Geographic accessibility plays a key role in health care inequality but remains insufficiently investigated in China, primarily due to the lack of accurate, broad-coverage data on supply and demand. In this paper, we employ an innovative approach to local supply-and-demand conditions to (1) reveal the status quo of the distribution of health care provision and (2) examine whether individual households from communities with different housing prices can acquire equal and adequate quality health care services within and across 361 cities in China. Our findings support previous conclusions that quality hospitals are concentrated in cities with high administrative rankings and developmental levels. However, after accounting for the population size an “accessible” hospital serves, we discern “pro-poor” inequality in accessibility to care (denoted as GAPSD) and that GAPSD decreases along with increases in administrative rankings of cities and in community ratings. This paper is significant for both research and policy-making. Our approach successfully reveals an “unexpected” pattern of health care inequality that has not been reported before, and our findings provide a nationwide, detailed benchmark that facilitates the assessment of health and urban policies, as well as associated policy-making.

China’s rapid urbanization drive, marked by extensive urban renewal projects, necessitates a meticulous examination of their transformational impact on the human settlement environment (HSE) across urban landscapes. This study investigates the impact of China’s urban renewal progress on the spatial–temporal changes in the HSE from 2009 to 2019, using data from 40 prefecture-level cities in the Yangtze River Delta. Our findings reveal an overall positive relationship between the spatio–temporal evolution of urban renewal and the HSE, suggesting that urban renewal projects have had a beneficial impact, particularly following the announcement of China’s New Urbanization policy in 2014. However, the extent of this positive impact varied among different areas, with more significant improvements observed in core cities and economically developed areas. Additionally, our study uncovered significant variations in how urban renewal influenced the HSE over time. We found that the primary influencing factor shifted from material renewal to industrial renewal. These findings offer valuable insights for improving the HSE during urban renewal processes, both in China and other regions undergoing rapid urbanization.

Chinese cities are experiencing urban shrinkage due to demographic, environmental, economic, and political changes. However, urban form is another reason for urban shrinkage. This study first identified the shrinking of 293 cities in China based on the values of the change in brightness extracted from multi-year nighttime light data. Next, the characteristics of construction land morphology from 2019 were analyzed using landscape pattern analysis. Finally, the impact of urban form on urban shrinkage was explored using Geodetector. The results show that: (1) In total, 293 cities experienced different degrees of shrinkage. Regions with severe shrinkage were concentrated in the underdeveloped provinces, and autonomous central and western regions of China; moreover, (2) All factors of urban form significantly affected urban shrinkage. The largest q-values were found in patch density (0.144) and urban area (0.133), indicating that the degree of construction land fragmentation and urban area scale affected urban shrinkage the most; and (3) The interaction effects of pairwise factors were mutually or nonlinearly enhanced. The influence of urban form and socio-economic factors was stronger than that of socio-economic factors alone. This shows that the coupling of urban form and socio-economic factors strengthens the impact of urban form on urban shrinkage.