CityHealth offers the 2018 updated assessment of how our nation’s 40 largest cities fare when it comes to policies that can make real, lasting impacts in people’s everyday quality of life. All of our recommendations are based in evidence, backed by experts, and have a track record of bipartisan support. Learn what’s happening in a city near you.

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CityHealth awarded each city an overall gold, silver, bronze, or no medal, according to their performance in the assessment. The group also awarded nine policy-specific medals to each city, according to the quality and strength of the laws in place.

CityHealth ratings are an assessment of how the nation’s 40 largest cities fare in nine policies based in research, coded by our legal researchers.

Earned Sick Leave

Earned sick leave laws reduce the spread of contagious illnesses, increase employment and income stability, and save cities money in health care costs.

High-quality, Universal Pre-Kindergarten

Children who attend high-quality pre-k are more likely to succeed in school, go on to stable jobs and earn more as adults—all of which are linked to better health and stronger communities.

Affordable Housing/Inclusionary Zoning

As cities grow, it’s important that residents of all income levels have access to affordable housing that sets them up for good health.

Complete Streets

Complete streets policies unlock opportunities by allowing city residents to safely walk, bike, drive and take public transit around their community.

Alcohol Sales Control

Neighborhoods with high concentrations of alcohol outlets are linked to more drinking and higher rates of violence and driving under the influence. Policies that control the number of alcohol sales outlets can reduce crime, increase safety, and reduce spending on health care and criminal justice.

Tobacco 21

Curbing tobacco use among young adults has been shown to decrease the number of people who start—and continue—smoking.

Smoke Free Indoor Air

Comprehensive smoke-free air laws protect non-smokers from secondhand smoke and reduce smokers’ consumption of tobacco—the leading cause of preventable death in the US.

Food Safety and Restaurant Inspection Rating

Policies requiring food establishments to publicly post safety inspection “grades” empower consumers, reduce foodborne illness rates and cut down on health care costs.

Healthy Food Procurement

Policies that make sure healthy food options are available on public property aid city residents in making smart decisions that will help them achieve and maintain a healthy weight.
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