Overview
The City Heartbeat Index measures the policies, processes and risk-factor-mitigation efforts that are key to reducing the burden of cardiovascular disease (CVD) in cities and aims to enhance awareness of the multiple factors contributing to CVD risk in urban environments. It seeks to foster collaboration among policymakers and other stakeholders to develop and implement evidence-based approaches, encourage improved public health infrastructure, and promote equity in access to healthcare services and prevention programmes.
The City Heartbeat Index is designed to act as a comprehensive benchmark ranking 50 cities globally on their efforts to protect their population’s health from cardiovascular disease with measures including governance, city planning, and health services. Download now to find out how your city ranks.
Download the City Heartbeat Index 2024Why the City Heartbeat Index was created
CVD is the leading global cause of mortality, causing 17.9 million deaths in 2019 alone. Urbanisation is known to be associated with an increase in risk factors for CVD.
With over 55% of people living in cities as of 2022, The City Heartbeat Index seeks to uncover the factors influencing cardiovascular health in cities, providing a heart health benchmark of 50 cities worldwide.
What the research found
- Data collection deficiencies: Critical data for understanding CVD risk factors are often not collected at the city level, hindering targeted public health interventions.
- Policy implementation gaps: The availability of limited data has had a knock-on effect on prioritising certain health risks. While data on some health risks including obesity, diabetes, and hypertension suggests that these areas are being prioritised, other risk factors such as low vegetable consumption, high cholesterol, and trans-fat intake are receiving less attention.
- Life expectancy correlation: Higher Index scores are associated with increased life expectancy and healthier ageing. Cities with better physical environments and health services, such as Helsinki and London, have higher healthy life expectancy at age 60.
- Wealthier cities have an advantage: Middle and low-income countries face limitations in funding, infrastructure (including green spaces and public transport), and social determinants such as employment and education, that have impacted their ranking towards the bottom of the list.
What next?
Given that over half of the world’s population resides in cities, we must have effective prevention and management strategies for CVD, tailored for urban settings. These should encourage healthy behaviours and tackle the underlying social determinants that can increase the risk of CVD.
Policymakers and other stakeholders need to tackle limitations in funding, population behaviour, infrastructure (including green spaces and public transport), and social determinants such as employment and education to reduce the risk of CVD in cities. Prioritising data collection at the city level is also essential as the foundational step in developing tailored urban health policies.
Methodology
The Index assesses city-level efforts to understand, prevent and address CVD in 50 cities across diverse locations and economies. It addresses barriers to improving the cardiovascular health of urban populations. The development of the Index was driven by the creation of a theoretical framework, as informed by the literature review and discussions with an expert panel. The framework was intended to be a first-of-its kind, holistic benchmark of city-level approaches to heart health. Cities were assessed across five domains: Social Determinants, Physical Environment, Health Risks, Health Services and Governance.
About this report
The work for this project was commissioned by Novartis and independently conducted by Economist Impact. It aims to raise awareness of the importance of a city-level focus on CVD.