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Utility-driven evidence for healthy cities: Problems with evidence generation and application


  • de Leeuw, Evelyne
  • Skovgaard, Thomas


The question whether the WHO Healthy Cities project 'works' has been asked ever since a number of novel ideas and actions related to community health, health promotion and healthy public policy in the mid 1980s came together in the Healthy Cities Movement initiated by the World Health Organization. The question, however, has become more urgent since we have entered an era in which the drive for 'evidence' seems all-pervasive. The article explores the nature of evidence, review available evidence on Healthy Cities accomplishments, and discusses whether enough evidence has been accumulated on different performances within the realm of Healthy Cities. A main point of reference is the European Healthy Cities Project (E-HCP). Building on the information gathered through documentary research on the topic, it is concluded that there is fair evidence that Healthy Cities works. However, the future holds great challenges for further development and evidence-oriented evaluations of Healthy Cities. There are problems with (1) the communication of evidence, (2) the tension between the original intention of the Healthy Cities Movement and its current operations, and (3) the complex nature of Healthy Cities and the methodological tools currently available.

Suggested Citation

  • de Leeuw, Evelyne & Skovgaard, Thomas, 2005. "Utility-driven evidence for healthy cities: Problems with evidence generation and application," Social Science & Medicine, Elsevier, vol. 61(6), pages 1331-1341, September.
  • Handle: RePEc:eee:socmed:v:61:y:2005:i:6:p:1331-1341

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    References listed on IDEAS

    1. repec:aph:ajpbhl:2003:93:4:557-574_3 is not listed on IDEAS
    2. Roberta Capello, 2000. "The City Network Paradigm: Measuring Urban Network Externalities," Urban Studies, Urban Studies Journal Limited, vol. 37(11), pages 1925-1945, October.
    3. repec:aph:ajpbhl:2003:93:3:383-388_6 is not listed on IDEAS
    4. Takano, Takehito & Fu, Jia & Nakamura, Keiko & Uji, Kazuyuki & Fukuda, Yoshiharu & Watanabe, Masafumi & Nakajima, Hiroshi, 2002. "Age-adjusted mortality and its association to variations in urban conditions in Shanghai," Health Policy, Elsevier, vol. 61(3), pages 239-253, September.
    5. Dobrow, Mark J. & Goel, Vivek & Upshur, R. E. G., 2004. "Evidence-based health policy: context and utilisation," Social Science & Medicine, Elsevier, vol. 58(1), pages 207-217, January.
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    Cited by:

    1. Berkeley, Dina & Springett, Jane, 2006. "From rhetoric to reality: Barriers faced by Health For All initiatives," Social Science & Medicine, Elsevier, vol. 63(1), pages 179-188, July.
    2. Goebbels, Adrienne F.G. & Lakerveld, Jeroen & Ament, André J.H.A. & Bot, Sandra D.M. & Severens, Johan L., 2012. "Exploring non-health outcomes of health promotion: The perspective of participants in a lifestyle behaviour change intervention," Health Policy, Elsevier, vol. 106(2), pages 177-186.
    3. Jolley, Gwyneth, 2014. "Evaluating complex community-based health promotion: Addressing the challenges," Evaluation and Program Planning, Elsevier, vol. 45(C), pages 71-81.
    4. repec:gam:jscscx:v:5:y:2015:i:1:p:3:d:61460 is not listed on IDEAS
    5. Hazel Williams-Roberts & Bonnie Jeffery & Shanthi Johnson & Nazeem Muhajarine, 2015. "The Effectiveness of Healthy Community Approaches on Positive Health Outcomes in Canada and the United States," Social Sciences, MDPI, Open Access Journal, vol. 5(1), pages 1-21, December.


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