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Abstract
A recent examination of the significant role of public health has prompted calls to re-investigate how the urban environment affects public health. A vital part of the solution includes Healthy City initiatives that have been the subject of extensive policies, implications, and practices globally. However, the existing literature mainly focuses on big cities and metropolitan areas, while investigations into small and midsized cities (SMCs) are lacking, and thus reflect the underlying issues of health inequity. This study develops an indicator system for evaluating Healthy City initiatives in SMCs, linking urban design and public health, supported by the analyzed opinions from experts collected using both questionnaires and interviews. The indicator system includes six primary dimensions and 37 variables: urban form and transportation (UFT); health-friendly service (HFS); environmental quality and governance (EQG); community and facility (CF); green and open space (GOS); and ecological construction and biodiversity (ECB). A fuzzy synthetic evaluation technique was used to assess the relative importance of factors, emphasizing the importance of UFT, HFS, and EQG, with importance indexes of 0.175, 0.174, and 0.174, respectively. This indicator system is helpful for SMCs seeking to construct a Healthy City in the future, and is based on urban design and governance inputs and for enhancing the Healthy City knowledge base of cities of varied scales.
Highlights
The concept of the Healthy City with 11 characteristics was first proposed in 1988 [1]; it received extensive attention followed by physical interventions globally
This study focuses on developing a health-spatial indicator system for small and midsized cities (SMCs) to better achieve Healthy City development through urban design and governance
We found six factors with an importance of hierarchy as lows: urban form and transportation (UFT), environmental quality and governance follows: urban form and transportation (UFT), environmental quality and governance (EQG), and health-friendly service (HFS) were important; community and facility (CF), (EQG), and health-friendly service (HFS) were important; community and facility (CF), green and open space (GOS), and ecological construction and biodiversity (ECB) were of green and open space (GOS), and ecological construction and biodiversity (ECB) were of neutral importance
Summary
The concept of the Healthy City with 11 characteristics was first proposed in 1988 [1]; it received extensive attention followed by physical interventions globally. While good health and well-being are part of the United Nations Sustainable Development Goals SDGs), there has been a call for global development addressing the causes of inequality [3]. More evidence from low- and middle-income countries on how urban planning contributes to public health is needed, and particular attention to underprivileged, vulnerable, and ignored geographic areas and social groups is necessary [4–6], especially in the post-COVID-19 landscape. Far more limited literature can be found for small and midsized cities (SMCs).
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