The development of Healthy Cities and place-based approaches in the UK: a comparative review

• Published in: The Lancet (British edition) 2024-11, Vol.404, p.S19-S19
• Main Authors: Jenkins, Catherine L, Sykes, Susie, Wills, Jane, Whitelaw, Alexander
• Format: Article
• Language: English
• Subjects: Cities; Community involvement; Documents; Funding; Health care; Health policy; Public health; Reviews
• ISSN: 0140-6736; 1474-547X
• DOI: 10.1016/S0140-6736(24)02064-6

The role of cities in population health has long been discussed. This historical and comparative review compares the discourse and policy underpinning two approaches: the World Health Organization (WHO) settings-based approach Healthy Cities, and more recent place-based approaches. It aims to illuminate what has been learned over the past three to four decades about how initiatives can best be developed for the future. Document analysis was conducted using the Ready Extract Analyse Distil (READ) protocol to review eligible grey literature: plans, guidelines or frameworks from any health policy-making body in the UK which defines their approach in relation to cities. A set of comparative criteria guided analysis and categorisation of documents: overall vision of the approach, underpinning principles, stakeholder roles, community participation and engagement, types of intervention, funding sources, impact, and legacy. A second researcher conducted a blind review of 20% of the sample. Preliminary data extraction finds that while both approaches seek to improve population health by leveraging the influence of cities, each describes how this is done in different ways, potentially reflective of their historical point in time and continuing trajectories. For example, principles of the current phase of WHO Healthy Cities include commitments to prosperity, peace, planet, and ‘healthy places and settings’ for the first time. Except settings, all these commitments are present in place-based approaches to reducing health inequalities. This review builds the evidence base about how cities shape health and identifies types of intervention likely to enhance health. Delineation of the differences between settings-based and place-based approaches, and between ‘settings’ and ‘places’ for health, is a key outcome: in a context of limited funding in the UK, it is important to ensure that learning is retained and informs the legacy of approaches as public health concepts and policies evolve. None.