CityHealth – A Project of the de Beaumont Foundation and Kaiser Permanente

Every person, in every community, deserves to live the healthiest possible life. And policy is one of our most powerful tools to improve people’s lives and make cities thrive.

Today, more than three of five Americans live in a city–and that number is rising. It’s more than a demographic shift. It’s an opportunity. Because cities can improve the odds for millions of people by making sure the rules of the game allow everyone, especially the most vulnerable, to have a fair shot at a good life.

We’re seeing it happen across the country. Cities are where innovative solutions are born, tested, and proven. In an era where other levels of government are locked in partisanship, cities have led the way in raising the minimum wage, requiring developers to provide affordable housing, and pioneering transportation innovations that unclog our streets and keep our air clean.

The de Beaumont Foundation’s CityHealth project provides city leaders with a package of policy solutions that will help millions of people live longer, better lives in vibrant, prosperous communities and an assessment of how our nation’s largest 40 cities fare on those policies. All of our recommendations are based in evidence, backed by experts, and have a track record of bipartisan support.

2018 Medals

In CityHealth’s most recent assessment, released in May 2018, a majority of the cities—25 cities total—earned a gold, silver, or bronze medal: Five cities – Boston, Chicago, New York, Los Angeles and San Jose – earned a gold medal overall, demonstrating that those cities’ leaders have used powerful policy tools to enhance their city’s health, well-being, and economic vitality. Nine cities earned an overall silver medal, and 11 cities earned an overall bronze medal. Last year, only 19 out of 40 of the largest cities medaled. To see how cities rate on each of the nine policies, and overall, visit

The Policies

Paid Sick Days

No one should have to choose between caring for themselves or sick family members and paying their bills. Paid sick policies reduce the spread of contagious illnesses, increase employment and income stability, and save cities money in health care costs.

Universal, High-Quality Pre-Kindergarten

Done right, all children benefit from early childhood education, regardless of family income or zip code. Access to high-quality pre-k benefits children and their communities throughout the course of their entire lives – it raises children’s lifetime wages, high-school graduation rates and years of education completed, reduces crime and teen pregnancy, and improves health outcomes.

 Affordable Housing and Inclusionary Zoning

Stable, safe, healthy, and affordable living conditions benefit everyone, and are crucial to children’s lifelong achievement. Affordable housing promotes diverse, inclusive neighborhoods and positive mental health, reduces crowding and exposure to environmental hazards, and frees up resources to pay for health care and healthy food.

 Complete Streets

We all need safe, convenient ways to get around our communities – whether that’s getting to work, getting your families to school, or enjoying recreation and active living. Complete streets policies harmonize safety with the needs of all forms of transportation from walking, to biking, driving or taking the bus. These policies expand economic growth, improve individuals’ health, and can save lives.

 Alcohol Sales Control

We all want our neighborhoods to be safe places to live, work, and raise families. Neighborhoods with high concentrations of alcohol outlets are linked to more drinking and higher rates of violence and driving under the influence. Policies that address a high density of alcohol outlets can reduce crime, increase safety and reduce spending on health care and criminal justice costs.

 Tobacco 21

Preventing tobacco use has already had a dramatic effect on our country yet smoking tobacco remains the single most preventable cause of death and disease. Policies that raise the minimum legal age for the sale of tobacco products to 21 reduce the number of young people using these products which greatly reduces their risk for addiction and disease.

 Clean Indoor Air

Everyone should have access to clean air. These policies protect non-smokers from the harmful effects of tobacco – which is the largest preventable cause of death – and they reduce smokers’ consumption of tobacco at the same time.

 Food Safety and Restaurant Inspection Ratings

Nearly half of the money we spend on food is in restaurants. Consumers should be empowered to make informed decisions before entering a restaurant to reduce their risk for foodborne illness. Policies that require food establishments to publicly post food safety inspection grades empower consumers, reduce foodborne illness and save on health care costs.

 Healthy Food Procurement

Everyone benefits from access to high quality, affordable food options. Our health is heavily influenced by what we eat, and what we eat is heavily influenced by the quality, variety, and cost of food served in our workplaces, schools, and other community institutions. Policies that ensure food sold and served in city buildings meets basic nutritional standards can provide more residents with affordable and healthy food choices and reduce some of the high medical costs associated with obesity.

Learn More

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