Principles of Healthy Cities as Envisioned by the Urban + Health Initiative at MSPH
In introducing their Healthy Cities project, the World Health Organization states that “Health is the business of all sectors, and local governments are in a unique leadership position, with power to protect and promote their citizens' health and well-being.” While the actions needed to improve population health will be specific to a given city and the challenges faced by residents, there may be characteristics common to the processes that are well suited to helping cities become healthier for all residents. As we frame how to best direct our efforts in support of healthier cities, we consider the following principles as central to our aspirations for cities:
Whole city orientation
Each geographic area and sociodemographic subpopulation has unique issues, yet these can be best addressed with sensitivity to pressures and constraints in the broader urban context; to the needs of old and young; and to inequities across racial, ethnic, or socioeconomic subgroups of the population.
Consortium and Community directed urban policies
Jointly envisioned goals and actions, avoiding either a pure “top-down” approach (imposed upon residents and devoid of local input and ownership) or a pure “bottom-up” approach (which would place the full burden of decision making and change implementation on residents).
Personal connection to place
Each city resident identifies with a local social group or organization with whom to collectively pursue opportunities for healthier lives; local control and sense of ownership support the behavioral change necessary to realize health benefits.
Coordination of evidence-informed action
Governmental decision-makers and other stakeholders communicate, use relevant research evidence, and receive expert input to avoid inefficiencies or unintended problems related to lack of information.
Enhanced access to resources
Individuals and community coalitions pursuing improved health know how to access relevant resources; barriers to accessing health promoting resources are brought to light and targeted for elimination.
Tracking health impact for harm avoidance and policy refinement
Ongoing surveillance is used to track both anticipated health benefits and unintended harms; such data are available to inform refinement of action strategies.
Value and incentive alignment for continuous improvement
Attention is given to continuing or emerging incentive structures that support or undermine the effectiveness of programs and structures intended to be health supportive.