Abstract
OBJECTIVE: This study analyzed China's four most politically significant and economically dynamic urban agglomerations-Beijing-Tianjin-Hebei (BTH), Yangtze River Delta (YRD), Pearl River Delta (PRD), and Chengdu-Chongqing (CY)-to explore their health development trends from 2005 to 2023 and compare their spatiotemporal characteristics in coordinated health development. METHODS: We employed an integrated index construction method and an improved urban gravity model to build urban health network models, investigating the coordinated relationships and features of health development in these agglomerations. RESULTS: Over 17 years, the four agglomerations showed both commonalities and unique differences in health coordination. The degree of coordinated development strengthened significantly, although it was notably influenced by major policies and public health events. Core cities exhibited substantial radiating effects on regional health coordination. PRD and YRD exhibited more pronounced growth in coordination intensity than BTH and CY. Distinct coordination patterns emerged: BTH displayed a unipolar radiation structure, YRD a polycentric network, PRD a core-periphery structure, and CY a dual-core, policy-driven coordination structure. CONCLUSION: The findings reveal the critical role of core cities and policy interventions in shaping regional health collaboration networks, providing insights into how to achieve more balanced health resource allocation and equity in urban agglomerations.