Piloting an Urban Health Index in Fast-Track Cities: Outcomes, Lessons Learned, and Pathways to Scale
1
Fast-Track Cities Institute, Washington, DC, United States
Popul. Med. 2026;8(Supplement Supplement 1):A1145
ABSTRACT
BACKGROUND:
Urban environments concentrate both risks and opportunities for health. To better capture multidimensional drivers of urban well-being, we piloted a new Urban Health Index (UHI) across five Fast-Track Cities, aiming to provide a composite, actionable metric for monitoring and guiding urban health interventions.
METHODS:
The UHI integrates indicators across four domains: environmental (air quality, green space, climate resilience), infrastructural (healthcare density, housing quality, transport access), social (inequities, poverty, education), and governance (public health investment, community participation). Municipal datasets, health surveillance systems, and geospatial analysis were combined and standardized (scale 0–100) to produce a single UHI score for each city. Pilot testing was conducted in Lisbon, Kyiv, Nairobi, Buenos Aires, and Bangkok, representing diverse geographies, economies, and governance structures.
RESULTS:
The UHI successfully differentiated health resilience profiles: Lisbon (82) and Bangkok (76) ranked highest, reflecting strong governance, health infrastructure, and investments in climate adaptation. Buenos Aires (64) scored mid-level, balancing robust healthcare with persistent social inequities. Nairobi (48) and Kyiv (42) ranked lowest, reflecting environmental exposures, housing vulnerabilities, and governance challenges amid political and economic instability. Higher UHI scores correlated with improved maternal health indicators, stronger HIV care continuum performance, and reduced heat-related morbidity. Stakeholders highlighted the UHI’s usefulness in synthesizing diverse data into a single decision-making tool, though challenges emerged around indicator standardization, data quality, and weighting equity-sensitive measures.
CONCLUSIONS:
The pilot demonstrates the feasibility of a multidomain Urban Health Index to monitor city-level health performance and resilience. Lessons include the need for simplified indicator frameworks, improved data governance, and local capacity building. Recommended adjustments for scale-up include integrating equity-disaggregated metrics, aligning with SDG targets, and embedding the UHI into city dashboards to support planning and accountability across the Fast-Track Cities network.
Urban environments concentrate both risks and opportunities for health. To better capture multidimensional drivers of urban well-being, we piloted a new Urban Health Index (UHI) across five Fast-Track Cities, aiming to provide a composite, actionable metric for monitoring and guiding urban health interventions.
METHODS:
The UHI integrates indicators across four domains: environmental (air quality, green space, climate resilience), infrastructural (healthcare density, housing quality, transport access), social (inequities, poverty, education), and governance (public health investment, community participation). Municipal datasets, health surveillance systems, and geospatial analysis were combined and standardized (scale 0–100) to produce a single UHI score for each city. Pilot testing was conducted in Lisbon, Kyiv, Nairobi, Buenos Aires, and Bangkok, representing diverse geographies, economies, and governance structures.
RESULTS:
The UHI successfully differentiated health resilience profiles: Lisbon (82) and Bangkok (76) ranked highest, reflecting strong governance, health infrastructure, and investments in climate adaptation. Buenos Aires (64) scored mid-level, balancing robust healthcare with persistent social inequities. Nairobi (48) and Kyiv (42) ranked lowest, reflecting environmental exposures, housing vulnerabilities, and governance challenges amid political and economic instability. Higher UHI scores correlated with improved maternal health indicators, stronger HIV care continuum performance, and reduced heat-related morbidity. Stakeholders highlighted the UHI’s usefulness in synthesizing diverse data into a single decision-making tool, though challenges emerged around indicator standardization, data quality, and weighting equity-sensitive measures.
CONCLUSIONS:
The pilot demonstrates the feasibility of a multidomain Urban Health Index to monitor city-level health performance and resilience. Lessons include the need for simplified indicator frameworks, improved data governance, and local capacity building. Recommended adjustments for scale-up include integrating equity-disaggregated metrics, aligning with SDG targets, and embedding the UHI into city dashboards to support planning and accountability across the Fast-Track Cities network.
| eISSN: | 2654-1459 |
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