Much of the discourse on the future of cities is trapped in a professional paradigm that focuses on the role of urban planners and policy makers, while everyday urban realities are being shaped by a very different set of informal processes and actors that are largely immune to planning and policy making. Based on the observation and analysis of projects, developments, and initiatives at a metropolitan level and “on the ground” in over twenty cities, this essay argues that the potential for social integration and democratic engagement of socially excluded urban residents is often realized through small-scale “acupuncture” projects, which succeed in bringing people and communities together in ways that formal planning processes have failed to do. What is happening on the ground can be described as a process of urban integration that both questions our role as urban designers and planners in terms of what we design and for whom and shifts the focus of analysis away from the rather blunt instruments of “top-down versus bottom-up” planning toward a more nuanced understanding of processes of urban “accretion and rupture.”

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