Abstract

There is increasing awareness of the critical role that urban environments play in determining the health and wellbeing of urban populations. Access to transport systems, decent and affordable housing, public open spaces, employment, shops and services, are some of the elements that impact on the health of communities, depending on how they are physically designed and located. As such, many policy sectors outside of health can contribute to the development of ‘healthy urban environments’, following a ‘Health in all policies’ approach. This research investigates how health, equity and the social determinants of health (SDH) are considered in strategic urban and transport policies in Santiago, the capital of Chile. Content analysis was utilised to analyse three national and metropolitan policies, identifying the explicit inclusion of health considerations in the documents, as well as the implicit support for key SDH in urban environments. The formal contribution of the health sector in the development of the policies was also assessed. It was found that health is not a strong explicit focus of land-use policies and that the health sector is not acknowledged as a participant in their development. Equity is addressed in the policies, but the understanding of this concept varies greatly across policies. Some key SDH are, to some extent, implicitly addressed in the policies, but important areas of action are either omitted or framed only as general policy goals. Santiago’s urban and transport policies could maximize their support for health and equity in the city by aiming to promote these outcomes more explicitly, and by incorporating specific actions and strategies to address the SDH. Such content should be informed by the knowledge and experience of the health sector in promoting health and wellbeing in the country.