The health of cities

Milan is a city that moves fast, driven by a rare energy in the European landscape: the ability to attract talent, investment, businesses, and culture.

But speed alone does not define the quality of development. The real challenge is aligning growth with widespread well-being: a metropolis’ competitiveness is also measured by the health of its citizens, the quality of its public spaces, and its ability to prevent problems before they escalate. Health is not a separate social chapter; it is a strategic infrastructure.

For this reason, a pilot epidemiological study dedicated to cardiovascular prevention has been launched in Milan’s Bicocca district. Its value goes beyond medicine: it is the BEA study (Bicocca Epidemiological Assessment of Cardiovascular Risk Factors), developed within the MUSA project (Multilayered Urban Sustainability Action), the Innovation Ecosystem that brings together Milanese universities and public and private stakeholders.

This is not merely academic research; it signals a method of governance. An ecosystem works when knowledge becomes governing capacity — that is, when public decisions are based on data. Cardiovascular prevention is an emblematic field because it connects environment, work, lifestyles, and access to services.

The Intervention

Prevention and Risks. The Bicocca Mission

The heart is not just an organ: it reflects the interaction between individual choices and the urban context.

For this reason, it can become an advanced laboratory for evidence-based urban policies. BEA builds an updated risk profile by considering not only blood pressure or cholesterol, but also air quality, noise, traffic, green spaces, housing conditions, social vulnerability, and mental health. Science defines all this as the “exposome”: the set of daily exposures that, over time, shape health trajectories. It changes from neighborhood to neighborhood, with the possibility of walking, with available leisure time, and with job quality.

A clear political implication follows: prevention is not only an individual responsibility, but also a matter of urban planning. A well-designed city becomes an ally of health; an unequal city becomes a multiplier of risk.

The BEA study involved over 800 randomly selected residents, offering free screenings and advanced clinical evaluations. It is a concrete example of the “third mission”: research returning to the community, producing immediate benefits and strengthening the public system’s ability to understand real needs. Not only electrocardiograms and lab tests, but also data on lifestyle, sleep, stress, and social conditions. Even the microbiome and emerging environmental contaminants become tools for anticipatory prevention.

Its institutional value lies in multidisciplinarity: cardiologists, epidemiologists, psychologists, and environmental experts working together. This is the same integration often missing in urban governance, where problems are divided into separate competencies. Here, health becomes a common language connecting mobility, urban planning, welfare, and the environment.

MUSA demonstrates its most strategic function: transforming research into a permanent policy infrastructure. Data serve not only individual citizens but also guide public decisions — where to locate services, how to design public spaces, how to reduce health inequalities. Prevention means governing better: investing where returns are highest in terms of healthy life years, sustainability, and trust. This is also a matter of political responsibility.

A city that measures risks must then take responsibility for acting on mobility, housing, service distribution, and territorial inequalities. The study has recently concluded and the results will soon be available. But its value is already clear: bringing together cardiovascular prevention, social and environmental sciences, innovation, and attention to vulnerabilities, within a transparent pact with citizens.

Milan has the strength to be not only an economic and cultural capital, but also a European benchmark in urban health governance — neighborhood by neighborhood, with method, responsibility, and vision.