Abstract
The importance of urban health in achieving global and planetary health goals is increasingly recognized. Cities offer important opportunities to improve health while also presenting significant challenges. As our understanding of and evidence for the importance of determinants of health beyond health care have grown, the need for urban health policies and actions that transcend disciplinary and sectoral boundaries and involve multiple stakeholders in urban decision-making has become clearer. Current urban health practice builds on decades of conceptual and operational work. This paper traces the evolution of the urban health paradigm through research, policy and practice in recent decades. We suggest that, despite the proven utility of urban health as a paradigm and its conceptual and practical evolution for effective urban health governance, significant challenges remain, especially related to implementing the systems approaches needed to improve health amidst the complexity of urban dynamics.