International Journal of Health Policy and Management

International Journal of Health Policy and Management

From Climate Concerns to Health Equity: Local Government Priorities for Smart Healthy Cities in South Korea

Articles in Press

Document Type : Original Article

Authors
Haejoo Chung 1
Minjin Jo 2
1 Division of Health Policy and Management, Korea University, Seoul, Republic of Korea
2 Department of Public Health Sciences, Graduate School, Korea University, Seoul, Republic of Korea
Abstract
Background
Smart healthy cities seek to integrate digital technologies with health-promoting environments to address urban health inequities. South Korea combines rapid urbanisation, population ageing, and advanced digital infrastructure, yet little is known about how local government health officials—key frontline implementers—prioritise health equity within smart healthy city agendas.

Methods
During the 2023 Korea Healthy Cities Conference, we conducted a real-time Mentimeter survey with local government health officials from 72 municipalities. Participants answered three sequential open-ended questions on (Q1) current healthy city challenges, (Q2) challenges better addressed through “smart” approaches, and (Q3) future priority values for Korean smart healthy cities. Free-text responses were coded into 43 indicators nested within 16 themes, mapped onto the six agendas of the World Health Organization (WHO) Copenhagen Consensus “6P” framework (People, Place, Participation, Prosperity, Peace, Planet). Aggregated counts were analysed using contingency tables, chisquare tests, correspondence analysis, and agenda-level (ie, across the six 6P categories) profile correlations.

Results
We analysed 482 coded mentions. For current challenges (Q1), responses centred on Planet (25.9%) and Participation (27.6%). For smart city–solvable challenges (Q2) and future priority values (Q3), distributions shifted markedly towards People: 23.0% (Q1), 41.4% (Q2), and 46.6% (Q3), while Planet and Participation declined. Agenda distributions differed significantly across the three questions (χ²[10] = 79.50, P < .001; Cramer’s V = 0.29), and Peoplecentred profiles for Q2 and Q3 were highly similar (r = 0.86, P = .028). Digital and health literacy, vulnerable populations, and service integration remained under-represented throughout.

Conclusion
Korean local government health officials increasingly frame smart healthy cities as vehicles for advancing health equity rather than as primarily environmental or technology-driven projects. However, persistent neglect of literacy, vulnerable groups, and service integration signals a gap between equity aspirations and implementation that equity-oriented digital governance and inclusive design must address.

Keywords
Smart Healthy Cities
Health Equity
Urban Health
Local Government
Republic of Korea
Mentimeter
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International Journal of Health Policy and Management

Articles in Press, Accepted Manuscript
Available Online from 14 September 2026

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  • Received Date 16 December 2025
  • Revised Date 14 July 2026
  • Accepted Date 13 September 2026
  • First Published Date 14 September 2026
  • Published Date 14 September 2026