As populations become increasingly focused in the urban environment the focus of integrating health into urban design becomes equally increasingly important. The Healthy Urban Design Index (HUDI) delivers a 250 m–resolution assessment of 13 indicators across 917 European cities.
It uses policy-relevant indicators related to urban design, sustainable transportation, environmental quality, and greenspace accessibility — key factors influencing human health and wellbeing. By measuring surrounding greenness (NDVI), universal access to at least 0.5 ha of green space within 300 m, and access to at least 5 ha of green space within 2 km, HUDI highlights the role of accessibility in the fabric of urban planning, it found an important relationship between urban green spaces and facilitated walkable and high-quality amenities.
The report goes on to find medium and small-sized cities (50 000–500 000 inhabitants) often excelled in environmental quality, boasting higher NDVI scores, yet lagged significantly in green space accessibility, while larger metropolitan areas—particularly in Northern Europe and Spain—paired robust sustainable transport with well-planned green networks. These large metropolitan areas (>1.5 million inhabitants) were more likely to have advanced urban design and sustainable transport with well-planned, accessible green networks—even under heavy land-use pressure.
The opportunity to combine a large amount of data, also amplified the opportunities to further develop investment and produce more accessible green infrastructure, such as parks, urban forests, and green corridors. The research also reported an east–west divide with the lower scoring cities in Romania, Bulgaria, and Poland. The HUDI tool provides policymakers and urban planners with information on opportunities to create more equitable and sustainable urban environments in future, with health-promoting urban planning.
Montana, Federica, Natalie Mueller, Evelise Pereira Barboza, Sasha Khomenko, Tamara Iungman, Marta Cirach, Carolyn Daher et al. “Building a Healthy Urban Design Index (HUDI): how to promote health and sustainability in European cities.” The Lancet Planetary Health 9, no. 6 (2025): e511-e526.
