Notre Dame

From Rio Grande Games: 

The players take on the roles of the heads of influential families in Paris at the end of the 14^th century. In the shadow of the Notre Dame cathedral, the players compete for prosperity and reputation. Each family controls one of the 3–5 boroughs that surround the site of Notre Dame. As head of his family, each player tries, through clever use of his action cards, to advance the power and prestige of his family, but penalties are assessed on those who do not take care of the health of the people who live in their borough. The player with the most prestige at the end is the winner.