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However, considering its continental size as well as its social and cultural diversity, Brazil harbours many different and thus far from homogeneous and simple health care and management systems. Additionally, the complex Brazilian health situation, both in terms of its epidemiological profile and the well-established, persistent inequality in allocation of public health resources are problematic. So, further elaboration is needed.2,3 In this context, the paper by Cavalini and Ponce de Leon4 is a welcome contribution. Central points are to be discussed under the light of this article, summar- ized as follows: the exposure variables, the ecological design and the analysis. Of all the exposure variables at any level, attention here is given to the innovative way to try to target a proxy of governance; understood as political decisions at the local level, in modelling the local health care system—'left-winged (pro public health care) or right- winged (pro private health care) parties'. It fits well with the recent definition of urban heath governance,

Commentary: Governance: does it matter in shaping health in urban settings? How in-depth can we go?