Moving Towards Health Equity via Social Urbanism in Medellín, Colombia

A current challenge for researchers and practitioners concerned about health inequities is how to intervene upon place to improve population health and reduce health inequities across ethnicity, class, and gender. This paper will critically analyze two slum upgrading interventions in Medellín, Colombia that employed health equity strategies to reduce violence and increase community social capital. The study employed case study theory generation methodology in order to answer the questions: 1) How did the city of Medellín integrate health equity strategies in its planning processes after the passage of the 1991 Constitution? What were the successes and the challenges?; 2) What population level indicators associated with better health and wellness did these place-based, health equity strategies improve?; and 3) Based on this case study, what processes of politics and government should future urban planning and public health professionals integrate into their place-based, health equity interventions? Results show that there were significant decreases in homicides and increases in social capital. Furthermore, there were increases in life expectancy, as well as reductions in poverty and income inequality. The paper concludes that Medellín is achieving the goal of building a healthy city by recognizing that place-based, health equity interventions must mitigate factors in the interactions occurring between people and place and especially the processes of politics and government that affect health outcomes across the life course. The city’s social urbanism policies are a promising best practice for urban planning and public health professionals seeking to conduct successful place-based, health equity interventions in urban settings.