CityHealth works with local governments and leaders to drive improvements in the day-to-day life, well-being, and health of residents through a series of evidence-based policy recommendations.

CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, was established in 2017 to help city leadership drive improvements in their communities through evidence-based policy solutions. Each year CityHealth rates the nation’s 40 largest cities in nine policy areas and also awards gold, silver, and bronze medals for their success in adopting these policies.

The policy package was created with a three-part process that considered the evidence base of policies addressing the key social determinants of health; cities’ jurisdictional authority and precedent; and analysis by a policy advisory committee representing key partners, influencers, and community representatives. The goal was to provide city leaders with a pragmatic, achievable, and aspirational package of policies that could align with their city priorities and needs. The policies:

  • Earned Sick Leave. Nobody should have to choose between paying their bills and taking care of themselves or family members when sick. Paid sick leave policies reduce the spread of contagious illnesses, increase employment and income stability, and save cities money in health care costs.
  • Accessible, High-Quality Pre-Kindergarten. 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 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 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 recreational activities. 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.
  • Safer Alcohol Sales. 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 to 21 for the sale of tobacco products greatly reduces the risk for addiction and disease among young people.
  • Smoke-Free Indoor Air. These policies protect non-smokers from the harmful effects of tobacco – which is the nation’s leading preventable cause of death – and they simultaneously reduce smokers’ consumption of tobacco.
  • Food Safety and Restaurant Inspection Ratings. 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. Overall 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 medical costs associated with obesity.


In 2017, the first year of assessments, more than half of cities did not receive an overall medal. In the second year, however, a majority of the cities earned gold, silver, or bronze. In just one year, cities earned 24 new medals for implementing proven policies to better the lives of the people who live, play, learn, and work in their jurisdictions.

At the same time, others still have work to do. Fewer than 13 percent of cities in the top 40 achieved gold — the same as the first year. Fifteen cities still don’t have strong enough policies in any area to warrant an overall medal. In addition, some cities saw a decrease in their medal status in certain areas.

For CityHealth, every unearned gold medal represents an opportunity to use policy as a lever to improve people’s quality of life and well-being, and to help their communities thrive.


If you’d like more information about CityHealth, contact Katrina Forrest at





Bechara Choucair, Sr VP & Chief Community Officer

At Kaiser Permanente, we share the de Beaumont Foundation’s belief that the power of local policy is one of the most promising and effective strategies for transforming health in America, and we are pleased to join them in this important work. The CityHealth initiative provides mayors and other community leaders an opportunity to harness some of that transformational power to improve health, drive down health care costs, and save lives.

Bechara Choucair, Sr VP & Chief Community Officer
Jonathan Fielding, UCLA Distinguished Professor in Residence

When city and county leaders focus on policies that improve people’s well-being and quality of life, their communities and economies flourish. All around, it’s a win-win. I saw that firsthand during my time as director of the Los Angeles County Department of Public Health, and it’s why I’ve been involved in advising the de Beaumont Foundation’s CityHealth project from the start.

Jonathan Fielding, UCLA Distinguished Professor in Residence