Community Context 

Located next to Lake Erie, Toledo serves as the seat for Lucas County. The city’s economic history is rooted in automotive manufacturing and manufacturing of materials such as glass and insulation. The region is now home to four Fortune 500 companies, but small businesses comprise about 45% of businesses in the region. 

Toledo has had a Democratic mayor for several years. Toledo has a shared city-county health department, which supports all of Lucas County. Obesity remains a significant health concern in Toledo, as almost 40 percent of adults are overweight or obese. 

Within Toledo, there is racial segregation, with more people of color in the city than in surrounding suburbs. Disparities in health outcomes also exist with Black and Latino individuals at higher risk for a range of physical and mental health outcomes. 

While quick actions by the governor and local health department at the start of the COVID-19 pandemic have been commended as important in slowing the initial spread of the virus in the city, many remain hesitant to get the COVID-19 vaccine.

Toledo’s Journey to Promote Health, Well-Being, and Equity

Toledo’s community capacity is rooted in a strong presence of anchor institutions in the health sector, with remaining needs being met by and in collaboration with committed nonprofits, businesses, and government entities.

Stakeholders in Toledo were working on initiatives to support the well-being of the community before 2017 and this work has continued. Initiatives today are focused on supporting the next generation of Toledo residents through a cradle-to-career approach, beautifying spaces and promoting a sense of belonging, and promoting equity and racial justice through formalized agendas and investments. Over the past five years, a focus on the social determinants of health in Toledo has remained, bolstered by additional investments and an increase in understanding around the connection between quality housing, education, transportation, and physical and mental health. However, stakeholders are mixed in their opinions as to whether this mindset has translated into meaningful action to address root causes of these challenges and longstanding inequity.

Baseline research started in 2016 to track community programs and initiatives. The most recent report, from 2022, provides more in-depth insights and analysis into the community's efforts to build a Culture of Health.

Lessons Learned: Where is Toledo’s Five Years Later?

Toledo’s journey to promote health, well-being, and equity is one that illustrates the importance of persistence and community engagement. 

Progress has happened slowly, but measurably, as the community navigates through challenges and is learning how to better engage the community. Other communities can learn from Toledo’s approaches to addressing social determinants of health and prioritizing the beatification of both the built and natural environments to foster a sense of place and community, as well as the challenges encountered. 

As COVID-19 recovery continues, with historic funding flowing to local communities, future research could consider the ways in which momentum around health, equity, and well-being influences community health narratives and decisions moving forward.

Toledo has benefited from a longstanding recognition of the importance of social determinants of health by many local stakeholders, but the city is challenged by a lack of collaboration, particularly on issues of racial justice.


  • Stakeholders who recognize and address the social determinants of health 

  • Leaders incorporate community voice for some major efforts

  • Commitments to equity by longstanding businesses may encourage others to follow suit


  • Racial inequity efforts face competing priorities

  • Racial segregation systematically puts some at greater risk for poor health and well-being

  • Robust actions are needed to address root causes of poor health