Health Promotion International Advance Access published online on April 7, 2006
Health Promotion International, doi:10.1093/heapro/dal006
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1 Quebec WHO Collaborating Center on the Development of Healthy Cities and Towns, Faculty of Nursing and Groupe de recherche et d'intervention en promotion de la santé (GRIPSUL), Université Laval, Québec, Canada G1K 7P4
* To whom correspondence should be addressed. SUMMARY Ever since their beginning in 1986, Healthy Cities projects all over the world have been confronted with the issue of evaluation. However, after 20 years, many key dilemmas constantly reappear, people often looking for a kind of ‘magic’ list of universally applicable indicators to evaluate these initiatives. In this article we address five questions, allowing to illustrate the evaluative dilemmas the Healthy Communities movement is confronted with: Why evaluate Healthy Cities? What should be evaluated? Evaluate for who? Who should undertake the evaluation? How should the evaluation be performed? We conclude by formulating three recommendations in order to stimulate exchanges and debate. Our argument is based on a recent thorough analysis of the evaluative literature pertaining to the Healthy Cities movement, as well as on two decades of reflection on and involvement with this issue locally, nationally and internationally. *A preliminary version of this article was presented at the workshop Community level indicators: building community capacity for health in Jasper, Canada, October 2002. Thanks to the organizers who provided the resources for a translation from French of that paper. Thanks as well for the comments of two anonymous reviewers that were very useful in the revision of this manuscript.
Article
Choosing indicators to evaluate Healthy Cities projects: a political task?*,
MICHEL O'NEILL 1 *
and
PAULE SIMARD 2
2 Quebec WHO Collaborating Center on the Development of Healthy Cities and Towns, Direction de la santé publique de l'Agence régionale de la santé et des services sociaux de l'Abitibi-Témiscamingue and Institut national de santé publique du Québec, Québec, Canada
MICHEL O'NEILL, E-mail: Michel.Oneill{at}fsi.ulaval.ca
Abstract 
A few semantic precisions. Internationally, the tendency is to talk about the Healthy Cities movement, whereas in Latin-America the expression Municipios saludables (Healthy Municipalities) is utilized. In many countries as in Canada for instance, as most communities are much smaller than cities, the choice has been made to talk about the Healthy Communities movement. In the Pacific Island countries, it is the expression Healthy Islands which has been retained due to the settlement patterns there. Finally, the original WHO Healthy Cities project was clearly aimed at local municipal authorities, whereas in many places in the world the movement does not systematically involve municipal governments. In this article, we will thus use the expression Healthy Cities to cover these different realities and the word local rather than municipal to reflect the frequent reality of HCP implementation without City Hall.
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