What cities can learn from the brain
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Unequal roles of cities in the intercity healthcare system
Cities are increasingly interdependent regarding healthcare provision and demand. However, the intercity healthcare system (IHS) behind the nationwide patient mobility remains insufficiently understood. Here, leveraging human mobility big data, we reveal cities’ roles in providing and demanding quality healthcare within the IHS of China. We find that 8% of Chinese cities are national and regional hubs that address the healthcare shortage of cities deprived of quality healthcare, while 63% of the cities that are unnoticed compensate for migrant workers being denied healthcare rights in megacities. The IHS generates new structural inequalities in healthcare access exhibiting a Matthew effect. The few cities (12%) that are already rich in healthcare resources benefit more and can strengthen their advantages in providing healthcare to local populations (32% of China’s total population). The many cities (35%), while facing healthcare shortages, are further disadvantaged in ensuring adequate healthcare for their local populations (26% of China’s total population).
The decreasing housing utilization efficiency in China’s cities
‘Ghost cities’ are a well-known phenomenon of (almost) complete vacancy of urban living space in China. Underutilization of urban living space, however, is far more common than complete vacancy. Here we propose the concept of housing utilization efficiency (HUE) and present the following findings: (1) the overall HUE in China’s highly urbanized areas decreased from 84% in 2010 to 78% in 2020, (2) the HUE in central, old urban areas was generally lower than that in the outer layers of urban areas and declined more from 2010 to 2020 and (3) four development types are found to represent different patterns of urban population movement, urban housing growth and HUE change at the intraurban level. These findings provide comprehensive insight into the discrepancies between urban housing supply and demand in China and highlight their connections to the country’s particular urbanization characteristics and policies, which are crucial for future housing development and planning.
Differences in walking access to healthcare facilities between formal and informal areas in 19 sub-Saharan African cities
Spatial accessibility to healthcare is a critical factor in ensuring equitable health outcomes. While studies on a global, continental, and national level exist, our understanding of intra-urban differences, particularly between formal and informal areas within cities in sub-Saharan Africa, remains limited.
Urban inequality, the housing crisis and deteriorating water access in US cities
The housing unaffordability and cost-of-living crisis is affecting millions of people in US cities, yet the implications for urban dwellers’ well-being and social reproduction remain less clear. This Article presents a longitudinal analysis of household access to running water—a vital component of social infrastructure—in the 50 largest US cities since 1970. The results indicate that water access has worsened in an increasing number and typology of US cities since the 2008 global financial crash, disproportionately affecting households of color in 12 of the 15 largest cities. We provide evidence to suggest that a ‘reproductive squeeze’—systemic, compounding pressures on households’ capacity to reproduce themselves on a daily and societal basis—is forcing urban households into more precarious living arrangements, including housing without running water. We analyze the case study of Portland (Oregon) to illustrate the racialized nature of the reproductive squeeze under a housing crisis. Our insights reveal that plumbing poverty—a lack of household running water—is expanding in scope and severity to a broader array of US cities, raising doubts about equitable progress towards Sustainable Development Goals for clean water and sanitation for all (SDG 6) and sustainable cities (SDG 11) in an increasingly urbanized United States.
Intercity personnel exchange is more effective than policy transplantation at reducing water pollution
Severe spatial disparities exist in water pollution and water governance. A popular solution is that lagging cities transplant policies from cities with successful experiences. However, environmental governance is more than policies. Merely copying policies from elsewhere may not generate intended effects. Here this research argues that intercity personnel exchange can be a more effective policy instrument than policy transplantation. We provide the first nationwide estimates in China of the effect of intercity exchange of city leaders on water pollution reduction. Using large-scale micro-level datasets on city leaders’ curriculum vitae, firm behaviors, patents and policy texts, we show that intercity exchange of city leaders leads to a 4.78–15.26% reduction in firm-level water pollution, which contributes to 39.45–57.98% of the national total water pollution reduction from 2006 to 2013. Exchanged city leaders facilitate the diffusion of governance experience across cities and the formulation of intercity cooperation. They are also more likely to initiate new policies to support industrial upgrading. Our findings highlight the importance and potential of intercity personnel exchange as a policy instrument for water governance in particular and green transition in general.
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