City Health Departments

In cities, opportunities exist to influence advances in healthcare, food systems, housing, transport, and the social, physical, and built environments to promote equity, well-being, and health. For cities to accommodate population increases and ameliorate existing conditions, they must seek greater local authority to act and regulate, decentralize power and revenue control from state and national governments, build stronger relationships among governmental sectors and civil society, and build technical and political capacity. This chapter addresses a critical mechanism by which public health as a sector must engage with these changes: local public health governance. It identifies challenges and constraints and offer recommendations for going forward.