptable and resilient in face of adversity. Furthermore, IoT can link atoms (humans) to other atoms (humans) (again via bits), resulting in the formation of ‘smart(er) communities’ that are socially connected in new ways and potentially happier. Cities, but also less urbanised regions and the countryside, could all benefit from, and harness the power of, IoT to improve the health, well-being and overall quality of life of the local populations, actively engage citizens in a smarter governance of their region, empower them to better care for one another, promote stronger social inclusion, and ensure a greener, sustainable and more enjoyable environment for all. Technology can also help reverse the ‘brain drain’ from the countryside and smaller towns to larger metropolises by making the former more attractive and connected, with better services akin to those found in larger cities. The article also discusses some ways of measuring and benchmarking the performance of smart cities and their impact on well-being. However, it should be emphasised that technology is not a panacea and that other factors are equally important in creating happier and healthier cities and regions. Electronic supplementary material The online version of this article (doi:10.1186/1476-072X-14-3) contains supplementary material, which is available to authorized users.

• Concerns: IoT data and device privacy and security • Conclusions The Internet of Things (and People) • The Universe, our bodies and the physical animate and inanimate objects around us have always generated enormous amounts of data, but we were not able to fully capture and make sense of those data until recently.
• Today, the Internet of Things (IoT) enables almost everything (people and objects on our planet and the Universe) to be automatically identified and located, e.g., using RFID or Radio-Frequency IDentification tags, instrumented using a very wide array of specialised sensors or detectors to capture data, and connected / interconnected to cloud servers for storage, processing and 'in context' / 'intelligent' analysis of captured data.
The Internet of Things (and People) • The result are smarter 'things' and smarter environments in which people and objects interact and cooperate with each other in better and new ways that can vastly improve our quality of life.
• A 'quantified self' is now possible, thanks to a growing range of wireless sensors in gadgets / wearables (e.g., smart watches and smart garments) and implantables that can continuously monitor and track in real time various aspects of a person's daily life and clinical status.
• Internet-connected wireless health sensors and sensors around the home are key to modern telehealthcare services (also known as 'connected health/care'), particularly those aimed at prolonging the independent living or 'ageing well' of older people (Ambient Assisted Living-AAL).
The 'smart garment' used in the eCAALYX EU-funded AAL project: http://ecaalyx.org/ • Connected 'things' can also have remotelycontrolled actuators or other mechanisms to trigger or modify actions carried out by those objects according to needs measured by sensors (or user-initiated), e.g., in home automation (domotics) scenarios.
How to convert an object to a connected 'smart thing' • Suppose we have a chair. We want to know (using an Internetconnected smartphone / tablet or computer) from anywhere in the world if it is occupied, and who is currently sitting in it.
• To convert the chair into a smart one, we first need to give it a unique identity (IPv6) to uniquely identify it and connect to it specifically (as opposed to all other / similar chairs in the same room or elsewhere).
• We then need to give it the ability to communicate (wirelessly) and equip it with the ability to 'sense' its own status and its environment via sensors.
• A pressure sensor on the seat can detect whether the chair is occupied or not. An RFID tag reader attached to the seat can identify any tagged person sitting in it.
• We can even think of ways to control that chair, e.g., move it, from anywhere in the world, using a remotely-controlled actuator / motor (though this does not make useful sense with the chair example).

• Boundaries between 'digital' (bits/data) and 'physical' (atoms/things) are getting blurred:
Internet-connected smartphones, phablets* and similar can also sense and 'recognise' where we are (location awareness) and the persons, places, things and objects around us (via camera/cloud-powered image recognition, QR [Quick Response] code scanning, etc.), and link them to relevant information (e.g., 'Layar' augmented reality app, ESRI 'My Place History' geomedicine app, Amazon Fire Phone and Google Glass), or even use them as elements of a digital game (or exergame) taking place in the real world! * Phone-tablet Video: IoT-powered (connected) pillbox • Length: 0:38 -https://www.youtube.com/watch?v=RTdRUwl9JsA (also locally embedded on next slide) Embedded video is not available in this copy of the presentation. Please refer to the previous slide for the YouTube version.

Connected vehicles
• The emerging EU 'connected cars' vision and standards (see http://europa.eu/rapid/press-release_IP-14-141_en.htm) have the potential of reducing traffic bottlenecks and road traffic accidents, in addition to improving ambulance response times. IoT generates (and consumes) big data • IoT-driven sensors, devices, systems and services generate big amounts of real-time data (not all of which are trustworthy and reliable).
• Much of the IoT-generated 'big data' are geo-tagged or geo-located. Location gives important context ('where'), as well as being an essential piece of information to know when responding to events and deploying appropriate actions (but also has some individual privacy implications).
• Big data and their context are key to gaining new insights that can inform better decision making in various scenarios. The importance of having robust, intelligent analytics systems in place to process and make sense of such data in real time cannot, thus, be overestimated.
The 4Vs of big data: According to Gartner (2012), "big data are high Volume, high Velocity, and/or high Variety information assets that require new forms of processing to enable enhanced decision making, insight discovery and process optimisation". A fourth V for 'Veracity' can be added to the definition to emphasise the importance of establishing data trustworthiness and accuracy. • Health is geospatial, and if we can see trends spatially (the 'where' / smart location component), we can monitor and improve population and individuals' health.
• But do not go beyond the actual statistical strength of the (big) data; accommodate sound 'error bars' around all inferred predictions.
• Also 'big data' methods can only be truly useful if they are paired with traditional forms of information collection, or what some researchers call 'small data'.

Dashboards and real-time visualisation
Smart traffic management in Hamburg, Germany • A 500-Km-long underground fibre network is being installed progressively as the city carries out routine maintenance to its roads and other underground services, which helps reduce installation costs significantly.
• Solar-panel-powered smart bus stops are connected to the city's fibre network. They display real-time bus information and times, tourist information and digital advertising, offer USB (Universal Serial Bus) charging sockets for mobile devices such as smartphones and tablets, and act as free WiFi (Wireless Fidelity) hotspots, allowing people to connect to the Internet using their mobile devices while waiting for a bus.
• The city's smart parking spots are also connected to Barcelona's WiFi network. They detect the presence of cars through a combination of light and metal detectors.
• Online searching and payment for the smart parking spots is possible using dedicated smartphone apps.
Image source: http://paulwallbank.com/2013/11/01/touring-barcelona-smartcity-internet-of-things/ Icon of apparkB app for Android and iOS • Reduce traffic congestion • Lower air and noise pollution • A city-wide network of sensors provides real-time information on the flow of citizens, noise and other forms of environmental pollution, as well as traffic and weather conditions, enabling local authorities to streamline city operations for better environmental management, reduction of costs, and improvement of socioeconomic and environmental sustainability.
• Barcelona's highly-energy-efficient LED (Light-Emitting Diode) streetlights are fitted with CCTV (Closed-Circuit TeleVision), environmental monitoring sensors (humidity, temperature, air quality / pollution and noise) and WiFi.
• The streetlights are capable of dynamically managing the level of lighting depending on surrounding conditions to save energy, e.g., dim lights when no motion or pedestrians are detected in the street.
Image source: http://paulwallbank.com/2013/11/01/touring-barcelona-smart-cityinternet-of-things/ • Barcelona's smart grid developments include rolling out one million new smart electricity meters in the city, providing customers with higher energy usage awareness and optimisation tools, and helping them better plan and adapt their consumption for greater savings and reduction of greenhouse gas emissions such as CO2 and NOx.
• Barcelona is also a strong supporter of electric vehicles and created Spain's first electric vehicle fast recharge point. • Barcelona's wirelessly-connected garbage bins are fitted with sensors that monitor trash levels.

An innovative solar-powered building in Barcelona
• The data reach the city council's team in charge, enabling the team to plan the optimal routes for garbage collection, update garbage truck drivers in real time regarding which routes to take, and in this way optimise productivity and reduce waste management service costs, as well as pollution caused by garbage trucks.
• Other compact drop-off street containers connect through pipes to a subterranean vacuum network sucking up trash below the ground, thus decreasing noise and air pollution caused by garbage trucks. • IoT-powered smart cities aim at improving the quality of life of their populations in a variety of ways, including through measures that promote ecofriendly, sustainable environments and the delivery of 'connected health/care' services to citizens at home and on the move.
• Smart cities stand better chances of becoming healthier cities. The WHO and associated national Healthy Cities networks have hundreds of member cities around the world that could benefit from, and harness the power of, IoT to improve the health and well-being of their local populations.
• IoT-powered smart cities rely on a growing number of sub-technologies and subsystems that need to be seamlessly interconnected and interfaced with one another in real time. This can only be achieved through the adoption of adequate standards and protocols for measurement, communication, integration, interoperability and control.