This review of seven Healthy People goals for the nation's 100 largest cities and their surrounding areas documents considerable but inconsistent progress toward improving health in urban and suburban America. It describes, for the first time, achievements in reaching Healthy People 2000/2010 objectives for a set of infant health and infectious disease indicators, and homicide. On average, the cities and their suburbs met or made progress toward meeting Healthy People 2000 goals for infant mortality, AIDS, tuberculosis, syphilis, and homicide between 1990 and 1999 or 2000. Low birth weight rates moved away from the 2000 target for both cities and their suburbs, on average, and the downward trend in gonorrhea rates reversed in many cities in the last half of the 1990s. The findings underscore the uncertainty around sustaining the progress made by many of these areas and the challenges that persist. This report uses national sources of information from various agencies of the Centers for Disease Control and Prevention, the Federal Bureau of Investigation, and the Bureau of the Census on the 100 largest cities, and their counties and greater metropolitan areas to compare cities to their surrounding suburbs. For indicators with data available for fewer than the 100 cities, the subset is comprised primarily of the largest cities and/or their greater metropolitan areas. While some communities have met many goals, virtually all have fallen short of key targets, and rates rose for some specific indicators during the last decade. Broad-based efforts, as well as targeted ones, are needed to ensure that cities and suburban communities do not lose the gains they have made.