Taking a strategic approach to urban health: a guide for decision-makers

Abstract

Governments face complex health challenges shaped by the evolving interactions of people and institutions with urban environments; these are compounded as cities expand and urban populations grow. This WHO guide provides a structured framework for addressing such challenges strategically, avoiding the limitations and undesired consequences of fragmented, short-term initiatives. The report reviews what urban health entails, why it matters, and how to make progress through integrated, long-term action. It outlines the case for prioritising urban health from epidemiological, economic, equity and sustainability perspectives, and shows how decisions in diverse sectors — from climate adaptation to digital transformation — affect well-being in cities. The guide centres on the idea that urban health is a shared responsibility and a strategic societal goal that requires coordination across government and with communities, civil society and the private sector. It proposes practical approaches to recognising complexity, leveraging political and policy entry points, and strengthening means of implementation through governance, financing, capacity-building, data systems, evidence-based decision-support, innovation, partnerships and participation. Drawing on contributions from experts and case examples from cities worldwide, the guide positions urban health as essential to sustainable development, equity and resilience.