It was down from 28th in the 2022 Good Growth for Cities Index.
Wolverhampton and Walsall performed above the UK average on work-life balance, income distribution and safety indicators, and in line with the UK average on health, affordability of housing, transport and the environment.
The index outlined areas for improvement as jobs, income, new business, skills and high streets.
Cities across the West Midlands ranked above UK average for work-life balance, measured by an increase in the proportion of employed people working less than 45 hours a week, and income distribution, measured by the ratio of median to mean income – an indicator of wealth equity.
Stoke-on-Trent is forecast to grow the most in the next two years, and was the third most overall improved city included in this year's index.
The Demos-PwC index ranks 50 the largest cities – those with populations of at least 350,000 people.
The report suggests that the West Midlands is expected to see the second weakest economic growth in both 2023 and 2024, with a growth rate of minus 0.2 per cent in 2023 and 0.74 per cent in 2024. This growth is lower than the UK average of 0.05 per cent in 2023 and 0.99 per cent in 2024.
Birmingham was the lowest performing West Midlands city in this year's analysis, ranking 47th out of 50 UK cities in the Index, decreasing from its 2022 ranking of 46th. Coventry was ranked 27th out of 50 UK cities in this year’s analysis, down from 21st in 2022. C
Stoke-on-Trent is ranked 21st, improving from 26th.
Oxford, Swindon, Exeter, Bristol and Southampton make up the top five cities in the overall Index. Cities in the lower performing end of the Index include London, Bradford, Middlesbrough and Stockton, Birmingham and Manchester.
Oxford is the top performing city, with a strong performance on economic measures such as income, employment rates and life expectancy helping it to maintain first place. However it is improving at a slower rate than lower performing cities, such as Bradford.
Matthew Hammond, PwC UK Midlands regional market leader and Birmingham senior partner, said: “The PwC 2023 Good Growth for Cities report highlights key areas in which the West Midlands performs below the UK average, including overall economic growth.
"The 2022 PwC economic outlook analysis showed that the region's economic output remained around 3.3 per cent smaller than pre-pandemic levels and identified the Midlands as one of the regions with most potential for growth The post-pandemic opportunities which will drive inclusive growth across the region are centered on our growth stock sectors - advanced manufacturing, med tech and life sciences, digital and creative technologies, future mobility and low carbon technologies, supported by financial, business and professional services. Future growth sectors should be used as a roadmap of opportunity, with continued support from public and private businesses, our world class universities, local and central government.
"Combined with ambitious plans for the continued regeneration of our towns and cities, connected by several of the most significant real estate and infrastructure projects in the UK, the medium and long-term transformation opportunities are clear but yet to be fully realised."
Neil Rami, chief executive of the West Midlands Growth Company, said: “Due to its industrial mix and demography, the West Midlands economy has been disproportionately affected by the impact of the Covid pandemic and new trade frictions with the EU. However, early indicators show the overwhelmingly positive impact of the Birmingham 2022 Commonwealth Games, which WMGC are witnessing first-hand through the growing, pan-regional demand from both inward investors and tourists. It is vital that the West Midlands Deeper Devolution Deal is fully realised as an important mechanism for public reform, in order to address the inequalities faced by our communities.”