From projects to policy: 'Healthy Cities' as a mechanism for policy change for health?

One of the aims of the European Healthy Cities project was to contribute to the development of healthy public policy. This paper examines the evidence from ten cities in the Netherlands and the United Kingdom which are either part of the World Health Organization (WHO) Healthy City Project or part of their respective National Networks Five key issues are identified based on current thinking in political and administrative science concerning change and policy-making. These provide a framework for the analysis of key informant interviews undertaken in the ten case studies. It was concluded that, at the time of the research, a substantive policy change had not taken place and in most cases the Healthy city initiatives were still projects rather than policies and, where plans or strategies had been developed, they were still insufficient in their impact in raising health as opposed to health care up the policy agenda.