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Do Healthy Cities Work? A Logic of Method for Assessing Impact and Outcome of Healthy Cities

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Abstract

In this article, we discuss an appropriate methodology for assessing complex urban programs such as the WHO European Healthy Cities Network. The basic tenets and parameters for this project are reviewed, and situated in the broader urban health tradition. This leads to a delineation of the types of questions researchers can address when looking at a complex urban health program. Such questions reach appropriately beyond traditional public health concepts involving proximal and distal determinants of health (and associated upstream, midstream, and downstream rhetoric). Espousing a multi-level, reciprocal pathways perspective on Healthy Cities research, we also adopt a distinction between impacts and outcomes of Healthy Cities. The former are value-driven, the latter intervention-driven. These approaches lead to the acknowledgment of a logic of method that includes situational and contextual appreciation of unique Healthy City experiences in a Realist Evaluation paradigm. The article concludes with a reflection of evaluation and assessment procedures applied to Phase IV (2003-2008) of the WHO European Healthy Cities Network and an interpretation of response rates to the range of methods that have been adopted.

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Notes

  1. In some official WHO documentation, a total of 79 cities participating in Phase Four is mentioned. Two cities withdrew from the project early. Research instruments were thus sent out to a total of 77 cities.

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  1. Community Health Systems and Policy, Deakin University, Victoria, Australia

    Evelyne de Leeuw

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  1. Evelyne de Leeuw
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Correspondence to Evelyne de Leeuw.

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de Leeuw, E. Do Healthy Cities Work? A Logic of Method for Assessing Impact and Outcome of Healthy Cities. J Urban Health 89, 217–231 (2012). https://doi.org/10.1007/s11524-011-9617-y

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