Phase IV was launched at the 2003 International Healthy Cities Conference in October 2003. It consisted of an overall commitment to health development with emphasis on equity, tackling the determinants of health, sustainable development and participatory and democratic governance. It also committed WHO European Healthy Cities Network members to working on:
- healthy ageing: to generate strong local political commitment and to introduce policies and planning processes that would ensure a holistic and well-balanced approach to the health development and care needs of older people;
- healthy urban planning: to integrate health considerations into city urban planning processes, programmes and projects and to establish the necessary capacity and political and institutional commitment to achieve this goal;
- health impact assessment: to integrate health impact assessment as a systematic framework in cities that enables decision-makers to take account of people’s health and well-being during policy, programme or project developments; and
- physical activity and active living: to develop strategies and innovative interventions including changes in the urban design and environment that facilitate and encourage physical activity and active living for all ages, and the tackling of obesity (endorsed as an additional theme in October 2004).
All cities in the WHO European Network, working individually and collectively, addressed these themes during Phase IV. Their work provided experience and know-how that will benefit all cities in Europe.