The three paradigms on urban health

Abstract

Abstract Background While public health and urban planning share a historical connection in the mid-19th century, when public health and sanitation became a key guiding principle for urban planning, the two disciplines evolved in separate ways after major technological and social developments such as the development of germ theory and the ascent of biomedicine. Recently, urban planners and public health experts globally are calling for a reconnection between the health and urban planning spheres. However, there are different schools of thought around how to address health in the urban context that originates from different worldviews and epistemological traditions of the disciplines. Methods This study is a narrative review that explores the core beliefs and assumptions of the different research traditions that are observed around health in the urban context. Results The study identifies three main traditions. The 'urban health science' tradition is characterized by the pathogenic and epidemiological analysis of urban problems, suggesting predominantly technological solutions to these issues. Scholars of this tradition emphasize that urban health requires straight Cartesian causal thinking to inform interventions to promote the health of urban populations. The 'healthy cities movement' tradition is based on the principles of the Ottawa Charter for Health Promotion with strong roots in social movements, and takes a value-based approach to solutions that embraces the principles of solidarity, equity, sustainability and empowerment. While these two traditions originate from the discipline of public health, the third 'healthy urban planning' tradition emerged from the urban planning discipline and proposes to include health as objectives in the spatial development of cities. Conclusions This study identifies the core beliefs and assumptions of the paradigms of urban health and highlights areas where beliefs and assumptions epistemologically or practically overlap and interface. Key messages Scholars from different epistemological traditions possess different worldview on the problem definition and solution to urban health. The three paradigms on urban health are not mutually exclusive, rather each could learn from each other to promote the health of urban citizens.