CityHealth has released its ninth annual policy assessment of the 75 largest U.S. cities.

This year, CityHealth awarded 51 cities (68%) with overall gold, silver, or bronze medals, with one city moving from silver to gold, four cities moving from bronze to silver, and five cities earning an overall bronze medal for the first time. Approximately 47.6 million people live in a city that has earned an overall medal — an increase of nearly 4 million people compared to 2024.

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 cityhealth.org/2025-assessment/

Eight exemplary cities rose to the top by earning overall gold medals: 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. 

In addition to Chicago, 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.

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.