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Health Cities

The Healthy Cities approach seeks to put health high on the political and social agenda of cities and to build a strong movement for public health at the local level. The concept is underpinned by the principles of the Health for All strategy and Local Agenda21.

The Healthy Cities Project promotes comprehensive and systematic policy and planning for health and emphasizes:

  • the need to address inequality in health and urban poverty
  • the needs of vulnerable groups
  • participatory governance
  • the social, economic and environmental determinants of health.

It is not about the health sector only. It includes health considerations in economic, regeneration and urban development efforts.


Concept of a Healthy City

The concept of a Healthy City emerged in the mid-1980s, articulating a vision of a healthy city as one:

“that is continually creating and improving those physical and social environments and expanding those community resources which enable people to mutually support each other in performing all the functions of life and in developing to their maximum potential” (Hancock and Duhl, 1988, cited in Tsouros, 1991: 20).


Beginnings of the Healthy City Movement

It was initiated by WHO as a smallscale European project that aimed “to put health on the agenda of decision-makers in the cities of Europe” (Tsouros, 1995: 133). Its first five year implementation phase sought to translate the rhetoric of Health for All and the Ottawa Charter into tangible action.

Informed by modern management theory and practice, the project was explicit in stating that a healthy city is defined by a process and not an outcome, and recognised from the start that success requires experimentation, learning, adaptation and change. It thus aimed to realise the vision of the healthy city through combining political leadership, visibility for health, institutional change and innovative action for health – supported by partnership working, networking, evaluation and dissemination.


Growth of the Healthy City Movement

Global : The approach quickly caught the imagination of professionals, politicians and citizens worldwide. By the early 1990s, Healthy Cities was fast becoming a major global movement for the new public health, having not only expanded within Europe but having taken root within other parts of the developed world such as Australia, Canada, Japan, New Zealand and the United States of America.

Europe : About 90 cities are members of the designated WHO European Healthy Cities Network, and 30 national Healthy Cities networks across the WHO European Region have more than 1400 cities and towns as members.

Within Europe, Healthy Cities is now at the end of its fifth five-year phase. At the start of each new phase, a set of criteria are issued, and European cities and towns have the opportunity to apply to become a WHO designated city. The application involves cities demonstrating competence and commitment against the range of process-focused requirements – showing that that they are committed to partnership working, capacity-building, networking and evaluation, and have in place:

  • multisectoral support for Healthy Cities principles and goals
  • an identified co-ordinator
  • a high level steering group
  • a city health profile
  • integrated strategic planning mechanisms

More information  about the Health Cities Project and its presence in the UK is available from the UK Healthy Cities Network.  


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