Planning for Healthy Cities

  • Marcus GrantEmail author


Humanity has chosen the urban environment as its habitat of preference, with a growing global population in towns and cities. Worryingly, having to a large extent understood how to design-out communicable disease in urban areas, we seem to lack knowledge about how to build human habitats without risk of non-communicable disease. We don’t deliberately build places to support healthy lifestyles and reduce health inequity. Planners, urban designers, transport practitioners and public health specialists are waking up to this reality. The evidence base is building and there is relevant experience in the European Healthy City Network and other cities. The solution lies in better understanding what elements of urban form support health, why cities develop in ways that undermine health; and then changing the ways we manage, renew and build urban environments. We need to form coalitions for healthier places, using a health lens across planning, transport and all other urban policy areas. Land use pattern, transport, greenspace and urban design are key for manipulation and design to better support urban health and health equity, and this includes planetary health. Spatial scale is important. At a strategic city and city-regional scale growth patterns, sprawl and long-term planning needs to be tackled. At the smaller scale, place-making with communities, in their local neighbourhoods can yield co-benefits across many of the Sustainable Development Goals. Effective action requires strong city leadership for health, broad coalitions for healthy city planning and a stronger link between what is happening in cities and public health research.


  1. Ajuntament de Barcelona. (2013). Barcelona green infrastructure and biodiversity plan 2020. Barcelona, Spain (in Spanish, English Summary). Retrieved from Scholar
  2. Anon 2013. Global thematic consultation on health: Health in the post-2015 agenda. Report of the Global Thematic Consultation on Health. New York: The World We Want.Google Scholar
  3. Arthurson, K., Lawless, A., & Hammet, K. (2016). Urban planning and health: Revitalising the alliance. Urban Policy and Research, 34(1), 4–16.CrossRefGoogle Scholar
  4. Barton, H. (2009). Land use planning and health and well-being. Land Use Policy, 26, S115–S123.CrossRefGoogle Scholar
  5. Barton, H., & Grant, M. (2006). A health map for the local human habitat. The Journal for the Royal Society for the Promotion of Health, 126(6), 252–253. ISSN 1466-4240 developed from the model by Dahlgren and Whitehead, 1991.Google Scholar
  6. Barton, H., & Grant, M. (2008). Testing time for sustainability and health: Striving for inclusive rationality in project appraisal. The Journal of the Royal Society for the Promotion of Health, 128(3), 130–139.CrossRefGoogle Scholar
  7. Barton, H., & Tsourou, C. (2000). Healthy urban planning. Copenhagen/London: World Health Organisation/SPON.Google Scholar
  8. Barton, H., Tsourou, C., & Mitcham, C. (2003). Healthy urban planning in practice: Experience of European cities. Copenhagen: WHO Regional Office for Europe.Google Scholar
  9. Barton, H., Grant, M., & Guise, R. (2010). Shaping neighbourhoods: For local health and global sustainability. Oxford: Routledge.Google Scholar
  10. Belfast Healthy Cities. (2014). Belfast: A WHO Healthy City through 25 years . . . Belfast: Belfast Healthy Cities.Google Scholar
  11. BHC. (2016). Taking action for child friendly places: First steps – strategic approach and action plan for Belfast. Belfast: Belfast Healthy Cities. Retrieved June 20, 2017, from Scholar
  12. Bowman, S., Gortmaker, S., Ebbeling, C., Pereira, M., & Ludwig, D. (2004). Effects of fast-food consumption on energy intake and diet quality among children in a national household survey. Journal of the American Academy of Pediatrics, 113, 112–118.Google Scholar
  13. Brown, C., & Grant, M. (2005). Biodiversity and human health: What role for nature in healthy urban planning. Built Environment, 31, 326–338. Scholar
  14. Burns, H. (2014). What causes health? Journal of the Royal College of Physicians Edinburgh, 44, 103–105.CrossRefGoogle Scholar
  15. Buse, K., Tanaka, S., & Hawkes, S. (2017). Healthy people and healthy profits? Elaborating a conceptual framework for governing the commercial determinants of non-communicable. Globalization and Health. Scholar
  16. Coutts, C., & Hahn, M. (2015). Green infrastructure, Ecosystem services, and human health. International Journal of Environmental Research and Public Health, 12(8), 9768–9798. Scholar
  17. Croucher, K., Policy, H., & Beck, S. (2007). Health and the physical characteristics of urban neighbourhoods: A critical literature review final report. Glasgow: Glasgow Centre for Population Health.Google Scholar
  18. CSDH. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health. Final report of the Commission on Social Determinants of Health. Geneva: World Health Organization.Google Scholar
  19. Dahlgren, G., & Whitehead, M. (1991). “The main determinants of health” model, version accessible. In G. Dahlgren & M. Whitehead (Eds.), (2007). European strategies for tackling social inequities in health: Levelling up Part 2. Copenhagen: WHO Regional Office for Europe.
  20. Dahlgren, G., & Whitehead, M. (2007). European strategies for tackling social inequities in health: Levelling up Part 2. Copenhagen: WHO Regional Office for Europe.Google Scholar
  21. EC. (2008). Progress towards achieving the Kyoto objectives, Communication from the Commission. Brussels, 19.11.2008, Com(2008) 651 Final/2, Commission of the European Communities.Google Scholar
  22. EEA. (2009a). About the urban environment, European Environment Agency website. Retrieved June 7, 2009, from
  23. EEA. (2009b). Ensuring quality of life in Europe's cities and towns. EEA Report No. 5/2009. Luxembourg: Office for Official Publications of the European Communities.Google Scholar
  24. Ellaway, A., Macintyre, S., & Bonnefoy, X. (2005). Graffiti, greenery, and obesity in adults: Secondary analysis of European cross sectional survey. British Medical Journal, 331, 611–612.CrossRefGoogle Scholar
  25. Ewing, R., & Cervero, R. (2010). Travel and the built environment: A meta-analysis. Journal of the American Planning Association, 76(3), 265–294.CrossRefGoogle Scholar
  26. Feng, J., Glass, T. A., Curriero, F. C., Stewart, W. F., & Schwartz, B. S. (2010). The built environment and obesity: A systematic review of the epidemiologic evidence. Health & Place, 16(2), 175–190.CrossRefGoogle Scholar
  27. Frank, L., Kavage, S., & Devlin, A. (2012). Health and the built environment: A review. The Canadian Medical Association: Quebec.Google Scholar
  28. Garfinkel-Castro, A., Kim, K., Hamidi, S., & Ewing, R. (2017). Obesity and the built environment at different urban scales: Examining the literature. Nutrition Reviews, 75(Suppl. 1), 51–61. Scholar
  29. Gartland, L. M. (2012). Heat islands: Understanding and mitigating heat in urban areas. Oxford: Routledge.CrossRefGoogle Scholar
  30. GCPH. (2011). Asset based approaches for health improvement: Redressing the balance. Glasgow Centre for Population Health. Retrieved from
  31. GCPH. (2012). Putting asset based approaches into practice: Identification, mobilisation and measurement of assets. Glasgow Centre for Population Health Retrieved from
  32. Graham, H., & White, P. C. L. (2016). Social determinants and lifestyles: Integrating environmental and public health perspectives. Public Health, 141, 270–278.CrossRefGoogle Scholar
  33. Grant, M. (2015). European Healthy City Network Phase V: Patterns emerging for healthy urban planning. Health Promotion International, 30(Suppl. 1), i54–i70.CrossRefGoogle Scholar
  34. Grant, M., & Barton, H. (2013). No weighting for healthy sustainable local planning: Evaluation of a participatory appraisal tool for rationality and inclusivity. Journal of Environmental Planning and Management, 56(9), 1267–1289. ISSN 0964-0568.CrossRefGoogle Scholar
  35. Grant, M., & Lease, H. (2014). MOTHER REPORT: WHO EURO Healthy Cities Phase V Evaluation: Healthy urban environment and design. Bristol: University of the West of England.Google Scholar
  36. Grant, M., Coghill, N., Barton, H., & Bird, C. (2009) .Evidence review on environmental health challenges and risks in urban settings. For WHO European Centre for Environment and Health. Technical Report. WHO Collaborating Centre for Healthy Cities and Urban Policy, University of the West of England (UWE), Bristol. Available from Scholar
  37. Hancock, T. (1985). The mandala of health: A model of the human ecosystem. Family & Community Health, 8(3), 1–10.CrossRefGoogle Scholar
  38. Hanlon, P., Carlisle, S., Hannah, M., Reilly, D., & Lyon, A. (2011). Making the case for a “fifth wave” in public Health. Public Health, 125(1), 30–36.CrossRefGoogle Scholar
  39. Harlan, S. L., Brazela, A. J., Prashada, L., Stefanovb, W., & Larsenc, L. (2006). Neighborhood microclimates and vulnerability to heat stress. Social Science & Medicine, 63(11), 2847–2863.CrossRefGoogle Scholar
  40. Healey, P. (1996). The communicative turn in planning theory and its implications for spatial strategy formation. Environment and Planning B: Planning and design, 23(2), 217–234.CrossRefGoogle Scholar
  41. Healey, P. (2003). Collaborative planning in perspective. Planning Theory, 2(2), 101–123.CrossRefGoogle Scholar
  42. Hewitt, S., Grant, M., & Bristol Partnership. (2010). Building health into our plans from the start: Report and review of the health impact assessment workshop on the Knowle West Regeneration Strategy. Bristol: NHS Bristol/Bristol City Council/University of the West of England. Available from Scholar
  43. Hill, P. S., Buse, K., Brolan, C. E., & Ooms, G. (2014). How can health remain central post-2015 in a sustainable development paradigm? Globalization and Health, 10(1), 18.CrossRefGoogle Scholar
  44. Hippocrates. (1849). On air, waters, and places. In The genuine works of Hippocrates. New York: W. Wood. Translated with a commentary by Francis Adams. London: The Sydenham Society.Google Scholar
  45. Jackson, T., & Senker, P. (2011). Prosperity without growth: Economics for a finite planet. Energy & Environment, 22(7), 1013–1016.CrossRefGoogle Scholar
  46. Jones, R., & Yates, G. (2013). The built environment and health: An evidence review. Briefing paper 11. Glasgow Centre for Population Health.Google Scholar
  47. Kelly, M. P., Charlton, B. G., & Hanlon, P. (1993). The four levels of health promotion: An integrated approach. Public Health, 107(5), 319–326.CrossRefGoogle Scholar
  48. Khreis, H., Kelly, C., Tate, J., Parslow, R., Lucas, K., & Nieuwenhuijsen, M. (2017). Exposure to traffic-related air pollution and risk of development of childhood asthma: A systematic review and meta-analysis. Environment International, 100, 1–31.CrossRefGoogle Scholar
  49. Kickbusch, I. (2012). Addressing the interface of the political and commercial determinants of health. Health Promotion International, 27(4), 427–428. Scholar
  50. Kickbusch, I., Allen, L., & Christian, F. (2016). The commercial determinants of health. Lancet, 4(2016), e895–e896. Scholar
  51. Lavin, T., Higgins, C., Metcalfe, O., & Jordan, A. (2006). Health impacts of the built environment: A review. Dublin and Belfast: The Institute of Public Health in Ireland.Google Scholar
  52. LBTH. (2006). Equality impact assessment: Aldgate masterplan supplementary planning document. London Borough of Tower Hamlets. Retrieved August 6, 2017, from
  53. de Leeuw, E. (2017). Cities and health from the neolithic to the anthropocene. In E. de Leeuw & J. Simos (Eds.), Healthy cities: The theory, policy, and practice of value-based urban planning (pp. 3–30). New York: Springer.CrossRefGoogle Scholar
  54. de Leeuw, E., & Simos, J. (Eds.). (2017). Healthy cities: The theory, policy, and practice of value-based urban planning. New York: Springer.Google Scholar
  55. Leppo, K., Ollila, E., Pena, S., Wismar, M., & Cook, S. (2013). Health in all policies-seizing opportunities, implementing policies. Finland: Ministry of Social Affairs and Health.Google Scholar
  56. Maas, J., Verheij, R. A., Groenewegen, P. P., De Vries, S., & Spreeuwenberg, P. (2006). Green space, urbanity, and health: How strong is the relation? Journal of Epidemiology & Community Health, 60(7), 587–592.CrossRefGoogle Scholar
  57. Mayors Forum. (2016). Shanghai consensus on healthy cities 2016. In 9th global conference on health promotion. Retrieved August 6, 2017, from
  58. McCormack, G. R., & Shiell, A. (2011). In search of causality: A systematic review of the relationship between the built environment and physical activity among adults. International Journal of Behavioral Nutrition and Physical Activity, 8(1), 125.CrossRefGoogle Scholar
  59. McLeroy, K. R., Bibeau, D., Steckler, A., & Glanz, K. (1988). An ecological perspective on health promotion programs. Health Education Quarterly, 15, 351–377.CrossRefGoogle Scholar
  60. Mitchell, R., & Popham, F. (2008). Effect of exposure to natural environment on health inequalities: An observational population study. Lancet, 2008(372), 1655–1660.CrossRefGoogle Scholar
  61. Mueller, N., Rojas-Rueda, D., Basagaña, X., Cirach, M., Cole-Hunter, T., Dadvand, P., et al. (2017). Urban and transport planning related exposures and mortality: A health impact assessment for cities. Environmental Health Perspectives, 125, 1–36. Scholar
  62. Muralidharan, K., & Prakash, N. (2017). Cycling to school: Increasing secondary school enrollment for girls in India. American Economic Journal: Applied Economics, 9(3), 321–350.Google Scholar
  63. Nadin, V., & Stead, D. (2008). European spatial planning systems, social models and learning. disP – The Planning Review, 44(172), 35–47.CrossRefGoogle Scholar
  64. Nieuwenhuijsen, M. J., & Khreis, H. (2016). Car free cities: Pathway to healthy urban living. Environment International, 94, 251–262. Scholar
  65. Nieuwenhuijsen, M. J., Khreis, H., Triguero-Mas, M., Gascon, M., & Dadvand, P. (2017). Fifty shades of green. Epidemiology, 28(1), 63–71.CrossRefGoogle Scholar
  66. Oni, T., & Unwin, N. (2015). Chronic non-communicable diseases and infectious diseases. In A. D. G. Aikins and C. Agyemang (Eds.), Chronic non-communicable diseases in low and middle-income countries (pp. 30–49). cabi.Google Scholar
  67. Oni, T., Smit, W., Matzopoulos, R., Adams, J. H., Pentecost, M., Rother, H. A., Albertyn, Z., Behroozi, F., Alaba, O., Kaba, M., & van der Westhuizen, C. (2016). Urban health research in Africa: Themes and priority research questions. Journal of Urban Health, 93(4), 722–730.CrossRefGoogle Scholar
  68. Pawson, R., & Tilley, N. (1997). Realistic evaluation. Sage.Google Scholar
  69. Peden, M. M. (Ed.). (2008). World report on child injury prevention. Copenhagen: World Health Organization.Google Scholar
  70. Pickett, K. E., & Wilkinson, R. G. (2015). Income inequality and health: A causal review. Social Science & Medicine, 128, 316–326.CrossRefGoogle Scholar
  71. Povall, S., Whitehead, M., Gosling, R., & Barr, B. (Eds.). (2007). Focusing the equity lens: Arguments and actions on health inequalities. Liverpool: World Health Organization Collaborating Centre for Policy Research on Social Determinants of Health.Google Scholar
  72. Rao, M., Prasad, S., Adshead, F., & Tissera, H. (2007). The built environment and health. The Lancet, 370(9593), 1111–1113.CrossRefGoogle Scholar
  73. RCEP. (2007). The urban environment, royal commission on environmental pollution. London: The Stationery Office.Google Scholar
  74. Robinson, V. (2004). Fast food and obesity—Is there a connection? Health and Healthcare in Schools, 4, 12.Google Scholar
  75. Rydin, Y., Bleahu, A., Davies, M., Dávila, J. D., Friel, S., De Grandis, G., Groce, N., Hallal, P. C., Hamilton, I., Howden-Chapman, P., & Lai, K. M. (2012). Shaping cities for health: Complexity and the planning of urban environments in the 21st century. Lancet, 379(9831), 2079.CrossRefGoogle Scholar
  76. Saelens, B. E., Sallis, J. F., Black, J. B., & Chen, D. (2003). Neighborhood-based differences in physical activity: An environment scale evaluation. American Journal of Public Health, 93, 1552–1558.CrossRefGoogle Scholar
  77. Sallis, J. F., & Owen, N. (2002). Ecological models of health behavior. In K. Glanz, B. K. Rimer, & F. M. Lewis (Eds.), Health behavior and health education: Theory, research and practice (3rd ed., pp. 462–484). San Francisco, CA: Jossey-Bass.Google Scholar
  78. Scottish Government, NHS Health Scotland, Architecture and Design Scotland. (2015). Place Standard. Retrieved August 14, 2017, from
  79. Scottish Government, NHS Health Scotland, Architecture and Design Scotland. (2017). Place Standard process evaluation: Learning from case studies in year one. Retrieved August 14, 2017, from
  80. Tfl. (2017). Healthy streets for London. The Mayor’s Office: Transport for London Retrieved from
  81. Thompson, C. W., Roe, J., Aspinall, P., Mitchell, R., Clow, A., & Miller, D. (2012). More green space is linked to less stress in deprived communities: Evidence from salivary cortisol patterns. Landscape and Urban Planning, 105(3), 221–229.CrossRefGoogle Scholar
  82. Townshend, T. G. (2017). Toxic high streets. Journal of Urban Design, 22(2), 167–186. Scholar
  83. Tsouros, A. D. (2017). Healthy cities: A political project designed to change how cities understand and deal with health. In E. de Leeuw & J. Simos (Eds.), Healthy cities: The theory, policy, and practice of value-based urban planning(pp. 489–504). New York: Springer.CrossRefGoogle Scholar
  84. Vardoulakis, S., Wilkinson, P., & Dear, K. (Eds.). (2016). Healthy polis: Challenges and opportunities for urban environmental health and sustainability. Environmental Health, 15(Suppl. 1), S30.Google Scholar
  85. Verbruggen, A. (Ed.). (2007). Glossary. In B. Bert Metz, O. Davidson, P. Bosch, R. Dave, & L. Meyer (Eds.), IPCC fourth assessment report. Cambridge: Cambridge University Press.Google Scholar
  86. Walker, G., Fairburn, J., Smith, G., & Gordon, M. (2003). Environmental quality and social deprivation. R&D Technical Report E2-067/1/TR. Bristol: Environment Agency.Google Scholar
  87. Ward Thompson, C., Aspinall, P., Roe, J., Robertson, L., & Miller, D. (2016). Mitigating stress and supporting health in deprived urban communities: The importance of green space and the social environment. International Journal of Environmental Research and Public Health, 13(4), 440.CrossRefGoogle Scholar
  88. WHO. (2002). The World Health Report 2002 – Reducing risks, promoting healthy life. Geneva: World Health Organization.Google Scholar
  89. WHO. (2003). Extreme weather events: Health effects and public health measures. Fact Sheet EURO/04/03, Copenhagen, Rome 29 September 2003. Retrieved June 7, 2009, from
  90. WHO. (2007). Quantifying burden of disease from environmental noise: Second Technical Meeting Report, Bern, Switzerland.Google Scholar
  91. WHO. (2011a). Health in the green economy: health co-benefits of climate change mitigation – Housing sector. Geneva: World Health Organization.Google Scholar
  92. WHO. (2011b). Burden of disease from environmental noise: Quantification of healthy life years lost in Europe. Copenhagen: World Health Organization Regional Office for Europe.Google Scholar
  93. WHO. (2014). Promoting health while mitigating climate change. In Technical briefing for the World Health Organization conference on health and climate discussion draft (pp. 1–33). Retrieved from
  94. WHO. (2016). Health as the pulse of the new urban agenda: United Nations conference on housing and sustainable urban development, Quito, October 2016. Geneva: World Health Organization.Google Scholar
  95. WHO. (2017a). EUR/RC67/9: Roadmap to implement the 2030 Agenda for Sustainable Development, building on Health 2020, the European policy for health and well-being. World Health Organisation.Google Scholar
  96. WHO. (2017b). Urban green space interventions and health: A review of impacts and effectiveness. Full report. World Health Organization Regional Office for Europe. Retrieved from
  97. WHO EURO. (2009). Phase V (2009–2013) of the WHO European Healthy Cities Network: Goals and requirements. Copenhagen: WHO Regional Office for Europe.Google Scholar
  98. WHO EURO. (2016). Urban green spaces and health: A review of the evidence. Copenhagen: WHO Regional Office for Europe.Google Scholar
  99. WHO-UN. (2016). Global report on urban health: Equitable, healthier cities for sustainable development. Geneva: World Health Organization and UN-Habitat.Google Scholar
  100. Yue, W., Liu, Y., & Fan, P. (2013). Measuring urban sprawl and its drivers in large Chinese cities: The case of Hangzhou. Land Use Policy, 31, 358–370.CrossRefGoogle Scholar

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Authors and Affiliations

  1. 1.Environmental Stewardship for HealthBristolUK

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