1980). Swift’s (1992) proposal cited by Culley and Hughey (2008:99), to move beyond a conventional understanding of power as power over, toward - a more synergistic and relational perspective of power – power with- , seems particularly relevant to the theme of this paper .
It can be difficult to distinguish truly influential and effective governance arrangements and practices from superficial changes that have little effect on underlying power relations, and to recognize that there are cases that merely present a more participatory gloss without really increasing the capacity to addressing or ameliorating the social determinants of health (see Annex Box 1-4). Research on health inequities needs to both draw on and contribute to this analysis.
As mentioned earlier, this paper focuses on governance, health equity and power and is based upon a review of the literature15. A total of 1600 abstracts were identified. Two authors independently extracted the most relevant papers for review. The meetings facilitated by GRNUHE provided an important opportunity to discuss and to complement/triangulate information among participants and authors. Due to limitations in time, space, and capacity, this paper presents preliminary findings16 of the literature review.
The paper first refers to the historical knowledge about the role of urban governance in addressing health inequities. It continues exploring governance concepts, innovations and trends; and then goes on to examine a number of issues that were identified in the literature as requiring further discussion. The next section underlines the embedded, dynamic and changing nature of governance. Concrete examples illustrate impact, constraints, challenges and possibilities. Finally, a summary is given of knowledge gaps and of research questions to be addressed.
Historical knowledge: The role of urban governance in addressing health inequalities
15 Search strategy and terms: 1: Urban governance/participatory governance/democratic governance/ urban politics - health (in) equit*/ (dis)parit*/(in)equalit*); 2. Urban governance/participatory governance/democratic governance/urban politics - social inclusion/ social exclusion, social justice, spatial justice, empowerment, healthy environment, public policy, intersectoral action, intersectoral planning, health impact assessment, power, decentralization, participation, partnerships.
16 Intersectoral action in particular whole-of-government approaches, governance, power and health equity will be discussed in a separate paper.