Smarter and healthier cities in the era of AI: A state-of-the-art review

The smart city agenda has focused on technological solutions to urban problems. However, rapid social, environmental, and technological change, especially the rise of AI, have revealed significant transformations, highlighting the need for a state-of-the-art academic concept. This study proposes the concept of the Smarter and Healthier city, grounded in a systematic review of smart and healthy city research using the PRISMA protocol. We analyse the literature across three domains (governance, environment, and modelling) with emphasis on AI. In this study, we define smarter and healthier cities as AI-enabled urban systems that integrate advanced digital technologies with human-centred objectives, including environmental sustainability, and inclusive governance. Our review identifies that AI is driving conceptual transformations within the governance domain toward (1) integrative, (2) participatory, and (3) anticipatory governance, and within the environmental domain toward (1) dense IoT and crowdsensing infrastructures, (2) multimodal and transferable learning approaches, and (3) edge intelligence architectures. We further propose principles to address the emerging urban challenges, emphasising (1) ethical safeguards, (2) environmental justice, and (3) trustworthy AI systems. Overall, the smarter and healthier cities framework contributes an integrative perspective that bridges technological innovation, responsible governance, and human well-being in the context of AI-driven urban transformations and challenges.