I'm fairly certain my outside cats are not suffering, they are healthy and robust. My unscientific observation is if I don't have barn cats I have mice. If I do have barn cats, not so much. Perhaps in the city this doesn't work as well but it certainly does in a rural setting. I'm of the mindset that animals belong outside most (if not all) of the time. Perhaps that is an old fashioned view in these days of coddling and dressing up pets. But, works for me.
Edited to add: I don't mean to come across as snarky - just offering an alternate opinion re in/out cats based largely on urban/rural differences.
