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46 of America’s Largest Cities Garner Top Policy Medals in CityHealth’s 2023 Assessment

CONTACT: Tom Martin / 

Seven Cities Rise to the Top by Earning Overall Gold Medals

WASHINGTON, DC — DECEMBER 5, 2023 — Today, CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, released its 2023 annual policy assessment of the largest 75 cities in the United States, finding significant progress made by cities advancing health-promoting, prevention-oriented policies that support community health. This year, 46 cities (61%) were awarded overall medals, up from 37 cities (49%) in 2022. More than 43 million people live in a city that has earned an overall medal — an increase of more than 4 million people compared to last year. The findings suggest that local leaders continue to prioritize health as they seek solutions to a diverse set of challenges — from a lack of affordable housing to mitigating the effects of climate change and extreme weather.

“We are thrilled to see more than half of the largest cities across the country increasingly adopting health-oriented policies aimed at addressing pressing challenges that are faced by communities,” said CityHealth Co-Executive Director Katrina Forrest, JD. “Our local leaders are operating at the intersection of complex and convergent issues; everything from homelessness and housing affordability to food insecurity. This growth is encouraging as it clearly shows that local leaders are seeing the critical role they play in promoting health equity through policy.”

This year, seven cities — Boston, Denver, Minneapolis, New Orleans, Portland, San Antonio and St. Louis — have succeeded in earning overall gold medals. These cities qualified for overall gold by earning at least five gold medals across 12 individual policy areas: Boston, Minneapolis and Portland earned seven gold medals; and Denver, New Orleans, San Antonio and St. Louis earned six gold medals. (See the full overall medal list below.)

“Working alongside city leaders and partners, our goal is to empower local stakeholders to transform health outcomes across the country,” said CityHealth Co-Executive Director Catherine Patterson, MPP. “The CityHealth model serves as a framework to equip leaders, policymakers and residents with tools to drive meaningful health improvements in their cities to help them lead healthier lives today and in the future.”

Cities can earn individual gold, silver, or bronze medals in CityHealth’s 12 policy areas, with overall medals awarded to cities earning 5 or more individual policy medals. The medals are awarded for city laws that meet CityHealth’s policy criteria, which provide an evidence-backed framework that cities can use to help promote health equity and address key public health concerns such as affordable housing, earned sick leave, access to greenspace, and more.

CityHealth assessment press release quote: “Vibrant, healthy communities are a result of effective policies and programs,” said Brian C. Castrucci, DrPH, MA, president and CEO of the de Beaumont Foundation. “The CityHealth assessment serves as a valuable benchmark for evaluating cities’ efforts in improving community health. We are pleased to see the progress made from the last assessment, and we are hopeful for more progress to be accomplished in more cities across the country.”

Two policy areas that saw significant movement in 2023 were Affordable Housing Trusts and Greenspace. With the end of most pandemic-era funding that supported local health-promoting initiatives, cities are increasingly adopting laws that address the housing crisis and access to public outdoor space. Over half (59%) of cities earned a medal for their Affordable Housing Trusts policies to help ensure sustained funding for affordable housing projects. Similarly, 69% of cities earned medals for their Greenspace policies, with many prioritizing investments in parks that are driven by principals of equity.

“Cities are uniquely positioned to create community conditions that promote health and wellbeing,” said Bechara Choucair, MD, senior vice president and chief health officer at Kaiser Permanente. “The CityHealth initiative is proud to support localities in adopting evidence-based health policies that give everyone the opportunity to thrive.”


CityHealth, in partnership with the Center for Public Health Law Research at Temple University’s Beasley School of Law and other evaluation partners, rated America’s 75 largest cities based on the criteria established for each of the 12 policy solutions (listed below) using gold, silver and bronze medals. For complete results, including individual medals by policy area, go to:



  1. Boston
  2. Denver
  3. Minneapolis
  4. New Orleans
  5. Portland
  6. San Antonio
  7. St. Louis


  1. Atlanta
  2. Chicago
  3. Kansas City
  4. Los Angeles
  5. Milwaukee
  6. New York
  7. Newark
  8. Philadelphia
  9. Pittsburgh
  10. San Francisco
  11. San Jose
  12. Seattle
  13. St. Paul
  14. Washington, DC


  1. Albuquerque
  2. Anaheim
  3. Aurora
  4. Baltimore
  5. Cleveland
  6. Colorado Springs
  7. Columbus
  8. Dallas
  9. Detroit
  10. Fort Worth
  11. Fresno
  12. Henderson
  13. Houston
  14. Indianapolis
  15. Lincoln
  16. Long Beach
  17. Louisville
  18. Nashville
  19. Oakland
  20. Riverside
  21. Sacramento
  22. San Diego
  23. Santa Ana
  24. Stockton
  25. Tucson


CityHealth’s tried and tested policies help all people in our nation’s largest cities have access to have a safe place to live, a healthy body and mind, and a thriving environment. Learn more: