Data-driven assessment framework of health cities for elderly individuals in China

The "Healthy Cities Project" is a well-recognized response to the health challenges associated with rapid urbanization. While previous studies have adopted qualitative or quantitative methods to guide the development of healthy cities for elderly individuals, they do not offer an assessment framework based on stakeholders' expectations or the interdependent relationships among aspects of the assessment. To address these challenges, this study proposes a hybrid method that integrates quantitative normalization, exploratory factor analysis and reliability tests, Google Trends data transformation, and the fuzzy synthetic method with the decision-making trial and evaluation laboratory method to develop a data-driven assessment framework. The results reveal that (1) current developments exhibit imbalances in regional performance and among socioeconomic, health, and societal factors; (2) the development of healthy cities should take public expectations into account, which may help to address the issues stemming from the abovementioned imbalances; (3) healthy cities for elderly individuals in China have their own characteristics for development (concentrating on socioeconomic aspects), and these characteristics differ from the characteristics of similar cities worldwide (focusing on the environment). The results demonstrate the importance of health and stakeholder interests, which may have universal relevance for correcting imbalance issues worldwide.