Urban residents are subject to a range of adverse environmental exposures-- from heat which is exacerbated by urban heat island effects, to air pollution which is enhanced by industrial and other human activities. Much of the attention in understanding the drivers and distribution of environmental exposures and health outcomes to date has been focused on large cities and mega-urban regions or at coarse scales of global analysis. Efforts to mitigate heat and other environmental exposure disparities within communities have, to date, been likewise focused on large cities and mega-urban regions. This session will explore the varying scales of interventions and practices that can be implemented within the range of urban landscapes, with a particular focus on smaller urban systems. Small and medium sized cities (SMSC), home to a diverse and growing segment of the population, face unique barriers and vulnerabilities which may not be fully captured by research at the scale of large cities and mega-urban regions. The session will cover the challenges of understanding and mitigating environmental health impacts within urban climates, particularly in SMSC, with the goal of promoting healthier urban communities.