Portland receives gold medal from CityHealth
After several years of earning bronze, then a silver medal in 2022, Portland earned one of only seven 2023 CityHealth gold medals awarded to cities across the United States for implementing policies that promote health equity and address key public health concerns across the most marginalized communities.
In Portland, many of the evaluated policy areas represent a mix of city- and county-level policies. Multnomah County’s restriction of flavored tobacco sales, which was passed by the Board of County Commissioners in December 2022, was key among the recent policy initiatives pushing our region from silver to a gold medal rating.
Multnomah County Health Department Director Rachael Banks and Kaiser Permanente Government Relations Director for the Northwest Region Elizabeth Edwards on Tuesday, March 5, briefed the Board of County Commissioners about the ongoing CityHealth initiative.
“I wanted to take this opportunity to celebrate this achievement together as a board whose work has contributed not just to achieving this distinction, but to building a community that is truly focused on health and wellness,” said Chair Jessica Vega Pederson. “We know that moving major public health policy takes dedication, discipline and work over the course of years, as is the case with our restriction on flavored tobacco products, which helped us get gold.”
The CityHealth initiative by the de Beaumont Foundation and Kaiser Permanente annually awards the nation’s largest cities with gold, silver or bronze medals across different policy areas that improve quality of life, address health disparities and inspire healthy choices among communities. In addition to Portland, six other cities qualified for an overall gold recognition by earning at least five gold medals across 12 individual policy areas identified by CityHealth: Boston, Denver, Minneapolis, New Orleans, San Antonio and St. Louis.
“This is a wonderful opportunity to acknowledge you all and the difficult work to pass really leading policies for our region,” said Edwards. “The flavored tobacco restriction really helped to put us over the top this year. I want to just offer a huge thank you to the County Commission for being a leader in this space and for taking decisive action.”
Chair Vega Pederson acknowledged the role the City of Portland played in helping achieve the gold medal ranking. “I know some of the bigger policies we talk about are areas like the flavored tobacco ban and access to preschool, but there are policies like the transportation investments, the parks and green space investments that are directly related to the City’s work.”
Banks walked the Board through a timeline of behind-the-scenes efforts that ultimately resulted in the December 2022 approval of the restriction on flavored tobacco sales.
“So much work went into passing this thoughtful policy, including bringing together community wisdom, research and data, and community partnerships,” said Banks. “The gold medal represents a response to health outcomes and a definitive action that says we’re not going to tolerate health inequities in our communities and was many years in the making.
“I want to send a sincere thank you to this Board, to health system partners, community-based organizations, youth, educators, parents, County Health Department staff, and all the voices that have both been seen and behind the scenes.”
In 2023, Portland earned six gold medals in the following policy areas:
- Flavored tobacco restriction
- Affordable housing trusts
- Complete streets
- Eco-friendly purchasing
- Greenspace
- Smoke-free indoor air
Portland also earned a silver medal for high-quality and accessible pre-K, as well as two bronzes for healthy rental housing and earned sick leave policies.
More information regarding the 12 policies that were measured can be found on CityHealth’s website. CityHealth’s latest full report rated 46 of America’s largest cities.
Board comment
Commissioner Julia Brim-Edwards asked how CityHealth integrates emergency or episodic events that have huge impacts on the community when looking at indicators of a healthy community.
“There are lots of external signs of an unhealthy part of our community and just a huge negative impact on people's health because of the fentanyl and meth crisis,” said Commissioner Brim-Edwards.
Edwards responded that one of the reasons to celebrate the gold medal is that it shows the longer-term work around creating a healthy community.
“What we’re experiencing now is the accumulation of some failures at the federal, state and local level that's created a crisis on our streets,” she said.
“But that is related to folks having safe places to live, access to economic opportunities and access to healthy environments. It’s about maintaining the good work overall on that longer arc and having space and time and attention to address the emergent issues that are coming before us.”
“So many of the root causes of preventable deaths are driven by the legacies of racism and discrimination in this country, and are really hard to index and make measurable impacts on,” said Commissioner Jesse Beason, “so I appreciate the effort of trying to get what is measurable.
“I also want to appreciate the County's leadership in the work on tobacco. I was definitely swayed by plenty of big tobacco structures in my youth that had an impact on my community.”
Commissioner Sharon Meieran expressed concern for what is being measured over the long term to ensure that the policies on paper are actually having impacts on the public’s health.
“These things are challenging for me to hear in the context of what I see in the real world, but I appreciate the presentation,” said Commissioner Meieran. “I appreciate the efforts that you’re making and I hope you can speak to how these policy areas are tied to the reality in the world of what we're seeing and how that will be measured.”
“We’ve achieved some of the things we sought out to do,” Banks responded. “But we still have additional work to do with both the policies that are in the CityHealth portfolio, but also additional policies that we are talking about and will be grappling with in the days and months to come.
“Part of the reason we wanted to come before you today to celebrate is to bolster and thank you for that longer-term, longer-horizon important work while acknowledging there’s more that needs to be done. The upstream work can’t fall off while addressing the really urgent needs on the street.”
“Celebrating the fact that Portland has gotten this gold medal today is because we have done hard, big, difficult things before,” said Chair Vega Pederson. “We have gained distance on things that have been incredibly damaging public health issues for our community members. We have a lot of really important things to look back on that we’ve done and we have a lot of important work to do in the future.”