<![CDATA[Medan City, as a center of metropolitan growth, has achieved a very high Human Development Index (HDI). However, it still presents a paradox in the form of sharp mortality disparities across social groups and administrative areas, making Medan City an important case for study. This research aims to analyze mortality dynamics in Medan City within the context of urban demographic and epidemiological transitions, as well as to examine the role of public policy in reducing mortality rates in a sustainable and equitable manner. This study employs a qualitative approach using policy analysis based on Walt & Gibson policy implementation model. The findings indicate that, in general, mortality rates in Medan City have declined over the medium to long term, as reflected in the decrease in infant, under-five, and maternal mortality rates, along with an increase in life expectancy. However, this decline hasn’t been evenly distributed, as disparities remain across administrative areas and socioeconomic groups. Medan City also faces the challenge of a double burden of disease, marked by the dominance of non-communicable diseases alongside the continued presence of communicable diseases among certain population groups. The effectiveness of mortality reduction policies is influenced by the local context, the involvement of relevant actors, the content of policies and programs, and the policy implementation process. Therefore, a policy model is needed that emphasizes equitable resource distribution, the strengthening of primary healthcare services, and integrated cross-sectoral preventive and promotive approaches. This study recommends strengthening policy implementation, improving the capacity of policy implementers, and integrating health policy with other sectors to achieve inclusive and sustainable mortality reduction.]]>
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