Our cities, our health, our future: Acting on social determinants for health equity in urban settings
Chair and Lead Writer: Tord Kjellstrom
Report of the Knowledge Network on Urban Settings, WHO Commission on Social Determinants of Health
Prepared by the WHO Centre for Health Development,
Available online as PDf file [70p.] at: http://www.who.int/social_determinants/resources/knus_report_16jul07.pdf
“…..A conceptual framework for urban health was suggested by Vlahov et al. (2006, 2007) and was adapted for the report (Figure 4). The core concept is that the social and physical environments that define the urban context are shaped by multiple factors and multiple players at multiple levels. Global trends, national and local governments, civil society, markets and the private sector shape the context in which local factors operate. Governance interventions in the urban setting must consider national and municipal determinants and should strive to influence both the urban living and working environments as well as intermediary processes that include social process and health knowledge.
The framework assumes that the urban environment in its broadest sense (physical, social, economic, and political) affects all strata of residents, either directly or indirectly. It should be pointed out that interventions can also influence the key global, national and municipal drivers. The health sector has an important role to play, for instance via the “healthy cities” approach….”
Table of contents
Political briefing
Executive summary
1. Introduction
2. Urbanization and the urban setting as health determinants
2.1. Urbanization in a global context
2.2. Slum formation with rapid urbanization
2.3. A conceptual framework for urban health
2.4. The economics of urban health development
2.5. Poverty, deprived urban living conditions and health vulnerability
2.6. Healthy urban governance
3. The urban health situation
4. Key issues and challenges in achieving health equity
4.1. Environmental health threats in the home and neighbourhood
4.2. Environmental health threats in the wider urban area
4.3. Health threats at work
4.4. Urban health impacts of global resource depletion and environmental change
4.5. Health care systems and emergency services
4.6. Gender and women’s health equity issues
4.7. Other vulnerable groups
5. A broad spectrum of interventions
5.1. Building trust, social capital and social cohesion
5.2. A range of specific interventions
5.3. Interventions via primary health care
5.4. Conditional cash transfers: global social welfare support
5.5. Healthy settings and healthy cities approaches to interventions
5.6. Urban development planning and investment to avoid new slum formation
5.7. Good governance bringing together all interventions
6. Approaches and policies to make interventions happen
6.1. Toward an integrated approach to reducing health inequity
6.2. Health, a rallying point for achieving improved life quality
6.3. Microfinance and local investment
6.4. The global investments required for health equity
6.5. A fairer distribution of resources for health
7. Conclusions and recommendations
References
Drafting Team: Susan Mercado, David Sattherthwaite, Gordon McGranahan, Sharon Friel and Kirsten Havemann
Contributing writers: Françoise Barten, Jaimie Bartram, Daniel Becker, Cate Burns, Scott Burris, Waleska T. Caiaffa, Alana Campbell, Tim Campbell, Diarmid Campbell-Lendrum, Rachel Carlisle, Carlos Corvalan, Annette M. David, Jorge Jimenez Jane Dixon, Kai Hong Phua, Kelly Donati, Katia Edmundo, Nick Freudenberg, Sharon Friel, Sandro Galea, Fiona Gore, Wei Ha, Trevor Hancock, Ana Hardoy, Andre Herzog, Philippa Howden-Chapman, Andrew Kiyu, Albert Lee, Josef Leitmann, Vivian Lin, Gordon McGranahan, Helia Molina Milman, Diana Mitlin, Frederick Mugisha, Catherine Mulholland, Kaoru Nabeshima, Danielle Ompad, Abiud M. Omwega, Giok Ling Ooi Sheela Patel, Pat Pridmore, Fernando Proietti, Eva Rehfuess, Jaime Sapag, David Sattherthwaite, Shaaban Sheuya, Ruth Stern, Liz Thomas, David Vlahov, Lisa Wood, Shahid Yusuf
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