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Energy-health interactions are important to discern because sustainability at global scale is tightly linked to how cities resolve development challenges like climate change and resource efficiency, which cut are cross-sectoral in nature (Simon et al., 2016; Parnell, 2016; Holmstedt et al., 2017; Patel et al., 2017; Rybski et al., 2017). This is partly the implication of the 17 Sustainable Development Goals (SDGs), which underscore the importance of making cities inclusive, safe, resilient and sustainable (SDG 11); while ensuring accessibility to affordable and clean energy (SDG 7) as well as healthy lives for all (SDG 3). Simultaneous implementation of the SDGs presupposes integrative and cross-sectoral governance approaches, which build on the negative and positive interactions between energy and health. The positive interactions are those that create enabling conditions for minimizing the risks and shocks associated with for example pollution-intensive energy sources. Conversely, the negative interactions are characterized by elements that constrain the city’s ability to harness the co-benefits of energy efficiency. For instance, inadequate housing condition may not permit fuel switching from inefficient traditional fuels to efficient modern fuels amongst the urban poor, thus burring their ability to incrementally develop sustainable urban environments. Nonetheless, the unpacking of the energy-health nexus is largely dualistic in nature, viewing institutionalist and non-institutionalist approaches as mutually exclusive or conflicting pathways, thus contradicting with consensus amongst scholars and practioners that the interwoven nature of global and urban development challenges requires non-compartmentalized lenses in both theory-building and practice (Ramaswami et al., 2017; Swilling & Hajer, 2017; Kleibert, 2017; Wang et al., 2017; Schlör et al., 2018).
Non-institutionalist literature usually focuses on social actors in the shadows of policy-making and formal institutions, but influential in leapfrogging communities towards sustainability due to the reflexive way in which they form and function. For example, in Kibera-Kenya, youth-based associations empowered citizens to use GPS technology to collect data and plot housing and urban health challenges, then used the collected information to influence policy and development by advocating for their needs (Graesholm, 2012). In Kampala city, Buyana and Lwasa (2011) found that low-income neighborhood groups took the initiative to extract and add value to waste materials for alternative energy, thereby illustrating the gradual shift to neighborhood interdependencies in addressing energy shortfalls and environmental quality provision. By bridging theoretical perspectives on social mixing, innovation, urban governance and community action; non-institutionalist studies provide insights on the trade-offs of confronting urban development challenges beyond the preview of the state.