Developing an Indicator System for a Healthy City: Taking an Urban Area as a Pilot

Abstract

Purpose

The Healthy Cities Project is an important strategy for global health. This study aimed to develop a scientific and appropriate indicator system for the evaluation of a Healthy City in Chongqing, China.

Methods

Data were collected via a review of government documents, focus group discussions, and in-depth interviews. A total of 34 government documents were reviewed to build the indicator database based on our previous studies. The first round of focus group discussions, which involved eight health-related experts, was conducted to form the indicator system framework. In-depth interviews with 15 experts from government departments were conducted to design the improved indicator system. The second round of focus group discussions, which featured four experts, was conducted to obtain the final recommended list of indicators. A thematic framework was used to analyze the detailed interview notes.

Results

The indicator system for the Healthy City consisted of 5 first-level indicators, 21 second-level indicators (e.g., health literacy), 73 third-level indicators (e.g., incidence of myopia), and three characteristic indicators. This indicator system spanned the scope of the environment, society, health services, healthy people, and health behaviors.

Conclusion

This indicator system was based on the current status of the construction of the Healthy City in the pilot district. The indicator system could be dynamically adjusted according to the development of the Healthy City in the pilot district. Government departments play an important decision-making role in the development process of this indicator system.

Keywords:

• healthy city
• urban health
• indicator system
• health in all policy
• public health
• healthy China

Acknowledgment

We would like to thank all participants in this study for their time and cooperation. Special thanks to Aihua He, Ken Chen from Chongqing Municipal Health Commission for their valuable advice on this paper.

Ethics Approval

Ethics approval was obtained from the Ethics Committee of Chongqing Medical University, China (2017021).

Author Contributions

Study design: Y.Z., H.Z., and T.L.; data collection: Y.F., D.W., H.Z. Y.Z., and T.L.; data analysis: T.L., H.Z., and Z.S.; data interpretation: T.L., H.Z., and Z.S.; writing original draft: T.L., H.Z.; manuscript review & editing: T.L., H.Z., Z.S., and M.S.; project administration: D.W., Y.F., and Y.Z.; All authors made substantial contributions to conception and design, acquisition of data, or analysis and interpretation of data; took part in drafting the article or revising it critically for important intellectual content; gave final approval of the version to be published; and agree to be accountable for all aspects of the work.

Disclosure

The authors report no conflicts of interest in this work.

Additional information

Funding

Funding for this study was supported by cooperation program named ‘Developing an Indicator System for a Healthy City’ between Center for Disease Control and Prevention of Nan'an District in Chongqing and Chongqing Medical University, and also was supported by Chongqing Municipal Health Commission (project no. 2017MSXM158) of China.