Exploring the roles of urban municipal governments in addressing population health disparities: A census of opinions of politicians and senior-level staff

The 1986 Ottawa Charter for Health Promotion stimulated an outpouring of literature on health disparities. Yet, despite the profusion of empirical evidence, establishment of a substantial knowledge base, and development of insightful policy recommendations, academic activity has inadequately translated into policy action to alleviate health disparities in Canada. Many challenges to knowledge translation have been articulated but the roles of urban municipalities in addressing health disparities remain unclear. Urban municipalities are important partners in this struggle because of consistent urban population growth across Canada, the characteristic of cities as socio-spatial sorting mechanisms, and the importance of urban planning in creating viable spaces for geographically concentrated populations.

Metro Vancouver is an urban region in Canada consisting of 21 independently governed municipalities. Reported here are the results of a mail-administered survey to politicians and senior-level staff (N=651) of the 17 Metro Vancouver municipalities with populations of 10,000 or more. The objective of the survey was to conduct a census of these influential government actors regarding their knowledge of the determinants of population health, and their views concerning the roles, responsibilities, and constraints on municipal governments in reducing local health disparities. Survey respondents were also asked to indicate which determinants of health municipalities are best and worst positioned to address, to indicate the level of responsibility of municipal governments relative to other levels of government and sectors of society, and to identify any existing municipal policies or programs that address health disparities.