As safe as houses? Why standards for urban development matter

Standards for designing, improving, and maintaining the built environment have conceptual and practical value for health. Yet, their importance runs the risk of being subsumed in tangential discourses, including over their applicability for particular populations or in particular contexts. This paper applies an integrative systems perspective to several relevant scenarios, while broadly revisiting the health rationale for built environment standards. As with any intervention, standards can have negative unintended consequences, in some cases inducing adverse outcomes. Yet, forgoing standards is not an acceptable answer for sustainable urbanization. The systems perspective adopted here surveys some of the driving forces that underlie adverse outcomes, and suggests potential leverage points and criteria for action.