Are Cities Implementing Heart Health Policies?

The de Beaumont Foundation analyzed 40 cities' public health policies and Tobacco 21 ordinances.


As part of its heart health mission, the American Heart Association (AHA) is looking at how cities measure up when it comes to health policies. More than half of the largest U.S. cities don't have the policies in place to improve health, according to an AHA partner.

The news is based on the recent CityHealth Initiative analysis by the de Beaumont Foundation, which looked at public health policies of the 40 largest U.S. cities from Dec. 29, 2014-June 10, 2016. City health studies typically compare death and obesity rates, but the foundation is looking upstream at the inherent factors that contribute to higher rates -- factors that municipal policies can help address.

While CityHealth showed some cities are making progress toward meeting AHA recommendations in:

Only 19 cities analyzed rated gold, silver or bronze medals on the initiative's two-year old scale, which looks at nine policy areas overall. In addition to the AHA-recommended health policy categories, CityHealth also looks at how cities address:

Twenty-one of the cities earned three or fewer individual medals in the nine health policy areas.

"Cities across the nation should focus on heart-healthy policy change in all neighborhoods to move their communities forward. Walkable, smoke-free communities with access to healthy foods ensure that families can live healthier lives,” said Eduardo Sanchez, M.D., chief medical officer for prevention and chief of the Center for Health Metrics and Evaluation for AHA.

Tobacco 21 Ordinances

While 36 of the cities have some form of smoke-free air laws, only 13 cities earned medals for having laws that restrict people under 21 from buying tobacco.

A closer look at the CityHealth research protocol and policy document for Tobacco 21 laws revealed that CityHealth used the Westlaw database to search relevant city ordinances.

According to CityHealth, raising the minimum legal sale age of tobacco products to 21 reduces lifelong usage rates.

Research shows that raising the tobacco sales minimum age to 21 years would decrease tobacco retailer and industry sales by approximately 2 percent but could contribute to a substantial reduction in tobacco use and addiction," according to the foundation's Tobacco 21 policy breakdown document.

Citing research by the National Academy of Medicine, Tobacco 21 policies account for a 25 percent decline in smoking initiation by 15-17 year olds, and a 12 percent drop in overall smoking rates.

Within five years, 16,000 pre-term birth and low-birth weight cases could be averted. And over 50 years, more than $212 billion could be saved in tobacco-related medical and other costs.

Connected Policies Improve Public Health

It's not just one policy that earns the CityHealth gold standard. It's a mix of factors that make it city life healthier.

“The ability to eat in a restaurant that doesn’t expose you to second-hand smoke is important, just as it’s important to know the food is safe before you go into that restaurant. Eating healthy food in a city facility is important, but so is your ability to walk to that facility or school,” said  Ed Hunter, president and chief executive of the de Beaumont Foundation.

Cities that received five or more CityHealth individual gold medals received a gold medal overall--those cities are Boston, Chicago, Los Angeles, New York and Washington D.C. Cities like Philadelphia and several in California received silver overall medals overall, and places like Denver and Kansas, City, Mo., earned bronze overall medals.

The foundation will monitor the progress of the 40 cities analyzed over the next three years and are offering technical assistance to each city to help it improve its health policies.

Read the original story on the AHA website.

Access information about the 2018 report.

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