Collaborative urban leadership provides strong base for building healthier cities

Considering four approaches helps prioritise and pursue more coherent urban solutions.

Four paradigms of urban health offer unique insights for collaborative solution-building in our cities, says an expert from the UNSW Cities Institute.

“Understanding what it means to be a healthy city is integral to addressing urban health inequities,” says Scientia Fellow Dr Jinhee Kim. “Health means different things to diverse urban stakeholders.

“But health here moves beyond health services or the treatment of ill health to focus on health promotion, positive health prevention and social cohesion,” the transdisciplinary researcher says. “It’s about how we create a more liveable space for everyone.”

The UNSW Cities Institute brokers partnerships that build governance systems for smarter, healthier and more equitable urban environments in the Asia-Pacific region. It bridges knowledge, policy and practice for informed urban responses to complex legacies of settlement, climate change and community marginalisation.

Dr Kim has identified four paradigms for urban health: the medical-industrial; the urban health science; the healthy built environments; and the health social movements approaches.

“Understanding how these paradigms co-exist and complement one another is integral to driving greater urban health equity,” the former local government bureaucrat says.

The medical-industrial lens of urban health prioritises urban development focused on healthcare infrastructure and technology, Dr Kim says. “Cities with thriving health precincts and innovation districts create jobs, infrastructure, growth and better educational opportunities.

“However, this approach can overlook broader social needs around community health and health equity, such as access to affordable housing or healthy local food environments.”

By contrast, an urban health science lens emphasises evidence-based interventions and measurable outcomes, examining, among other things, cause and effect, she says.

“A data-driven approach has helped researchers understand how urban design aspects impact public health, for example, how much green space helps reduce obesity. However, social issues stretch beyond the technical; this approach can undervalue the ‘human’ element.”

The third paradigm prioritises healthy built environments. “This lens is rooted in urban planning, integrating health considerations into all aspects of city design. This has led to innovations in planning guidelines – health and environmental impact assessments – but can face political and economic barriers.

“Finally, a health social movements approach commits to community empowerment and equity. It’s grounded in the idea that healthy cities are not determined by their epidemiological health status but shaped by residents’ needs and aspirations.”

In practice, successful urban health initiatives often draw from multiple perspectives, she says. “For example, public space planning might combine evidence-based metrics from an urban health science lens with the community empowerment emphasis of health social movements while working within the practical framework of healthy built environments.

“This moves beyond building health infrastructure to creating environments that promote wellbeing, using evidence-based approaches.

“Acknowledging local context and community values, integrating health considerations into urban planning, and empowering communities to shape their environments helps build more equitable and healthy cities.”