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Cities Directory
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City Directory Item – Affordable Housing
Coming Soon MedalCity Directory Item – Affordable Housing
City Directory Item – Complete Streets
Coming Soon MedalCity Directory Item – Complete Streets
City Directory Item – Earned Sick Leave
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City Directory Item – Healthy Food
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City Directory Item – Pre-K
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City Directory Item – Housing Laws
Coming Soon MedalCity Directory Item – Housing Laws
City Directory Item – Support for Renters
Coming Soon MedalCity Directory Item – Support for Renters
City List by Policy
Cities with Earned Sick Leave Laws
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- Eco-Friendly Purchasing: A Commitment to Human and Environmental HealthEco-Friendly Purchasing: A Commitment to Human and Environmental HealthArticle
Eco-Friendly Purchasing: A Commitment to Human and Environmental Health
- Legal Support for Renters: Preventative Legal MedicineLegal Support for Renters: Preventative Legal MedicineArticle
Legal Support for Renters: Preventative Legal Medicine
- Legal Support for Renters: Representation Leading to Better HealthLegal Support for Renters: Representation Leading to Better HealthArticle
Legal Support for Renters: Representation Leading to Better Health
- New Report: Earned Sick Leave: How Local Officials Can Improve Public Health and Economic SecurityNew Report: Earned Sick Leave: How Local Officials Can Improve Public Health and Economic Security
New Report: Earned Sick Leave: How Local Officials Can Improve Public Health and Economic Security
- Report: Amid COVID-19 Pandemic and Beyond, Local Officials Can Improve Public Health and Economic Security Through Earned Sick Leave PoliciesReport: Amid COVID-19 Pandemic and Beyond, Local Officials Can Improve Public Health and Economic Security Through Earned Sick Leave PoliciesPress Release
Report: Amid COVID-19 Pandemic and Beyond, Local Officials Can Improve Public Health and Economic Security Through Earned Sick Leave Policies
- Earned Sick Leave: How Local Officials Can Improve Public Health and Economic SecurityEarned Sick Leave: How Local Officials Can Improve Public Health and Economic SecurityPolicy Report
Earned Sick Leave: How Local Officials Can Improve Public Health and Economic Security
- Earned Sick Leave: Protecting the Health of Our WorkforceEarned Sick Leave: Protecting the Health of Our WorkforceArticle
Earned Sick Leave: Protecting the Health of Our Workforce
- Affordable Housing Trusts: A Healthy Housing Choice for CitiesAffordable Housing Trusts: A Healthy Housing Choice for CitiesArticle
Affordable Housing Trusts: A Healthy Housing Choice for Cities
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Default Kit
Explore Our Policies – Page
CityHealth rates the nation’s 40 largest cities based on their progress in adopting an evidence-based policy package.
This policy package was derived using a three-part process that considered:
- The evidence-base of policies addressing the key social determinants of health
- Cities’ jurisdictional authority and precedent
- Analysis by a policy advisory committee representing key partners, influencers, and community representatives
The goal was to provide city leaders with a pragmatic, achievable, yet aspirational, package of policies that could align with their city priorities and needs.
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.
Gold Medal8
Silver Medal9
Bronze Medal19
High-quality, Accessible 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.
Gold Medal22
Silver Medal14
Bronze Medal31
Affordable Housing/Inclusionary Zoning
AAs cities grow, it’s important that residents of all income levels have access to affordable housing that sets them up for good health.
Gold Medal0
Silver Medal0
Bronze Medal0
Complete Streets
Complete streets policies unlock opportunities by allowing city residents to safely walk, bike, drive and take public transit around their community.
Gold Medal6
Silver Medal18
Bronze Medal2
Tobacco 21
Curbing tobacco use among young adults has been shown to decrease the number of people who start – and continue – smoking.
Gold Medal0
Silver Medal0
Bronze Medal0
Smoke Free Indoor Air Policies
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 U.S.
Gold Medal24
Silver Medal5
Bronze Medal8
Safer Alcohol Sales
Earned sick leave laws reduce the spread of contagious illnesses, increase employment and income stability, and save cities money in health care costs.
Gold Medal23
Silver Medal11
Bronze Medal0
Food Safety and Restaurant Inspection Ratings
Policies requiring food establishments to publicly post safety inspection “grades” empower consumers, reduce foodborne illiness rates and cut down on health care costs.
Gold Medal0
Silver Medal0
Bronze Medal0
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.
Gold Medal0
Silver Medal0
Bronze Medal0
Featured Content
First Resource Card
- July 11, 2021
First Resource Card Reverse
- February 22, 2023
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Creating the new gold standard for health and well-being in cities
CityHealth offers the 2019 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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WE BELIEVE
Every person, in every city, deserves to live the healthiest possible life.
Policy Graph
Gold Medal
Silver Medal
Bronze Medal
The state of earned sick leave policies in big US cities
Twenty-three out of 75 cities received a medal for earned sick leave policies, including five golds, six silver, and 12 bronze.
Policy List
Affordable Housing Trusts
Affordable Housing Trusts policies are a community-driven way for cities to invest in building and maintaining affordable housing for everyone.
Gold Medal0
Silver Medal0
Bronze Medal0
Complete Streets
Streets should be designed and maintained to meet all our needs. Whether you walk, bike, roll, drive, or use public transit, we all deserve streets that are safe.
Gold Medal6
Silver Medal18
Bronze Medal2
Earned Sick Leave
When we’re sick or injured, we need paid time off from work to rest and heal. Cities that require companies to offer Earned Sick Leave ensure that all employees feel secure in their jobs when they fall ill — and keep communities healthy by stopping the spread of contagious illness.
Gold Medal8
Silver Medal9
Bronze Medal19
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Our Policy Package
Earned Sick Leave
Earned sick leave laws require employers to allow people to take paid time off for illness or injury for themselves or their family members. The quality of cities’ policies is linked to how many family members and what size employer are covered by the law, as well as the number of hours people can earn. Done well, these policies reduce the spread of contagious illnesses, increase employment and income stability, and save cities money in health care costs.
Our assessment of earned sick leave policies includes information about city-specific laws, along with the relevant county- and state-level laws that affect them. This cross-sectional dataset displays laws valid through August 1, 2019, including those passed but not effective until later dates.
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Our Policy Package
High-quality, Accessible Pre-Kindergarten
Done right, all children benefit from early childhood education, regardless of family income or zip code. High-quality pre-k improves children’s school readiness and success: they enter school better prepared and are less likely to repeat a grade or be referred to special education. Long-term benefits include higher high-school graduation rates, lower rates of crime and teen pregnancy, higher lifetime earnings, and better health outcomes.
CityHealth’s assessment of pre-k quality is based on the National Institute of Early Education Research’s 10 research-based quality standards benchmarks, along with an assessment of the level of enrollment in the city’s largest pre-k program. These benchmarks are consistent with what research suggests as minimums for highly effective programs. Data are based on assessments as of September 30, 2020. For details on quality benchmarks and how data were collected, please download the research protocol at the bottom of this page.
Gold Medal
Silver Medal
Bronze Medal
*Out of the Nation’s 40 Largest Cities
The state of high-quality pre-k in big US cities
Thirty-three out of 40 cities received a medal for high-quality pre-k, including 15 gold, three silver, and 15 bronze.
Measuring big cities’ high-quality pre-k programs by Quality and Enrollment
| How did we award high-quality pre-k medals? |  Bronze Medal |  Silver Medal |  Gold Medal |
|---|---|---|---|
| Meets 8 out 10 quality benchmarks for a Pre-K program (For detailed breakdown, please see the Data Deep Dive section below) |  |  | |
| Over 30% of children enrolled in Pre-K programs | | | |
Data Deep Dive
Data were created and maintained by the Center for Public Health Law Research and the National Institute of Early Education Research (NIEER).
Related Resources
- Press Release
- December 20, 2022
High-quality, accessible pre-k medal table
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- Gold City
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Related Resources
Related Resources
- Press Release
- December 20, 2022
Resource Card
- July 11, 2021
Resource Feed (with Featured Item)
- Article
- February 13, 2024
Stats
Making an Impact
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.3
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people live in a city with an overall medal
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individual policy medals earned by cities in 2021
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cities earned a 2021 overall medal
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Our Policy Package
Who We Are
CityHealth, an initiative of the de Beaumont Foundation and Kaiser Permanente, advances a package of evidence-based policy solutions that will help millions of people live longer, better lives in vibrant, prosperous communities. CityHealth regularly evaluates cities on the number and strength of their policies.
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WYSIWYG
Cities’ housing markets and the quality of housing stock varies across the US, which means the best policy approaches will be comprehensive commitments to ensuring affordable, safe, quality options for all. While IZ works best in “hot” markets to promote affordable options alongside new development, it’s an important policy for all cities to consider before demand outstrips supply. For a more detailed discussion of inclusionary zoning and affordable housing policy, see the policy brief at the bottom of this page.
Our assessment of inclusionary zoning includes information about city laws valid through June 1, 2020, including those passed but not effective until later dates.
