Abstract
A smart city is an urban area that uses emerging technologies to enhance city operations and citizen services. With over 250 smart city initiatives worldwide and a market projected to reach $97.9 billion by 2026, the focus is shifting from efficiency and technology toward prioritizing citizen health and equity. Recent research underscores the profound impact of external environments on health, highlighting the need to assess the multidimensional environmental factors. Smart monitoring technologies create promising opportunities for innovative solutions in smart cities. This research systematically reviews technologies for environmental and health monitoring in smart cities, examining trends, challenges, and opportunities for creating healthier urban environments. Our analysis of 64 studies identifies twelve distinct monitoring domains categorized by spatial dimension (home, neighborhood, city) and target (behavioral vs. environmental). Key findings reveal that residential-level monitoring primarily focuses on individual health behaviors, while neighborhood- and city-level technologies enable broader applications including real-time air quality mapping, noise assessment, and integrated urban monitoring. These technologies facilitate early detection of community-level disease risks, efficient environmental pollutant management, and faster emergency responses. However, implementation challenges persist, including technical limitations, marketability concerns, usability barriers, privacy issues, and health equity considerations. As monitoring capabilities show growing disparity between developed and developing regions, addressing these challenges is crucial for implementing these technologies equitably to reduce health disparities and promote community health across all populations.