The Healthy Cities movement has its origins in the recognition that health is determined much less by health services than by social, environmental and economic factors, as originally pointed out by McKeown.2 Observations of this kind gave rise to the now well-established concepts of Health Promotion and Primary Health Care and policies such as WHO’s Health for All. Despite these ideas having been promoted for more than 20 years, responsibility for health matters in most city governments falls within a single department, which in most instances finds itself having to devote the greater part of its budget to curative medical care.

View the complete Healthy Cities Initiative report and Evaluation manual