There is increasing recognition of the importance of the physical environment of cities for the health and wellbeing of residents. Along with the social and institutional aspects of cities, the physical urban environment can play a significant role in influencing health-related behaviours and outcomes. In some ways, it may seem easier to address the physical urban environment than the social one, but without any associated upstream or downstream support or engagement, such changes do not always have the expected outcomes.

The most commonly used concepts and tools for understanding the relationships between physical urban environments and health and wellbeing are largely based on empirical work undertaken in the global North, as, indeed, are the concepts of ‘health’ and ‘urban’ that underpin this body of knowledge. On the one hand, some of the existing guidelines on how to create healthy urban environments (see, for example, Barton and Tsourou 2000) are of limited use in cities such as Cape Town, South Africa, where contextual realities are very different from those in the global North, and many of the assumptions underpinning the dominant body of knowledge do not necessarily apply. On the other hand, some guidelines cannot easily be labelled as Northern, particularly where they have been adopted to address issues of global development, such as the Millennium Development Goals. For example, urban violence is a problem in the cities of the North as well as the South.

Nonetheless, different assumptions distinguish Northern and Southern planning approaches. This is largely because modern urban planning, as a discipline and practice, originated in the global North in response to earlier waves of rapid urbanization. Thereafter, these approaches were transplanted to the global South primarily to control the development of emerging colonial towns, but were still based on assumptions that shaped their emergence in their areas of origin; namely, that planning would be implemented in contexts characterized by: strong economies and public institutions, relatively high levels of employment and income, manageable populations amenable to spatial control, as well as reasonably good levels of infrastructural development. In most of the global South few of these assumptions hold, yet Northern concepts and positions on urban planning continue to dominate.