In a recent report, World Health Organization (WHO) Europe summarizes the evidence on the social determinants of health and the built environment, and in particular to the role of local government across countries in the WHO European Region. The paper, entitled ’Addressing the social determinants of health: the urban dimensions and the role of local government, argues that through their leadership,’ argues that local government has a profound role to play in cross-sectoral working with civil society partners to support and accelerate action to address the social determinants of health and the underlying causes of health inequalities. The report builds up on the work of the WHO European Healthy Cities Network.
The report covers priority action areas and identifies key implementation issues of particular relevance to creating healthy and sustainable places and communities.
As local government usually has the primary responsibility for planning and/or delivering many of the services that are crucial to addressing the social determinants of health (such as education, transport, housing and urban planning) its role is a very important one to be taken into account.
The structures underpinning local government, especially decentralization, have the inherent potential to stimulate change by reducing central influence and promoting local autonomy for concerns of a daily life as transport, air pollution, road safety, neighbourhoods and facilities, housing and urban planning, green spaces, crime, urban environment, and climate. This especially applies to population groups disadvantaged by relative poverty, unemployment, low status, gender, sexual orientation, ethnicity or disability.
Local government has a specific role in:
identifying population needs, including collecting information from communities to inform the design of neighbourhoods and the local development of services and facilities;
promoting and supporting communities in participating in co-producing, directing and controlling local services and/or interventions;
developing social capital by enhancing community empowerment;
assessing the effects of urban planning on health and inequalities in health;
giving priority to access to green spaces and community safety in spatial planning;
ensuring that fuel efficiency is a key priority in both new housing developments and refurbishments of older housing stock;
using local regulatory mechanisms to limit the number of retail fast food outlets, especially in deprived areas;
giving priority to evidence-informed preventive strategies;
acting as an exemplary employer and using commissioning and contracting powers to improve working conditions within the local area.
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