The 'healthy' city, expertise, and the regulation of space

This paper critically examines the concept of the 'healthy' city as it has been articulated in the health promotion literature and the policy documents and programme evaluations of the World Health Organization's Healthy Cities project. It begins by discussing the emergence of this concept within health promotion and the new public health, then questions the claim that the Healthy Cities project represents a fundamentally new approach to urban health problems. Attention is drawn to the continuing modernist belief in the power of science and in rational administrative solutions to problems. The paper focuses on some assumptions, limitations and implications of the strategy of 'community participation', which is a key feature of the Healthy Cities project and Health for All by the Year 2000. It is concluded that it is important for those who are concerned about advancing the health of urban populations to critically examine the basic concepts of Healthy Cities and the new public health.