The Centers for Disease Control and Prevention estimates that chronic diseases account for about 75 percent of health care costs and 70 percent of deaths. The costs of treating diabetes, heart disease, hypertension, cancer, and other noncommunicable diseases pose a staggering burden to society, particularly for disproportionately affected low-income and minority populations. What’s more, fully half of Americans will be obese—not overweight, but obese—by 2030, and more than a third of the nation’s youth are either currently overweight or obese.



In light of this epidemic of chronic diseases and their costs, disease prevention— principally through health and wellness promotion—is critically important. While the causes of chronic disease reach deep into our society and far beyond the purview of local government, innovative leaders can fight chronic disease by using health as a framework for planning, policies, and decision making. In fact, many local governments have taken progressive efforts to reduce and prevent chronic diseases among their residents, establishing wellness plans to guide city efforts across departments, evaluating the health effects of all policies (such as transportation, infrastructure, and safety), increasing residents’ access to fresh foods, directly increasing opportunities for daily active living, and providing outreach and education to promote these efforts.


Women’s Health

While many decisions about women’s health are determined at the state or federal level, cities have unique opportunities to dramatically impact women’s access to health care as well as the social and physical determinants of their health.

Opioid Epidemic

As the opioid epidemic has swept across the country, cities must take the lead in addressing the epidemic. Taking a public health approach, instead of criminalization, is key to rolling back and preventing its spread.  

Combating Childhood Obesity

Seventeen percent of children in the U.S. are obese. Cities across the country are using a variety of tools to combat this trend, including land use planning, parks, pedestrian infrastructure, taxation, education and more. 

Increasing Access to Healthy Local Food

Within cities, residents face stark disparities in their access to fresh, healthy produce, with low-income communities often the most affected by this limited access. 

Mental Health

While counties and health providers are the most common providers of mental health services, cities have been stepping up to better link residents to care and reduce harms associated with police and other governmental interactions.