The ranking of Healthy Cities 2023 in France
What are the Healthy Cities 2023?
Like every year, Meersens reveals the cities where it is good to live in France. The study, conducted by our team of experts using environmental and health criteria divided into six categories, compares the 20 largest cities in metropolitan France. Discover the ranking of the healthiest cities to live in in 2023 in France.
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In 2050, it is predicted that more than 70% of the world’s population will live in an urban environment. Living in a city is synonymous with urban pollution (noise, NO2, SO2, fine particles, heat islands, etc.). This exposure can be the cause of disorders such as the development of psychiatric disorders or asthma in children for example. This exposure can increase the risk of developing respiratory and cardiovascular diseases, cancers, sleep problems or metabolic diseases… Each city has its own topography, climate, politics, socio-economic context and populations with their own habits, which can lead to differences in health impacts.
Meersens, with its data and experience in exposome eanalysis and personalized health risks, has analyzed 20 of the most populated French cities according to health-related criteria. These cities are ranked according to 6 health factors (data at the city, department, and regional levels): :
Healthy cities 2023 – Meersens
Whatis the Top 3 healthy cities to live in France in 2023?
1️⃣ At the top of the ranking : Angers and its ideal living environment
First in the list of the best cities to live in France, the capital of Anjou: Angers, which gets an overall score of14,27 out of 20.
Located in the department of Maine-et-Loire and the region of Pays de la Loire, Angers is a city considered to have a good air quality and many green spaces..
Called the “black city” because of its slate roofs, Angers was named the most attractive city in 2020 and proudly labeled “City of Art and History”. From a cultural point of view, Angers does not lack wealth: the castle of King René housing the famous Tapestry of the Apocalypse, many museums or the gallery David d’Angers.
It is considered one of the safest cities in France, ranking 12th as well as 10th as a student city.
2️⃣ In second place: Nantes, neighbor of the best city for living
Called the City of Dukes and nicknamed the “Venice of the West”, Nantes is a booming city located in the Loire-Atlantique region..
For the past ten years, the capital of the Pays-de-la-Loire region has been one of the metropolises that attracts the most students thanks to its numerous universities, business schools and engineering schools, which are among the top in France. It is also attractive in terms of employment with its economic hub of the Grand Ouest.
Nantes is a great place to live because it was the first French city to be elected as the Green Capital of Europe and has many green spaces such as parks and gardens.
In addition, Nantes is the city with the best air quality score!
3️⃣On the third place of the podium of cities where it is good to live in 2023: Paris, our beautiful capital
It may seem surprising that Paris is in 3rd place in this ranking. And yet, the beautiful capital of France obtains the best scores on several criteria: chronic diseases, BMI, Health Index.
It must be said that the most beautiful city in the world has a cultural life without equal! Living in Paris means being able to enjoy museums, exhibitions, concerts, theaters and movies, festivals and many other great events.
Its weak point? The air quality (in addition to the cost of living), making it the city with the highest number of exceedances of daily threshold recommanded by the WHO.
City with the fewest chronic pathologies: Paris
The prevalence of chronic pathologies that can be linked to the environment and lifestyle is a good indicator of the quality of life in the areas concerned.
To obtain this result, the data come from the health insurance and take into account: vascular risk treatments, psychotropic treatments, cardio-neurovascular diseases, diabetes, cancers, chronic respiratory diseases (excluding cystic fibrosis), psychiatric diseases, other long-term illnesses, liver or pancreatic diseases (excluding cystic fibrosis), neurological or degenerative diseases
Even if Paris reaches the 1st place on this point, the scores remain quite low because the prevalence of the different chronic diseases studied remains high and could be reduced significantly through primary, secondary and tertiary prevention actions. It should be noted that the proportion of the working population (24-59 years) is the highest in Paris and that of the over 60s the lowest compared to the rest of metropolitan France, which could also explain the lower proportion of people treated for chronic diseases. 
City with the best Body Mass Index (BMI): Paris
BMI is the most common measure to estimate whether a population is overweight or obese. Individuals are considered obese if their BMI is equal to or greater than 30 kg/m².
Obesity is a major public health problem in France: it affects 17% of adults, or 7 million people. 
In large cities, the obesity rate remains low, as in Paris.
Living in a city gives access to better nutrition (fresh products, diversified nutrition) and more physical exercise, thanks to access to better sports infrastructures (gyms, etc.) and to the fact that one uses the car less to get around, as in rural areas.
City with the highest life expectancy: Paris : Paris
The health index corresponds to life expectancy at birth. The upper threshold was set, according to the HDI methodology, at 85 years. The lower threshold was the one set by the Paris Region Institute: 65 years.
Life expectancy in France is high regardless of the city. However, there are some differences at the departmental level, which can be as much as several years. Lille, which is at the bottom of the rankings, has a life expectancy at birth of 80.5 years compared to 84.2 years for Paris.
However, life expectancy can differ between regions (the average life expectancy of a Parisian is 78.1 years while that of an inhabitant of Seine-Saint-Denis does not exceed 76.1 years. ) )
The fact that Paris is the city where people live the longest is explained in particular by the high proportion of executives and higher intellectual professions, since these social categories are the ones who live the longest, while workers have the lowest life expectancy. According toINSEE figures, male executives live on average 6.3 years longer than male workers (2000-2008 mortality conditions). The very difference in occupations partly explains these differences. Managers have fewer accidents, illnesses or occupational exposures than workers. In addition, they have lifestyles that are often more conducive to good health.
City with better mental health: Le Havre
In order to judge the impact of the psychological well-being of the citizens of the cities, the regional variations in the percentage of antidepressant prescriptions were taken into account during the post-confinement period due to Covid-19.
The mental health of the French people has been badly treated these last years (Covid-19, war, inflation…) and the consumption of antidepressants can be a criterion among many others in order to evaluate a malaise in the population.
Le Havre is situated in the region where the delivery of antidepressants has been the lowest after the confinement due to Covid-19.
City with the best air quality: Nantes
The air quality of a city has a real impact on the health of the population. A degraded air quality can endanger vulnerable populations but also favor the development of respiratory, cardiovascular or even mental diseases. In France, more than 90,000 deaths are attributed to air pollution each year.
To judge and compare the air quality of the cities, the number of days when the following thresholds are exceeded over the period from January 1, 2022 to December 31, 2022 is taken into account, according to WHO recommendations.
With an average of 13.4, the city of Nantes obtains the best score.
Despite the increase in car traffic and population growth, the air quality of the city of Nantes tends to improve. It would be thanks to the “Climate Plan” that 78% of the days have been classified as good to very good according to French pollution standards.
The pollutants that are most prevalent in Nantes are: particulate matter, nitrogen dioxide and ozone.
Air quality scores for all cities could be improved through daily environmental monitoring and then targeted actions to reduce sources of the most problematic pollutants.
Cities in France, guaranteed access to quality drinking water
In France, access to drinking water is guaranteed throughout the country and it undergoes controls to ensure its safety and potability. However, some areas of France have drinking water quality that may not meet the quality standards. As the majority of water in France is of very good quality, only those cities that deviate from this rule receive a malus depending on their level of compliance with the recommended or regulatory values (low conductivity, high temperature, pesticides, chemical compounds, heavy metals…).
The malus is applied to the final average and can be as high as 1. A malus of 1 is applied if the water is not drinkable, a malus of 0.5 is applied if the water does not comply with the quality references or if it contains pesticides (with values not exceeding the regulations).
In Rennes, there were periods when there was no residual chlorine, which is necessary to prevent bacterial proliferation in the networks. During these periods, the water of this city remained quite drinkable and did not pose a health risk.
Drinking water data are from Meersens data*
Meersens helps you take action to improve the health and well-being of your citizens. Monitor the environmental quality of public spaces and streets with real-time modeling and IoT data.
Healthy cities 2023:
Our complete ranking
The Meersens Health Index allows cities to be ranked according to criteria that target areas of improvement for better population health. Despite the limitations presented, the ranking and evaluation of the criteria reveal the areas of development on which action is needed. The aim of the study is mainly to identify the criteria that can be improved rather than to compare the cities with each other.
Within the framework of the PNSE 4, published in 2021, actions in cities and metropolises to prevent health risks are highlighted.
Meersens through its solution, allows to act:
👉 Setting up studies to collect data related to population health,
👉 Providing the necessary tools to cities to specifically target areas of improvement for better health of their citizens via the use of environmental data in the form of API or our SaaS platform tool,
👉 Doing awareness workshops on environmental health to the population to make them actors of their health,
👉 Track the population (habits, pollutant exposures and health problems) and make them proactive by making the invisible visible and providing advice and customized solutions to reduce their exposure,
👉 Act as a link between the city and its citizens by delivering the necessary information via various communication tools,
👉 Providing indications of effectiveness on prevention policies,
👉 To help in the decision making process and to develop specific prevention tools (path of least exposure)
Small changes sustained over the long term rather than large changes sustained over the short term are the key to achieving sustainable health improvement.
Limitations of the study
The model has limitations that are important to consider:
- The data sources are heterogeneous (Meersens, Assurance Maladie, Insee, etc.)
- The choice of cities excludes French cities outside metropolitan areas (DOM-TOM)
- The dates for obtaining the data vary between 2017 and 2021 depending on the indicators
- The score calculated for the prevalence of obesity is at the regional level and therefore not totally representative of the cities themselves
- Some data do not concern cities directly but the regions or departments where the cities are located
- Some indicators are variable over time (air pollution) and should be revised regularly to keep the ranking up to date
- Many criteria are not taken into account and can therefore introduce a bias in the final ranking
- The formulas used to establish the scores are derived from the development of the Meersens methodology and may be different or similar to some other methods (which themselves have limitations)
- It is possible that there are correlations between criteria which may lead to an overestimation of certain points. (e.g. air quality, BMI and prevalence of chronic diseases)
- The study does not take into account the socio-economic factors of the cities and the migratory status of the population, which could change the results if there was an adjustment for these factors; however, adjusting for these factors would tend to neglect them, whereas they should be taken into account in the development of city policies
- Cities are considered as a whole, yet there are significant health inequalities between neighborhoods or boroughs (which are reflected in median incomes between neighborhoods/boroughs)
- The change in certain data sources and therefore in methodology does not allow for a direct comparison between the years 2021 and 2022.