Frontiers in public health
Urban health performance configurations in Chinese cities: longitudinal fsQCA, 2019-2024
By Ye D and Wang J.
Abstract
Introduction
Composite city indices can rank urban health but rarely explain which conjunctions of public provision, economic capacity, resident action, and environmental conditions are sufficient, whether those conjunctions persist, or how cities move between them over time. This study addresses this configurational and temporal gap using longitudinal evidence from Chinese cities.
Methods
We analyzed a balanced panel of 296 Chinese cities from 2019 to 2024, comprising 1,776 city-year observations. Urban health utility (HR), derived from the Tsinghua Urban Health Index (TUHI), was used as the outcome, while government health services (HS), health infrastructure (HI), health industry (HP), health behavior (HA), and health environment (HE) were treated as conditions. Longitudinal fuzzy-set qualitative comparative analysis (fsQCA) was conducted using pooled calibration anchors, supplemented by annual models, pooled/between-year/within-city diagnostics, dominant-configuration transitions, robustness analyses, and a 1-year lag model.
