68% of the world population will live in urban settings by 2050, primarily in low- and middle-income countries. Population health is determined by policies from all sectors, not just healthcare, with varying impacts across population groups. The United Nations (UN) plays a normative role in guiding government action through guidelines, frameworks, and measurement tools. This paper identifies and classifies existing measures available within the UN system to monitor urban health and associated technical areas. We identified all UN bodies relevant to urban health and manually searched UN system databases for frameworks, indices, and tools related to urban health published between January 1st, 2015, and March 7th, 2024. We extracted measures and their metadata and applied a taxonomy that: (i) classified each measure as an indicator or criterion, (ii) assessed its urbanicity and equity dimensions, and (iii) assigned it to domains and themes informed by the World Health Organization (WHO) Healthy Cities Programme. A plurality of documents with health-related measures were produced by the WHO (30.0%). Most measures were originally developed for national level assessment (69.8%). Relatively few measures included an equity dimension (9.7%); most required additional disaggregation to achieve a health equity lens. Cities are critical to population health. It is well recognized that macrosocial factors determine health, but this is not reflected in the available measures to monitor and evaluate urban health. Available measures also lack incorporation of urban and equity dimensions. These gaps highlight the need for more holistic approaches to urban health evaluation.

Authors:
Catalina Melendez Contreras, Washington University in St Louis, United States
Nandini Agarwal, Boston University, United States
Madison Pickerel, Washington University in St Louis, United States
Sandro Galea, Washington University in St Louis, United States
Salma Abdalla, Washington University in St Louis, United States

About the Presenter(s)
Catalina Melendez Contreras, MD, MPH, is a Senior Research Manager the Healthier Futures Lab, at Washington University in St. Louis School of Public Health.

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