CityHealth’s latest policy assessment of the 75 largest U.S. cities found that in 2024, city leaders, state legislatures, and voters adopted or strengthened evidence-based policy solutions to improve health. This year, CityHealth awarded 47 cities (63%) with overall gold, silver, or bronze medals, with eight cities moving from bronze to silver and one city earning a bronze for the first time.

Conducted since 2017, CityHealth’s annual assessment found that Greenspace and High-Quality, Accessible Pre-K rose to the top as the most-adopted solutions, while policies like Eco-Friendly Purchasing and Legal Support for Renters saw slower uptake, representing prime opportunities for policy adoption in 2025. CityHealth is an initiative of the de Beaumont Foundation and Kaiser Permanente. Cities can earn individual gold, silver, or bronze medals in CityHealth’s 12 policy areas, with overall medals awarded to cities earning five 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, paid sick leave, greenspace access, and more.

Seven exemplary cities rose to the top by earning overall gold medals: Boston, Denver, Minneapolis, New Orleans, Portland, San Antonio, and St. Louis — each of which also earned an overall gold medal in 2023.

Nine cities showed progress by improving their medals in 2024, including eight that moved from overall bronze medals to overall silver medals — Albuquerque, Aurora, Baltimore, Lincoln, Long Beach, Sacramento, San Diego, and Santa Ana. One city, Omaha, earned its first overall medal, a bronze.

CityHealth partners with the Center for Public Health Law Research at Temple University’s Beasley School of Law and other evaluation partners to surveil the laws and policies and rate the cities on their combined quality and quantity of policies in place in the 12 policy areas.