Índice de salud en las ciudades 2021

2021 City Health Index

DKV e IdenCity han creado el Índice de Salud de las Ciudades para ser conscientes de su realidad y actuar sobre potenciales mejoras. 

En este estudio te contamos qué hacen que nuestras ciudades sean más saludables. 

What if we could use a Health Index as a guide for making our cities healthier? This is what has been achieved with DKV's City Health Index and IdenCity Cities. We are currently living in an era of "Infoxication", in which we have all the information at a click. However, this does not always meet our expectations. In a very practical and precise way, the City Health Index changes the way we see data y and provides the community with relevant information aimed at proposing clear actions and solving a genuine global challenge.  

What does the City Health Index consist in?

This is what City Health Index is about, a project by DKV Instituto de la Vida Saludable and IdenCity, a consulting firm specialising in indexes. The report reflects the health status of the 50 province capitals and two autonomous cities in Spain, as well as their population. But it does not only study this, it also analyses the social determinants that contribute to it. Among these are urban, socio-economic, work-related and community aspects, which enable us to design and assess public policies. This way, we search for a specific reason, identifying, or not, the problem and giving it a solution. All the information is given a practical meaning.

Download the study here

How does it analyse it?

In order to analyse the health status and determinants of 52 Spanish cities, the City Health Index includes 78 indicators, which provide an approximation to the concept of health. These 78 indicators are grouped into 5 scopes and 12 categories:

infographic City Health Index


Madrid, Barcelona, Valencia and Zaragoza

Now, let's see what the results of the City Health Index say. Despite the fact that up to 52 Spanish cities have been studied, the Index focuses on four main cities:


It is the city with the highest overall score in the City Health Index, 73.9%, when compared to the average score of Spanish cities, which is at 70%. Madrid particularly stands out, together with Valencia, Seville, Cádiz and Barcelona, for its adoption of healthy behaviours (daily consumption of fruit and vegetables, no smoking, etc.). It also performs very well in terms of housing and equipment, considering factors related to residences and their surroundings (adequate temperature, offer of social housing, etc.) 

As in Zaragoza, family and community networks are essential aspects in the city, and this is reflected in the results.

However, it has to overcome an obstacle: sustainable mobility. The city has 0.04 km of bike paths per km² of urban land. A very lower figure when compared to other cities such as Barcelona or Valencia.


With an overall score of 71.6%, the city has its own distinguishing feature:  sustainable mobility. Barcelona has 2.51 km of bike paths per km² of urban land, which highlights its commitment to active mobility.

Its healthcare is also worth noting, whether due to its equipment (operating theatres and capacity in day hospitals) or its medical staff. However, as in most large cities, spatial segregation is its weak point. It has a higher concentration of high and low income households in different neighbourhoods of the city. We must not forget the relationship between health and the socio-economic conditions of citizens. 


The healthy behaviours of the population in Valencia stand out. 53% of its inhabitants consume fruit and vegetables every day. This gives us an idea of the extent to which healthy food is promoted by the city. What's more, its pedestrian and cycling infrastructure is also significant. Together with Barcelona, it is one of the best rated cities in sustainable mobility. This evidences its promotion of sustainable transport, such as cycling.

Like in the other cities that have been studied, its weakest point is its health services. This type of cities shows room for improvement in terms of number of ambulances and public and private hospital beds. However, its overall score is above average. Specifically, 72.7%.


The city is ranked in front of Madrid, Barcelona and Valencia in its inhabitant's years of healthy living. Specifically, they show an average of 81.57 years of healthy living. Furthermore, it is one of the cities with the best performance in the socio-economic sphere, especially in socio-economic security, meeting almost in its entirety its targets for poverty rate and access to dental health.