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Making Cities HealthyThe social, economic and environmental conditions that make a cityliveable also make it prosperous; these same conditions shape people'shealth. Health contributes to the prosperity of the city because to driveinnovation and economic growth, businesses depend on a productiveworkforce – well educated and healthy men and women. Consideringhealth implications early in policy or program development and investingin initiatives to prevent poor health outcomes can help contain healthcare costs in the long term for all taxpayers and contribute to theprosperity of the city. While prosperity is important for health, for a cityto grow and prosper, it needs to consider health in its decision-making. 114For a city to grow andprosper, it must behealthyHealthy lives are the result of the influences of many different andinteracting factors. Cities themselves are complex and the result ofdecisions and actions taken by local, provincial and nationalgovernments, the private sector, civil society, and individuals. They arealso affected by events around the world.Local governments' areas of responsibility – policing, firefighting,transportation, sewage, drinking water, waste management, planning anddevelopment, infrastructure, social welfare services, parks, recreation andcultural services – have the most direct effect on people's lives andprovide local government with important opportunities for influencingpeople's health in urban setting. 115,116The City of Toronto Act recognizes the unique status of Toronto inCanada and Ontario and provides a permissive legal framework thatgives the City a broad mandate for fostering the economic, social, health,safety and environmental well-being of the city and its people.Participation of business andcitizens in decision-makinghelps build a healthy andprosperous cityIn the end, a healthy, prosperous city does not happen without supportand contributions from a number of key stakeholders. This means thatwhile local public health units may assume a significant leadership rolein promoting health in the city, all city departments, other orders ofgovernment, business and the community play a role in protecting andpromoting health for everyone. Involvement of all stakeholders,including local residents and citizen groups and developing partnershipsacross local government departments, with provincial and federalgovernments, community organizations and the private sector is animportant way to help achieve a healthy and prosperous city.The Importance of Municipal GovernmentsA municipal government plays a number of roles including serviceprovider, investor, leader, champion, convener, partner and modelemployer. 117 It carries out many activities: it passes by-laws; adoptsbudgets, finances projects; generates revenue from taxes, fees, and othersources; develops, facilitates, delivers and administers programs andHealthy Toronto by Design | Toronto Public Health, October 201122