UK cities face a number of diverse issues affecting their future, with high levels of health inequality requiring local action to improve communities. In this article, Mark Tewdwr-Jones from Newcastle University outlines the case for utilising the skills of universities to overcome institutional fragmentation.[Image omitted: See PDF.]Cities in the United Kingdom and overseas are struggling to manage the diverse issues affecting their future. Changing demographics, economic uncertainty, climate change and threats of terrorism are all putting pressure on governments to deal with more immediate concerns, set against a backdrop of political upheaval, and changing governance frames. The challenge of addressing any of these is made particularly acute by a fragmented and volatile institutional restructuring process. This often militates against the need for a synoptic and long-term look at the drivers of change unique to individual places.[1] Increasing appetite for enhanced democracy raises pressures for innovative ways for the state to engage with citizens and businesses. It is often difficult to require institutions and professionals to move beyond their current form of engagement.[2] Public health is not immune from this turmoil.National, regional and local action to combat health inequalities is widely accepted as critical to creating improved communities. The Marmot Review[3] claimed a strong social justice and compelling economic case for reducing health inequalities. It is estimated that health inequalities cost over £30bn a year in lost productivity, welfare and health costs, leading Government to call for local areas to work together to address population health needs.[4],[5]There is a case for communities in our cities to benefit from more joined up (cross-boundary) planning and investment in health and social care.[6] Cross-sectoral benefits are contextualised by the extent to which local areas are able to make the most of healthcare procurement and employment policies and whether new institutions and agencies (such as devolved Combined Authorities, Local Enterprise Partnerships, and Health and Wellbeing Boards) can work effectively together across traditional boundaries, especially when many of the critical joining-up agencies are under pressure.This article reflects on the critical relationship between health, cities and planning, and makes the case for utilising the skills and anchoring role of universities in each city to overcome institutional fragmentation. Fiscal restraint has narrowed the debate to one of achieving healthcare in cities through innovative joint working with agencies beyond the National Health Service (NHS). This article seeks to rebalance the discourse through consideration of several interrelated issues:What opportunities for holistic action are delivered by the shift in managerial responsibilities for public health within cities?What is the role of health care in addressing wider societal and urban problems?What is the impact of the shifting governance of cities within which healthcare systems play an integral part?The new governance and new economic landscape for our largest cities requires more reliable forms of health intelligence, research evidence, and public engagement processes addressing the needs of different cities as unique places. It is not easy to coordinate intelligence needs and the potential of joint working across sectors. The critical question is whether universities - as one set of institutions rooted in distinct places - could play a central role by developing collaborative working models between sectors.The Interface Between Health, Cities and PlanningInteraction and linkages between health and cities are the basis for identifying the potential role of spatial coordination in supporting health and social care outcomes. Good health involves a combination of physical, mental and social wellbeing,[7] commonly referred to as the Health Triangle. …