Local Government and Health Governance

This chapter examines how local governance can be most effective in promoting health and then reviews developments in first urban and then rural and regional governance in terms of contributions to health equity, well-being, and sustainability. The chapter notes that while local government can be a positive part of the governance for health, it is not always benign. It can be captured by vested interests whose aim is to profit from development in a city, rather than acting in the interests of the public good. The argument is made that local government requires safeguards so that those who have only a profit motive in mind are not able to capture local authorities or exercise undue influence over them. The characteristics of good local governance are described. Examples are provided of urban and rural local governments acting in the interests of health and equity.