LESSONS FROM THE HEALTHY CITIES MOVEMENT FOR SOCIAL INDICATOR DEVELOPMENT

The author investigates emerging developments of social indicators thr ough the experience of a health planning initiative begun in 1986 unde r the coordination of the World Health Organization (Europe). By 1993 over 400 municipalities in first world countries had voluntarily commi tted themselves to participation. The paper results from interviews an d reviews of some participants' programs and materials, with significa nt reliance upon material from Canada and the coordinating WHO office. The author divides indicator development into political and technical components, stressing the former. He makes nine principal conclusions relating to indicators' success: (1) three stages of indicator develo pment are understanding, consensus and commitment; (2) indicators must be grounded in target population's reality; (3) indicators are histor ical artifacts; (4) programs must be in place that make indicator need apparent; (5) process is product; (6) new skills must be supplied; (7 ) indicators are client-driven; (8) good process protects indicators' integrity from inappropriate influence; and (9) quality is a culturall y-derived value defying aggregation.