Healthy cities initiative in China: Progress, challenges, and the way forward

China implemented the first phase of its National Healthy Cities pilot program from 2016-20. Along with related urban health governmental initiatives, the program has helped put health on the agenda of local governments while raising public awareness. Healthy City actions taken at the municipal scale also prepared cities to deal with the COVID-19 pandemic. However, after intermittent trials spanning the past two decades, the Healthy Cities initiative in China has reached a crucial juncture. It risks becoming inconsequential given its overlap with other health pro-motion efforts, changing public health priorities in response to the pandemic, and the partial adoption of the Healthy Cities approach advanced by the World Health Organization (WHO). We recommend aligning the Healthy Cities initiative in China with strategic national and global level agendas such as Healthy China 2030 and the Sus-tainable Development Goals (SDGs) by providing an integrative governance framework to facilitate a coherent intersectoral program to systemically improve population health. Achieving this alignment will require leveraging the full spectrum of best practices in Healthy Cities actions and expanding assessment efforts.Funding Tsinghua-Toyota Joint Research Fund Healthy city systems for smart cities program.Copyright (c) 2022 The Authors. Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/)

Automated summary

China's National Healthy Cities pilot program and related urban health governmental initiatives have raised awareness of health among local governments and the public. However, the Healthy Cities initiative in China is at a crucial juncture due to overlapping efforts, changing public health priorities, and partial adoption of the World Health Organization's approach. Aligning the initiative with national and global agendas will require integrating governance frameworks and best practices to improve population health systematically.