Urban health is increasingly central to contemporary planning, yet its operationalization remains challenging due to the multidimensional and often heterogeneous nature of determinants influencing quality of life. The Healthy City paradigm developed by the WHO has, over the years, worked to prioritize actionable policy responses. The paper presents a methodological framework that links the DPSIR (Driver-Pressure-State-Impact-Response) model with the Analytic Hierarchy Process (AHP) to support municipal decision-making for Healthy City Strategies. DPSIR offers a diagnostic framework to identify and categorize negative factors affecting urban health, while AHP provides a transparent, quantitative method to rank potential policy responses. Indeed, the decision-support tool Decision Mentor was adopted to perform AHP evaluations, leveraging its intuitive interface and privacy-oriented architecture. The methodology was applied to Stradella, an Italian medium-sized municipality, located in the Southern part of Pavia province, currently engaged in renewing its Territorial Government Plan (PGT). The priorities coming directly from the local administration were used to define the evaluation criteria and choices. Results demonstrate how the proposed framework supports evidence-based prioritization, enhances strategic coherence, and provides replicable insights for medium-sized European municipalities.