title: Roundtable on Urban Living Environment Research (RULER).
abstract: For 18 months in 2009-2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO's Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health-namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.
authors: School of Nursing, University of California-San Francisco San Francisco, CA, USA, david.vlahov@nursing.ucsf.edu
authors: David
authors: D
authors: Vlahov
authors: Siddharth Raj
authors: SR
authors: Agarwal
authors: Robert M
authors: RM
authors: Buckley
authors: Waleska Teixeira
authors: WT
authors: Caiaffa
authors: Carlos F
authors: CF
authors: Corvalan
authors: Alex Chika
authors: AC
authors: Ezeh
authors: Ruth
authors: R
authors: Finkelstein
authors: Sharon
authors: S
authors: Friel
authors: Trudy
authors: T
authors: Harpham
authors: Maharufa
authors: M
authors: Hossain
authors: Beatriz
authors: B
authors: de Faria Leao
authors: Gora
authors: G
authors: Mboup
authors: Mark R
authors: MR
authors: Montgomery
authors: Julie C
authors: JC
authors: Netherland
authors: Danielle C
authors: DC
authors: Ompad
authors: Amit
authors: A
authors: Prasad
authors: Andrew T
authors: AT
authors: Quinn
authors: Alexander
authors: A
authors: Rothman
authors: David E
authors: DE
authors: Satterthwaite
authors: Sally
authors: S
authors: Stansfield
authors: Vanessa J
authors: VJ
authors: Watson
mesh_terms: D019049:Developed Countries; D003906:Developing Countries; D006126:Group Processes; D054624:Health Status Disparities; D006801:Humans; D011159:Population Surveillance / Q000379:methods*; D012106:Research; D014504:Urban Health; D014505:Urban Population