Throughout 2025, local leaders navigated a complex landscape, working through shifting policy environments, constrained resources, and evolving community needs. Yet despite these challenges, they continued to show that progress is possible. Cities as catalysts for change, accelerated new policy ideas, tested and refined solutions, and drove progress because residents rely on them to meet their unique needs.
Now and in the future, CityHealth remains focused on what matters most: helping cities succeed. We recognize the headwinds local leaders face, but our role is to equip them with clear, actionable tools and resources. By meeting with officials, sharing best practices, and offering targeted technical assistance, CityHealth strengthens the ecosystem that supports city leadership, helping local governments overcome barriers, celebrate progress, and create lasting change.
Key Findings
- In 2025, 68% of America’s 75 largest cities earned an overall medal.
- 8 cities earned an overall gold medal: Boston, Chicago, Denver, Minneapolis, New Orleans, Portland, San Antonio, and St. Louis — with Chicago earning its first overall gold under the current policy package, having previously earned an overall silver.
- Ten other cities showed progress by improving their medals in 2025, including five that moved from overall bronze medals to overall silver medals: Cleveland, Columbus, Louisville, Nashville, and Oakland. Five cities earned an overall bronze medal for the first time: Austin, Cincinnati, Irvine, Phoenix, and Tulsa.
- CityHealth awarded 434 individual policy medals across all 12 policies, including 175 (+9%) gold medals, 121 (+7%) silver medals, and 138 (-7%) bronze medals.
- Policies with the highest penetration include: High-Quality, Accessible Pre-K (71 medals), Greenspace (58 medals), and Affordable Housing Trusts (46 medals).
Explore the 2025 Medals
Resources for Cities & Partners
2025 Annual Webinar
Register for our 2025 Policy Assessment Webinar on Tuesday, December 16, 2025, to hear leaders from three national local government organizations —the Community Leaders of America, the Democratic Mayors Association, and the African American Mayors Association — discuss the challenges and opportunities that cities will face in the coming year.
📆 Dec. 16, 2025 at 12:00 p.m. ET.
How Does Your City Rate?
See how America’s 75 largest cities stack up when it comes to adopting equitable, health-promoting policies. Cities can earn overall medals as well as individual medals for each of CityHealth’s 12 policies.
