THIS PUBLICATION IS issued from a larger project supported by the European Commission to address issues relating to health and human settlements in Latin America. The information here focuses on the main issues concerning the health of urban populations in Latin America, with special sections on Sao Paulo in Brazil, Santiago de Chile and Guatemala City. Although this review is designed, particularly, to allow partners in the larger project to identify and prioritize needs in order to develop research, intervention and training activities, it is also useful for other groups, especially policy makers, planners and funding agencies.

The introduction points to two key themes: the heterogeneity of cities in the region and the significant variations both in degrees of urbanization and levels of health; and the critical importance of underlying economic, social and political trends in determining health status. The opening situation analysis considers these underlying trends and describes how they create inequalities and affect the health of different groups. It examines aspects of the urban environment at city, neighbourhood and household level which exacerbate these inequalities. It also considers the ways in which demographic and environmental changes in the region contribute to a changing balance between disease and injury.

The second chapter describes responses to urban health issues at national, municipal and community levels, discussing such trends as the move towards decentralized management, and projects such as Healthy Cities and Local Agenda 21, and the role of community participation. The three city case studies are followed by a concluding chapter which draws together key issues and considers the research questions which need to be addressed.