Healthy city: global systematic scoping review of city initiatives to improve health with policy recommendations.
Level 5 - mechanism / opinion, no new human data
Systematic scoping review mapping descriptive and policy initiatives without meta-analysis of clinical or controlled trials.
PubMed 37393224 · doi:10.1186/s12889-023-15908-0
What was done
A systematic scoping review following PRISMA guidelines and registered with PROSPERO (CRD42020166210) was conducted to characterize global literature on city-wide initiatives to improve health and healthcare.
What was found
From 42,137 original citations, 1,614 papers covering 227 cities met inclusion criteria. Most initiatives targeted non-communicable diseases and key risk factors termed the 'Vital 5' (tobacco use, harmful alcohol use, physical inactivity, unhealthy diet, planetary health). City health departments showed an increasing contribution over time, while the documented role of mayors appeared limited. No quantitative outcome effect sizes or pooled comparative statistics were reported in the abstract.
Why it matters
With over half of the global population living in cities, urban policy plays a critical role in health outcomes. This paper synthesizes 130 years of urban health initiatives to provide a framework for municipal policy.
Limits
As a scoping review, the study maps broad initiatives rather than synthesizing clinical outcomes or testing intervention efficacy. The abstract reports no quantitative outcome measurements, risk-of-bias assessments, or comparative effect estimates.