Characterising policy solutions for city specific health needs
File(s)
Author(s)
Danielli, Shaun
Type
Thesis
Abstract
Global health will increasingly be determined by cities. Currently over half the world’s
population, over 4 billion people, live in cities and this is projected to grow to over two thirds
of the world’s population by 2050. This thesis examines how cities can and have improved
health and healthcare, aiming to address research gaps and provide practical insights for city
health officials and mayors to drive real world change. The thesis begins with background
information on the author’s research journey and the relationship between cities and health,
explaining the motivation behind the thesis. Chapter 2 presents a systematic scoping review of
health-related evidence accumulated over 130 years. This review includes 1,614 original
citations from 227 cities, categorizing and indexing initiatives for the first time and identifying
knowledge gaps that guide the following chapters. Chapter 3 builds on this with a systematic
review of initiatives to combat obesity, proposing a composite model. Chapter 4 continues the
focus on obesity with a cross-sectional survey of nearly 200 urban health and physical activity
professionals. Chapter 5 presents another cross-sectional survey of health priorities from eleven
diverse cities across five continents. Chapter 6 examines health and healthcare reviews and
strategies in London over 200 years. Chapters 7 and 8 examine the role of mayors, focused on
London’s Mayor, firstly using a constructivist grounded theory to develop a framework to
understand their influence on health and healthcare. The framework is then used to examine
the impact of each of the three London Mayors impact. The thesis concludes by discussing the
implications of these findings and exploring future research opportunities.
population, over 4 billion people, live in cities and this is projected to grow to over two thirds
of the world’s population by 2050. This thesis examines how cities can and have improved
health and healthcare, aiming to address research gaps and provide practical insights for city
health officials and mayors to drive real world change. The thesis begins with background
information on the author’s research journey and the relationship between cities and health,
explaining the motivation behind the thesis. Chapter 2 presents a systematic scoping review of
health-related evidence accumulated over 130 years. This review includes 1,614 original
citations from 227 cities, categorizing and indexing initiatives for the first time and identifying
knowledge gaps that guide the following chapters. Chapter 3 builds on this with a systematic
review of initiatives to combat obesity, proposing a composite model. Chapter 4 continues the
focus on obesity with a cross-sectional survey of nearly 200 urban health and physical activity
professionals. Chapter 5 presents another cross-sectional survey of health priorities from eleven
diverse cities across five continents. Chapter 6 examines health and healthcare reviews and
strategies in London over 200 years. Chapters 7 and 8 examine the role of mayors, focused on
London’s Mayor, firstly using a constructivist grounded theory to develop a framework to
understand their influence on health and healthcare. The framework is then used to examine
the impact of each of the three London Mayors impact. The thesis concludes by discussing the
implications of these findings and exploring future research opportunities.
Version
Open Access
Date Issued
2024-12-19
Date Awarded
2025-06-01
Copyright Statement
Attribution-NonCommercial 4.0 International Licence (CC BY-NC)
License URL
Advisor
Ashrafian, Hutan
Darzi, Ara
Publisher Department
Department of Surgery & Cancer
Publisher Institution
Imperial College London
Qualification Level
Doctoral
Qualification Name
Doctor of Philosophy (PhD)