Healthy cities as catalysts for caring and supportive environments.

Area of Science:

• Public Health
• Urban Planning
• Social Determinants of Health

Background:

• Caring and Supportive Environments are central to the social model of health.
• This theme was a core focus of the World Health Organization (WHO) European Healthy Cities Network's Phase V (2009-2013).

Purpose of the Study:

• To synthesize qualitative evidence on creating supportive urban environments.
• To develop a schematic model illustrating the interaction of key factors within this theme.
• To test hypotheses regarding local governance, social inclusion, urban planning, and health equity.

Main Methods:

• Utilized realist evaluation methodology.
• Synthesized qualitative data from 112 case studies across 68 cities.
• Analyzed 71 responses to a General Evaluation Questionnaire on city attributes and trends.

Main Results:

• Revealed numerous innovative practices in creating supportive environments.
• Demonstrated partnerships between health/social services and agencies influencing wider determinants of health.
• Highlighted the use of social assets and health literacy campaigns, even during economic austerity.

Conclusions:

• Realist evaluation effectively illuminates pathways from interventions to health outcomes.
• Identified prerequisites and processes for initiating and sustaining investments in supportive urban environments.
• Confirmed that investments in health services, active citizenship, and health literacy enhance social inclusion and health equity.