San Antonio only ‘gold medal’ city in Texas, according to CityHealth’s rankings of public health policy

San Antonio on short list of 7 cities nationwide to receive top ranking in 2023, per CityHealth data

SAN ANTONIO – San Antonio recently landed a spot on a list of cities praised for their public health policies aimed at assisting marginalized communities, according to data from CityHealth.

CityHealth is a partnership between the de Beaumont Foundation and Kaiser Permanente that promotes “evidence-based policy solutions that will help millions of people live longer, better lives in vibrant, prosperous communities” in cities across the country.

Each year, the group reviews and awards the nation’s 75 largest cities with gold, silver, bronze or no medals for passing policies that improve the health and well-being of residents.

This year, San Antonio was one of seven cities nationwide and the only city in Texas receiving the recognition, according to a news release from Metro Health. The gold medal recognition is an improvement from last year’s overall bronze medal.

To qualify for overall gold medal recognition, a city had to earn at least five gold medals across 12 individual policy areas identified by CityHealth.

Click here to see more information and specific laws associated with each of the categories mentioned below.

San Antonio’s gold medals for 2023 are in:

  • Affordable Housing Trusts: Investing in building and maintaining affordable housing for everyone.
  • Greenspace: Ensuring all families, not just a few, have access to the benefits of public land and nature.
  • Healthy Food Purchasing: Making sure everyone has access to healthy food choices in public places where we work, play and learn.
  • High Quality, Accessible Pre-K: Safe spaces, paving the way to high school graduation and beyond.
  • Smoke Free Indoor Air: Eliminating the harmful effects of secondhand smoke and vapor, including casinos, gaming venues, bars and multi-unit housing.

The medals are awarded for city laws that meet policy criteria set by CityHealth that “provides an evidence-backed framework that cities can use to help promote health equity and address key public concerns,” a CityHealth news release said.

The city received a bronze medal in Eco-friendly Purchasing

According to CityHealth, “is a policy that requires that the products a city purchases — from furnishings to food ware to cleaning products — be free of toxic chemicals.”

The city’s current policy requires annual reporting. In future assessments, CityHealth wrote that a silver or gold medal could be earned if San Antonio meets two more criteria:

  • Silver - The city has an eco-friendly purchasing policy that meets independent standards for at least one of the following high-priority categories: furnishings, foodware and cleaning products.
  • Gold - The city’s eco-friendly purchasing policy applies to all requests for proposals and contracts.

San Antonio did not receive a medal for five categories, including:

  • Earned sick leave
  • Flavored tobacco restrictions
  • Health rental housing
  • Legal support for renters
  • Complete streets

Complete streets category slips

In 2021, San Antonio earned a gold medal in the complete streets category. However, CityHealth has since strengthened policy requirements for its categories to align with national standards.

San Antonio’s city website describes complete streets as a policy “that supports the creation of a safe, equitable multimodal transportation network through the strategy of requiring that every road construction and reconstruction project makes a street safe and comfortable for all users, preferably with prioritization of investment in communities that have historically been underserved.”

The City of San Antonio adopted its current complete streets policy in 2011.

In a Nov. 29 Transportation and Infrastructure Committee meeting, interim Transportation Director Catherine Hernandez said that while the current complete streets policy has been integrated with city codes and processes, the policy must be updated to match best practices.

Research into those best practices, which involved speaking one-on-one to cities with model complete street policies, showed five key elements missing from the 2011 policy.

  • Performance measures
  • Coordination
  • Design Updates
  • Project Selection Criteria
  • Prioritizing Equity

Hernandez said adding the missing elements would improve CityHealth rankings and Smart Growth America scores. The latter ranked San Antonio as the 20th most dangerous city for pedestrian safety.

Tom Martin, communication director with CityHealth, said the organization actively supports San Antonio’s efforts for its complete streets policy.

“CityHealth has been working with local advocates to support the City of San Antonio’s desire to improve street safety,” he told KSAT. “We assess cities on 13 criteria for their Complete Streets policies, which range from compliance measures to community engagement plans.”

He described how the organization has worked with the city in implementing health-focused policies across other categories.

“We’ve worked closely with Mayor Ron Nirenberg and Metro Health Director Dr. Claude Jacob to support their desire to adopt strong health-promoting policies needed to get the city to an overall gold medal,” Martin said. “This is despite challenges from the state, which has opposed cities from passing policies in certain areas, such as Earned Sick Leave, with legislation and lawsuits.”

San Antonio received gold and bronze medals overall from CityHealth in past years.

“We are grateful for CityHealth’s national recognition of our efforts on the ground,” Metro Health district director Claude A. Jacob said. “It’s been a little bit more rigorous for cities to at least meet these standards. We’re just excited to be recognized as one of the national partners in this mix.”

Jacob said that while the city is gracious for the recognition, work will happen to ensure the policies without medals be remedied.

“We do have a short list of the policies that are in our line of sight so we can continue to make steady progress year over year and maintain our gold designation,” Jacob said. “It is a yearlong endeavor. Some of these policies, we realize will take a little longer, but for now, we’ll focus on the policies that have shown to be most effective here in San Antonio.”

To see more breakdowns part of CityHealth’s 2023 policy assessment, click here.


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About the Authors

Mason Hickok is a digital producer trainee at KSAT. He graduated from the University of Texas at San Antonio with a communication degree and a minor in film studies. He also spent two years working at The Paisano, the independent student newspaper at UTSA. Outside of the newsroom, he enjoys the outdoors, walking his dogs and listening to podcasts.

Courtney Friedman anchors KSAT’s weekend evening shows and reports during the week. Her ongoing Loving in Fear series confronts Bexar County’s domestic violence epidemic. She joined KSAT in 2014 and is proud to call the SA and South Texas community home. She came to San Antonio from KYTX CBS 19 in Tyler, where she also anchored & reported.

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