Cities of Opportunity
Healthy People, Thriving Communities

Levers for City Action

Undergirding the cities’ work in the issue areas in the Agenda for Action are core, foundational capacities to drive city action. These levers are broadly applicable and generalizable to all issue areas cities may address. They also help cities zero in on the key populations and issues that most need action, and to leverage resources and strategies for lasting impact.

Civic Engagement – Residents have an authentic role in decisions that affect their lives and can inform policy to build consensus around key issues.
City actions include engaging residents in Participative Planning, using asset-based approaches to community development, and deploy tools to strengthen public participation.

Data – Strategic use of data to identify issues and populations to inform focused solutions and impact with a focus on disadvantaged groups.
City actions include increasing data availability and transparency, using disaggregated data to identify issues and impact on specific populations, and using data on community benefit investments to advance partnering with hospitals and health systems.

Equity Lens – Intentional focus to better tailor and target efforts where they are needed the most.
City actions include establishing processes and accountability for consistently ascertaining the impact of actions on groups that might be disproportionately burdened or unintentionally advantaged, using data in disaggregated ways to zero in on issues and solutions, demonstrating concentrated challenges in specific areas of a city, among other efforts.

Financing – Identify and leverage resources available to the city (directly and indirectly) to ensure financial resources are available to reach desired outcomes.
City actions include doing an inventory of potential funding sources (federal/state/local, public/private/philanthropic) available to the city, optimizing financing mechanisms to optimize health, and opportunities to leverage dollars that the city is already spending.

Multi-Sector and Inter-Disciplinary Collaboration – Work with diverse partners across the community and city agencies to align actions and further grow relationships and stakeholders in the city’s success.
City actions include convening stakeholders across sectors and leaders across city agencies to learn about each other’s work and identify paths for better aligning and collaborating, engaging unusual partners in city priorities, and system-wide improvement plans such as Community Health Assessments and Community Health Improvement Plans for the municipality.

Sustainability – Embed in strategies from the front end to ensure solutions are lasting.
City actions include institutionalizing partners so there is a stable set of accountable stakeholders across mayoral terms, working with anchor institutions (health systems, universities, large nonprofit, philanthropic organizations) who are rooted in the city, and partnering with CDFIs local to each municipality.

Cities can ensure all assets are leveraged and directed towards desired outcomes in a coordinated fashion, and that the influence of mayors, city leaders and key stakeholders are marshalled together to improve outcomes for vulnerable city residents.