Rapid urbanization and aging in many countries including the People’s Republic of China, along with lessons learned from the coronavirus disease pandemic, emphasize the urgent need to make cities healthier and more accessible for the elderly. This report offers an operational framework to turn the challenges of an emerging four-generation urban society into opportunities. Health impact assessments as well as healthy and age-friendly city action and management plans are proposed as holistic tools to create positive health outcomes and improve urban livability, services, and public spaces. Integrated with urban planning, these practical tools will help make cleaner, healthier, and safer cities that are more pleasant and competitive for people, business and economic development.