Sustainable Cities and Healthy Cities: Are They the Same?

There is robust literature examining the wide array of public policies and programs cities pursue in order to try to become more sustainable. Whether the focus of such programs is explicitly on improving the bio-physical environment, climate protection and adaptation, energy efficiency, land use regulation, or any of a number of other targets, such programs often carry with them an expectation that the programs will contribute to improve the health of populations. While there is significant attention to asserting that such a relationship exists, or ought to exist, there have been no efforts to explicitly and empirically link city policies to health outcomes. This paper tackles this issue head-on, investigating the extent to which cities in the US that have the most aggressive sustainability initiatives exhibit better health outcomes than cities with less aggressive sustainability initiatives. Using data from the largest cities in the US, this paper presents evidence concerning the strength of this relationship, discusses the foundations for the relationship, and provides a discussion of the implications for urban planning, sustainability policies and for improving the health of populations.