Mapping local perspectives on specialized healthcare: Insights from five global cities

Cities that specialize in healthcare are reshaping the global urban landscape, offering advanced medical services while facing challenges of equity and inclusion. This study examines how residents, healthcare professionals, and policymakers perceive these transformations across five internationally recognized medical hubs, Vancouver, Seoul, Yazd, London, and Bangalore. By using a comparative qualitative design supported by computational text analysis, we explored how people describe and evaluate the changing role of healthcare in their cities. A total of 100 semi-structured interviews were analyzed through sentiment analysis and topic modeling to identify emotional orientations and recurring themes. Findings reveal a dual narrative. participants expressed strong satisfaction with care quality, specialization, and global recognition, yet voiced concerns about infrastructural strain, unequal access, and cultural displacement. Thematic clusters highlighted four key areas shaping these perceptions. economic development, governance, cultural identity, and operational challenges. Overall, public trust and perceived fairness emerged as central to how specialized healthcare cities are experienced and legitimized. The study concludes that successful health city planning must integrate technical excellence with equity, transparency, and cultural sensitivity to ensure socially sustainable urban healthcare futures. • Specialized health cities reveal tensions between global ambitions and local equity. • Economic, infrastructural, and cultural contexts shape how residents experience healthcare specialization. • Residents express pride in service quality but concern over access, infrastructure, and cultural change. • Equitable and transparent governance is essential for socially sustainable health city planning.