Systems Approaches to Urban Health

This chapter reviews ways the concepts and tools of systems approaches can help understand how city environments affect health and identify the most effective policies. The authors discuss basic conceptual elements of systems thinking, review core systems modeling methods, and provide examples of their applications in urban health. They conclude with a discussion of the challenges involved in using these approaches.

Managing and Integrating Diverse Sources of Urban Data

This chapter serves to highlight strategies and challenges in bringing together multiple types of geographically referenced data for urban health research, such as linkage of electronic health records to area-based characteristics. The discussion highlights practical considerations that arise in data management, as well as strategies safeguard confidentiality.

What Is Urban Health?

This chapter discusses why urban health is an important public health priority and presents themes and approaches that are especially relevant to the field. It reviews key geographical concepts in urban health including definitions of urban areas, cities, and neighborhoods. It outlines key elements that are needed to understand and improve health in urban areas.

Concluding Remarks

We set out in this text to articulate a range of foundational concepts, research tools and engagement strategies relevant to urban health, all with the intent to provide both knowledge and skills to have an impact on population health in cities across the globe. We hope the four inter-related parts of the book have helped to introduce such a toolkit and enticed you to ponder other questions along the way. To summarize our thinking on this, one might now say that for urban health training, we would expect emerging professionals be ready to:...

Dissemination of Urban Health Research to Maximize Impact

As mentioned earlier in Part IV, research alone does not lead to change. Those committed to improving urban public health have a responsibility to translate and disseminate what they learn about urban health with those who make decisions about urban health, and with the input of those who are most impacted by those decisions. The authors start with chapter with a discussion of why dissemination is critical to urban health, how to plan for dissemination as research is initiated, and how to define and categorize urban health audiences. They then focus on two primary audiences for dissemination: policymakers/decision makers and community residents/leaders. They also discuss best practices for effective dissemination and the importance of measuring the impact of dissemination on urban health and action.

Analysis Strategies for Relating the Urban Environment to Health

The goal of this chapter is to provide an introduction and overview of the array of quantitative analytic methods that may be useful in descriptive, etiologic, and evaluation research in urban health. This chapter focuses on analytical issues commonly encountered in urban health, such as options to account for multilevel and spatial structure of the data, transformations of urban environment variables to address issues of nonlinearity or collinearity, and a range of design and analytic strategies to address confounding.

Human Perceptions and Reflections on the Urban Context

To highlight quantitative and qualitative approaches to better understand perceptions and reflections of urban residents relevant to the links between environmental features discussed in Chapter 5 geographically referenced health outcomes discussed in Chapter 7. Strategies to capture what residents perceive, feel, and recommend regarding their environments include characterization of lived experiences (via surveys, focus groups, in depth interviews) as well as detailed assessments of taking place within urban contexts (via ecological momentary assessment, photovoice, ethnography). Participatory approaches that engage community members are illustrated with examples from Bogotá, Madrid, and Philadelphia.

Assessment of the Urban Environment

This chapter discusses the assessment of urban environment characteristics that may positively or negatively affect human health. The chapter starts with an orientation to why, at what geographic level, and for what domains the urban environment is measured. The authors then turn to identification of existing data from governmental sources, open data, and proprietary sources, recognizing that many interests in measuring the urban environment can be met efficiently with careful use of existing secondary data. Anticipating those instances in which more customized data are needed to capture urban environmental variation, the authors next discuss selected primary data collection methods using observation of what is on the ground, in the air, and visible to urban residents as they move through their daily lives.

Partnerships and Collaboration

As Part IV of this book begins, the authors review the sectors and stakeholders in cities who put public health research into action and use public health science in their day-to-day activities to improve urban health. They identify the myriad of actors in urban health—from traditional public health departments and nongovernment organizations to sectors that are seemingly only tangentially engaged but whose work impacts the health of city residents every day, such as economic development and public safety. Finally, they discuss and provide examples of multi-sectoral partnerships and collaborations that can lead to positive change in urban health.

Urban Health Inequities

This chapter introduces the concept of urban health inequities and reviews approaches to describing the magnitude of inequities. It highlights some of the dynamic processes that contribute to health inequities in urban areas with a special focus on place-based factors. It concludes with a review of some approaches to reducing health inequities in cities.