Research into public health has now demonstrated that a person’s wellbeing and health is largely determined by the conditions in which they are born, grow, live, work and age.  This is as true for people living in both the developed world as well as those in developing countries.  See for example the 2003 WHO publication The Solid facts: Social Determinants of Health 

    In 2008, WHO published Closing the gap in a generation: health equity through action on the social determinants of health.

    This was followed in 2010 by England’s own Strategic Review of Health Inequalities in England Post 2010 (the Marmot Review). 

    These reports clearly show that many differences in people’s wellbeing and health are the result of unequal access to money, power and resources.  These differences – or inequalities – are avoidable, unjust and unfair.

    So if we are going to reduce health inequalities, we need to address the social determinants of health – income inequality and other life circumstances that result in low access to money, power and resources.

    In this context, the WHO overarching theme of Phase V is “Health and health equity in all policies”.  It means that we have to make sure that all policies and strategies we develop – from economic development to housing to transport to community development – are structured in such a way that they enhance health and reduce the social injustice that impacts on health outcomes.

     The overarching theme is underpinned by three core themes:

    • Caring and supportive environments: a healthy city should be above all a city for all its citizens, inclusive, supportive, sensitive and responsive to their diverse needs and expectations
    • Healthy living: a healthy city provides conditions and opportunities that support healthy lifestyles
    • Healthy urban development and design: a healthy city offers a physical and built environment that supports health, recreation and wellbeing, safety, social interaction, easy mobility, a sense of pride and cultural identity and that is accessible to the needs of all its citizens


    The WHO provides a list of important issues associated with each of the core themes.