Journal of Urban Health

, 88:793 | Cite as

Roundtable on Urban Living Environment Research (RULER)

  • David VlahovEmail author
  • Siddharth Raj Agarwal
  • Robert M. Buckley
  • Waleska Teixeira Caiaffa
  • Carlos F. Corvalan
  • Alex Chika Ezeh
  • Ruth Finkelstein
  • Sharon Friel
  • Trudy Harpham
  • Maharufa Hossain
  • Beatriz de Faria Leao
  • Gora Mboup
  • Mark R. Montgomery
  • Julie C. Netherland
  • Danielle C. Ompad
  • Amit Prasad
  • Andrew T. Quinn
  • Alexander Rothman
  • David E. Satterthwaite
  • Sally Stansfield
  • Vanessa J. Watson


For 18 months in 2009–2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO’s Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health—namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.


Social Capital Geographic Information System Urban Setting Informal Settlement Health Information System 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© The New York Academy of Medicine 2011

Authors and Affiliations

  • David Vlahov
    • 1
    Email author
  • Siddharth Raj Agarwal
    • 2
  • Robert M. Buckley
    • 3
  • Waleska Teixeira Caiaffa
    • 4
  • Carlos F. Corvalan
    • 5
  • Alex Chika Ezeh
    • 6
  • Ruth Finkelstein
    • 7
  • Sharon Friel
    • 8
  • Trudy Harpham
    • 9
  • Maharufa Hossain
    • 10
  • Beatriz de Faria Leao
    • 11
  • Gora Mboup
    • 10
  • Mark R. Montgomery
    • 12
  • Julie C. Netherland
    • 7
  • Danielle C. Ompad
    • 13
  • Amit Prasad
    • 14
  • Andrew T. Quinn
    • 7
  • Alexander Rothman
    • 7
  • David E. Satterthwaite
    • 15
  • Sally Stansfield
    • 16
  • Vanessa J. Watson
    • 17
  1. 1.University of California, San Francisco School of NursingSan FranciscoUSA
  2. 2.Urban Health Resource CenterNew DelhiIndia
  3. 3.Rockefeller FoundationNew YorkUSA
  4. 4.Federal University, Minas GeraisBelo HorizonteBrazil
  5. 5.Pan American Health OrganizationWashingtonUSA
  6. 6.African Population and Health Research CenterNairobiKenya
  7. 7.New York Academy of MedicineNew YorkUSA
  8. 8.Australian National UniversityCanberraAustralia
  9. 9.London South Bank UniversityLondonEngland
  10. 10.UN-HABITATNairobiKenya
  11. 11.Bleao Informática em SalúdeSão PauloBrazil
  12. 12.Population CouncilNew YorkUSA
  13. 13.New York UniversityNew YorkUSA
  14. 14.World Health Organization, Center for Human DevelopmentKobeJapan
  15. 15.International Institute for Environment and DevelopmentLondonEngland
  16. 16.Health Metrics Network World Health OrganizationGenevaSwitzerland
  17. 17.African Center for Cities, University of CapetownCapetownSouth Africa

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