Interpreting urban–health relationships in a Mediterranean port city: a spatio-temporal perspective from Tartous, Syria

Urban planning plays a critical role in shaping health-related urban conditions; however, planning frameworks often respond unevenly to long-term spatial transformation, particularly in port cities operating under constrained institutional frameworks. This study examines the evolution of urban–health relationships in the Mediterranean port city of Tartous, Syria. An integrated interpretative methodology is adopted, combining temporal and spatial analysis with a qualitative review of planning documents and regulatory frameworks. Space syntax analysis is employed across four key planning periods (1937, 1977, 2004, and 2022) to interpret how spatial transformation impacts health-related urban conditions. An Urban–Health Association Matrix is employed to develop a health-sensitive planning checklist, which is applied to evaluate the alignment of the Tartous Master Plan with established urban–health considerations. The findings reveal a progressive intensification of through-movement and traffic concentration over time, alongside a weakening of pedestrian-oriented spatial environments. While early urban configurations supported favorable health-related conditions, later phases introduced increasing trade-offs between urban development and health. The checklist assessment reveals that health-related considerations remain largely implicit in the current master plan, reflecting underlying governance and regulatory constraints. The study demonstrates the value of temporally grounded and spatially explicit approaches for interpreting urban–health relationships in data-scarce port-city contexts.