Governance is a key factor in urban health [Burris 2021] and is defined as the action or manner of governing a city and the relationships between the state agencies and society – the relationships among them determine what happens in the city.
Good governance can lead to better housing and living conditions, access to safe water and sanitation, safer working environments and neighbourhoods, food security, and access to key essential services [Kjellstrom 2007].
Furthermore, the Health in All Policies (HiAP) approach “is an approach to public policies across sectors that systematically takes into account the health implication of decisions, seeks synergies, and avoids harmful health impacts in order to improve population health and health equity” [Amri 2022].
It has been reported that the role of urban health should be decentralized from national to local levels because solutions to local problems arguably lie at the municipal level [Amri 2022].
However, there appears to be “pervasiveness of ‘behavioural’ and ‘biomedical’ perspectives, and a lack of consideration afforded to the roles and responsibilities of municipal governments, among the health inequities scholarly community” [Collins 2010].
Governance is a key factor in urban health [Burris 2021]. However, overall there is a dearth of high-quality evidence assessing the impact of city governance on health.
The European Health Policy Framework and Strategy: Health 2020 of the World Health Organization highlights four elements as cornerstones to creating healthy cities: political commitment, vision and strategy, institutional change, and networking [Tsouros 2013].
There were no systematic reviews assessing the effect of city governance on health outcomes.
There should be minor resource implications of governance given the manner of governing cities are largely in place and restructuring should require limited resources.
- Burris 2021. “Law and urban governance for health in times of rapid change.” Health promotion international vol. 36, Supplement_1 (2021): i4-i12. doi:10.1093/heapro/daab064
- Kjellstrom 2007. “Our Cities, Our Health, Our Future: Acting on Social Determinants for Health Equity in Urban Settings”. WHO Kobe Center, Kobe, Japan. July 2007.
- Tsouros 2013. “City leadership for health and well-being: back to the future.” Journal of urban health : bulletin of the New York Academy of Medicine vol. 90 Suppl 1,Suppl 1 (2013): 4-13. doi:10.1007/s11524-013-9825-8
- Amri 2022. “Healthy Governance for Cities: Synergizing Health in All Policies (HiAP) and Healthy Cities Approaches.” Journal of urban health : bulletin of the New York Academy of Medicine vol. 99,2 (2022): 231-234. doi:10.1007/s11524-022-00618-6
- Collins 2010. “The role of urban municipal governments in reducing health inequities: A meta-narrative mapping analysis.” International journal for equity in health vol. 9 13. 25 May. 2010, doi:10.1186/1475-9276-9-13
- Urban Governance. UN-Habitat. https://unhabitat.org/topic/urban-governance