Expanding Opportunities for Health in Small and Midsize Cities

Understanding smaller cities’ strengths, challenges, and opportunities for achieving health and well-being for all.

A family rides bicycles together along a river.

Small and midsize cities are finding innovative solutions to expand health and well-being.

Across America, many small and midsize cities are experiencing a resurgence—due, in part, to investments in green spaces and parks, upswings in local tech hubs, and downtown redevelopment.

At the same time, these places—home to one in five people in the United States—face higher rates of premature death and poverty than larger cities. The factors driving these disparities vary widely, from shifting demographics, to changing economies and disinvestment, to inadequate municipal tax funding for basic services.

And the sharp rise in population growth has led some places to struggle with the negative impacts of gentrification and displacement that can exacerbate inequalities and poor health.

Amid these complex issues, with a range of partners, the Robert Wood Johnson Foundation is supporting the efforts of small and midsize cities across the nation to develop solutions that effectively leverage local resources and strengths. These include strengthening community ties, engaging residents, and identifying more opportunities for working across sectors.

Connected with these efforts, this collection shares key research on small and midsize cities; insights into effective strategies for creating healthier, more equitable places to live; and resources for cities across America working to achieve better health for all.

What Works for Health

A County Health Rankings' tool helping communities identify what policy and system changes may be the best fit to address local health needs.

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Featured Initiatives

Evaluating Progress in Midsize Cities

A report from Mt. Auburn Associates evaluates the progress and team-based outcomes of 50 midsize cities participating in Invest Health.

Laboratories for Change

When looking for laboratories of urban development and resilience—check what’s happening in smaller cities.


In Buffalo, A Bustling Food Enterprise Emerges

Residents in Buffalo are turning an abandoned manufacturing building into an enterprise for new food choices in the community.

Strengthening Equity and Environmental Health

The Healthy Neighborhoods Equity Fund project helps promote equity and strengthens community and environmental health.

Where You Live Matters to Your Health

A new tool shows how where you live—down to the census tract level—affects your estimated life expectancy at birth.

Advancing Leadership in Smaller Cities

Across New England, the Working Cities Challenge is advancing collaborative leadership in smaller cities to transform the lives of their low-income residents

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Learn More About Our Work
Learn how is working with others to create healthier communities nationwide.
Browse research and resources supporting efforts to achieve better health for all.
Explore RWJF's vision for improving health, equity and well-being in America.