Smart Cities

Limited impact based on low quality evidence and high resource implications.


A smart city is a place where traditional networks and services are made more efficient through the use of digital technology for the benefit of its inhabitants and business [European Commission]. 

Smart cities use information and communication technology (ICT) to tailor essential services, e.g., utilities and healthcare, towards their population [Cook 2018]. Smart cities are considered a pathway to economic prosperity, ecological sustainability, and efficiency on the presumption that smart city benefits will be enjoyed equally by all citizens [Trencher 2017]. 

The main components of smart cities include smart people, smart government, smart environment, smart transportation, smart economy, and smart life [Attaran 2022]. 

A recent systematic review enumerated the barriers and facilitators of using ICT to include barriers to and facilitators of ICT to include design components, language, culture, medical and health, trustworthiness, and interaction with others [Whitehead 2023].


Smart cities have the potential to create more efficient settings. However, they have the potential to create inequities, and the evidence for their impact on health is currently limited as many are in the early stage of development. 


Three reviews, including a total of 94 articles, were identified. One review (n=28 articles) investigated the equity considerations of smart cities and high-tech urban interventions targeting human health [Buttazzoni 2020]. Another review (n=19 articles) assessed the relevance and use of smart city applications in relation to public health [Rocha 2019]. The third review (n=47 articles) examined smart approaches targeted at primary and secondary prevention of cancer in connected communities [Wray 2018].

Outcome: Smart city applications

  • The equity considerations most frequently considered in smart city health interventions were place of residence, SES, social capital, and personal characteristics [Buttazzoni 2020]. 
  • The most relevant applications are those that support surveillance of the populations and the environment [Rocha 2019].
  • The most commonly used smart applications are social networks, cloud computing and a wide range of sensors [Rocha 2019].
  • Almost all smart city applications are still in the early stages of development (proof of concept prototype) [Rocha 2019].

Outcome: Lung cancer

  • Living in close proximity to industry or major roadways or increased dependency on automotive transportation was considered to represent higher exposure to poor air quality and therefore hypothesized to be associated with an increased risk of lung cancer [Wray 2018].

Outcome: Skin cancer

Built environment features (e.g., shade interventions) and social environment features are associated with reduced UVR exposure and reduced risk of skin cancer [Wray 2018].

Strength of the evidence

One review (Buttazzoni 2020) provided information on study quality – the overall quality of the primary studies was low to moderate.

Resource implications

None of the included reviews assessed the resource implications of smart city interventions. However, they require substantial long-term investment to realise the benefits.


  • More robust evaluations of health-based smart city interventions are required, especially qualitative studies.
  • Future studies should allow for racial, ethnic, cultural, linguistic, and religious minority groups considerations.
  • Research targeting the use of smart city interventions in communities with lower educational levels is imperative.
  • Future research should also explore the potential benefits of smart governance approaches to health problems.

Related Resources

Reference to Reviews

Buttazzoni 2020. “Smart City and High-Tech Urban Interventions Targeting Human Health: An Equity-Focused Systematic Review.International journal of environmental research and public health vol. 17,7 2325. 30 Mar. 2020, doi:10.3390/ijerph17072325.

Rocha 2019. “Smart Cities and Public Health: A Systematic Review.” Procedia Computer Science 164 (2019) 516–523.

Wray 2019. “Smart prevention: A new approach to primary and secondary cancer prevention in smart and connected communities.Cities Volume 79, September 2018, Pages 53-69