{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T06:04:16Z","timestamp":1789365856711,"version":"build-2803163510"},"reference-count":30,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T00:00:00Z","timestamp":1789344000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      No single condition met the necessity-consistency threshold of 0.90. Two sufficient configurations for high HR were identified: ~HS\n                      <jats:sup>*<\/jats:sup>\n                      HI\n                      <jats:sup>*<\/jats:sup>\n                      HA\n                      <jats:sup>*<\/jats:sup>\n                      ~HE (consistency = 0.926; raw coverage = 0.329) and HS\n                      <jats:sup>*<\/jats:sup>\n                      HI\n                      <jats:sup>*<\/jats:sup>\n                      HP\n                      <jats:sup>*<\/jats:sup>\n                      HA (consistency = 0.877; raw coverage = 0.476). Their union had a consistency of 0.872 and coverage of 0.540. The four-domain HS\n                      <jats:sup>*<\/jats:sup>\n                      HI\n                      <jats:sup>*<\/jats:sup>\n                      HP\n                      <jats:sup>*<\/jats:sup>\n                      HA configuration recurred from 2021 to 2024 and was reproduced unchanged in the lagged model. Sample perturbations generally retained the main configurations, whereas compressed calibration anchors and subgroup analyses revealed sensitivity and heterogeneity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>High urban health performance is associated with multiple sufficient configurations rather than a single necessary condition. The longitudinal strategy distinguishes recurring configurational relations from changing city membership over time and supports differentiated policy portfolios while retaining environmental safeguards. These findings represent set-theoretic associations rather than causal effects.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1956149","type":"journal-article","created":{"date-parts":[[2026,9,14]],"date-time":"2026-09-14T05:38:51Z","timestamp":1789364331000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Urban health performance configurations in Chinese cities: longitudinal fsQCA, 2019\u20132024"],"prefix":"10.3389","volume":"14","author":[{"given":"Donghai","family":"Ye","sequence":"first","affiliation":[{"name":"School of Physical Education, Weifang University","place":["Weifang, Shandong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Physical Education and Health, Zhaoqing University","place":["Zhaoqing, Guangdong, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,14]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1146\/annurev.publhealth.26.021304.144708","article-title":"Urban health: evidence, challenges, and directions","volume":"26","author":"Galea","year":"2005","journal-title":"Annu Rev Public Health."},{"key":"B2","doi-asserted-by":"publisher","first-page":"167","DOI":"10.1016\/j.landurbplan.2007.02.001","article-title":"Promoting ecosystem and human health in urban areas using green infrastructure: a literature review","volume":"81","author":"Tzoulas","year":"2007","journal-title":"Landsc Urban Plan."},{"key":"B3","doi-asserted-by":"publisher","first-page":"112","DOI":"10.1016\/j.vhri.2017.04.001","article-title":"Healthy China 2030: a vision for health care","volume":"12","author":"Tan","year":"2017","journal-title":"Value Health Region Issues."},{"key":"B4","doi-asserted-by":"publisher","first-page":"1851","DOI":"10.1016\/S0140-6736(16)31842-6","article-title":"The best science for achieving Healthy China 2030","volume":"388","year":"2016","journal-title":"Lancet."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1863","DOI":"10.1016\/S0140-6736(16)31724-X","article-title":"Healthy cities in China: a Lancet Commission","volume":"388","author":"Xu","year":"2016","journal-title":"Lancet."},{"key":"B6","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1016\/S0140-6736(11)61878-3","article-title":"Urbanisation and health in China","volume":"379","author":"Gong","year":"2012","journal-title":"Lancet."},{"key":"B7","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1016\/j.apgeog.2018.01.011","article-title":"Inequality of public health and its role in spatial accessibility to medical facilities in China","volume":"92","author":"Yin","year":"2018","journal-title":"Appl Geograp."},{"key":"B8","doi-asserted-by":"publisher","first-page":"115458","DOI":"10.1016\/j.socscimed.2022.115458","article-title":"Inequalities of spatial primary healthcare accessibility in China","volume":"314","author":"Jia","year":"2022","journal-title":"Soc Sci Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"705","DOI":"10.1056\/NEJMoa1817364","article-title":"Ambient particulate air pollution and daily mortality in 652 cities","volume":"381","author":"Liu","year":"2019","journal-title":"N Engl J Med."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1110","DOI":"10.1016\/S0140-6736(10)60062-1","article-title":"Environmental health in China: progress towards clean air and safe water","volume":"375","author":"Zhang","year":"2010","journal-title":"Lancet."},{"key":"B11","doi-asserted-by":"publisher","first-page":"1429143","DOI":"10.3389\/fpubh.2024.1429143","article-title":"GIS-based assessment of spatial and temporal disparities of urban health index in Shenzhen, China","volume":"12","author":"Duan","year":"2024","journal-title":"Front. 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