Interrogating Healthy Community Discourse in Municipal Policies: Priorities of a Medium-Sized CMA in Ontario, Canada

The World Health Organization's Healthy Cities movement recommends action on the determinants of health and health equity. While economic and ecological circumstances have been studied with respect to health outcomes, research shows that the relationship between these broad determinants and population health is not always clear. Municipal governments, whose relative proximity to individuals means that they are optimally situated to address local health concerns, can demonstrate political will for healthy communities by developing health community policies. Therefore, the aim of this study is to interrogate how the idea of a 'healthy community' has been conceptualized by municipal governments in order to inform the future uptake of the concept. This study uses a post-structural policy analysis to examine government discourse on healthy communities in a medium-sized census metropolitan area (CMA) in Ontario, Canada. The findings highlight economic growth and ecological sustainability as priorities for fostering a healthy community. With emphasis on long-standing issues linking health outcomes to broader societal conditions, this study calls on municipal governments to explicitly consider the health impacts of healthy community strategies and adoption of a Health-in-All-Policies (HiAP) approach.