A livable city doesn’t just happen. It takes careful planning and sustained effort to create a place that gives all residents a chance to thrive by ensuring safety, health, housing, mobility and opportunity for all. 

Using an internationally validated approach, a team of researchers at the School of Public Health at Washington University in St. Louis conducted a livability assessment to determine how well the city of St. Louis supports the health and well-being of its residents right now – and where there is room for improvement. 

“There is a lot of evidence from around the world on what makes for a thriving, livable city,” said Rodrigo Siqueira Reis, MS, PhD, a professor of public health and the senior investigator on the study. “St. Louis, compared to other cities, is doing reasonably well. But I don’t think the question is how well St. Louis is doing compared to other cities. It’s how well St. Louis is doing compared to itself over time for its own residents. And in that regard, we have work to do. There are well-known and long-standing spatial inequities here. We have a lot of assets, but we need to make them more affordable and more accessible to all.”

The analysis, published online in the journal Cities & Health, revealed both strengths and opportunities for growth. The city is quite walkable, meaning that the streets are laid out in such a way that promotes a healthy level of physical activity. It also scores well in terms of having public policies in place designed to enhance livability. However, less than half of the population has adequate access to public transit, fresh food markets and public open spaces, particularly in north St. Louis. And while policies do exist to address these issues, such policies frequently lack measurable targets, making it difficult to implement them effectively and gauge their impact. 

The report highlights steps the city could take immediately to work toward better quality of life for its residents, such as assigning metrics to pre-existing policies and reconsidering policies that don’t align with evidence-based best practices for healthy cities. It also serves as a baseline from which residents and policymakers can measure the city’s progress going forward. The study was led by Ana Luiza Favarão Leão, PhD, an assistant professor at the State University of Londrina in Londrina, Brazil, and a consultant for WashU Public Health’s People, Health & Place Unit – St. Louis, which is co-directed by Reis.

“Our focus is really to promote livability in St. Louis by providing evidence-based indicators that can be tracked over time and used to inform policy,” Reis said. “There is an old saying in public health: What gets measured gets done. We have identified where the gaps are. Now we can start putting changes in place to move the city in the direction of enhanced livability.”

The St. Louis study is part of the 1,000 Cities Challenge launched by the Global Observatory of Healthy and Sustainable Cities in May 2022. Sponsored by the People, Health & Place Unit – St. Louis, the Global Observatory is a multi-institutional, transdisciplinary initiative providing evidence-based spatial and urban policy indicators to advocate for and track progress toward healthy and sustainable cities for all. The challenge aims to collect and analyze data on 1,000 cities worldwide to identify best practices and promote policies that enhance safety, inclusivity, health, sustainability, housing, mobility and opportunity for all residents, regardless of race, gender, socioeconomic status and education. 

In this study, Reis and colleagues applied the Global Observatory’s spatial and policy livability indicators to the city of St. Louis, using data from 2023 and 2024. Spatial indicators included such measures as the percentage of the population that lives within 500 meters (about a five- to seven-minute walk) of a grocery store or a public transit stop. Policy indicators included whether policies existed and how well they aligned with best practices across six domains: health and sustainability; walkability and destinations; public transport; public open spaces; air quality and management of natural ecosystems; and climate disaster risk reduction. 

The researchers continue to refine and extend the initial study. Drew Crenshaw, a public health sciences doctoral student who works with Reis, recently conducted a survey to understand what St. Louis residents value and how they assess livability in their own communities. Crenshaw is using that input to develop an online public platform to host localized livability metrics and resources to aid policymakers and community service providers. In addition, the team is working with colleagues at WashU McKelvey School of Engineering to use Google Street View to construct more detailed maps of the city that will support more nuanced, targeted approaches to improving livability. The researchers are also in the process of applying the same methodology to assess five cities in Brazil: Pelotas, Florianopolis, Curitiba, Rio de Janeiro and São Paulo.

Writer

Tamara Schneider, MPH, PhD, is the senior science writer and assistant director of communications for WashU School of Public Health. She holds a bachelor’s degree in molecular biophysics & biochemistry and in sociology from Yale University, a master’s in public health from the University of California, Berkeley, and a PhD in biomedical science from the University of California, San Diego.