Urban public health assessment and pattern analysis: comparison of four cities in different countries

Urban public health is an important global issue, and receives extensive attention. It is necessary to compare urban public health status among different cities, so that each city can define its own health patterns and limiting factors. The following assessment indicators were established to evaluate urban public health status: living conditions, physical health, education and culture, environmental quality, and social security. A weighted-sum model was used in combination with these indicators to compare the urban public health status in four cities-Beijing, New York, London, and Tokyo-using data for 2000-2009. Although the urban public health level of Beijing was lower than that of the other cities, it showed the greatest increase in this level over the study period. Different patterns of urban public health were identified: London had the most balanced, steady pattern (almost all factors performed well and developed stably); New York and Tokyo showed balanced, but unsteady patterns (most factors remained high, though social security and environmental quality fluctuated); Beijing had the most unbalanced, unsteady pattern (the different factors were at different levels, and education and culture and social security fluctuated). For enhanced urban public health status, environmental quality and education and culture clearly need to be improved in Beijing. This study demonstrates that a comparison of different cities is helpful in identifying limiting factors for urban public health and providing an orientation for future urban development.