How San Antonio is improving its health reputation

Why it matters: The analysis tracks research-based improvements for San Antonio, which has a long history of landing on lists of "unhealthiest" cities.

• CityHealth's analysis enables local leaders to benchmark their initiatives against each other to help them see what's working and what's not.

What they did: CityHealth, a nonprofit initiative of de Beaumont Foundation and Kaiser Permanente, looked at 12 health policies for the analysis. A city had to earn five or more gold medals in the individual policy areas to earn overall gold recognition.

• San Antonio earned gold medals in affordable housing trusts, greenspace, healthy food purchasing, high-quality accessible pre-K and smoke-free indoor air.
• The city earned a bronze medal in eco-friendly purchasing.

CityHealth co-executive director Katrina Forrest tells Axios that the organization analyzes established policies.

• "I personally think of policy as a prescription. But by itself, you will not heal. There is work that you have to do, but the prescription is what puts you on the path," she says.

Zoom out: Portland, Oregon; Denver; Minneapolis; St. Louis; New Orleans; and Boston also earned gold medals.

Of note: San Antonio has consistently been recognized by the CityHealth analysis — which started in 2017 — for early education through its "Pre-K for SA" program.

• CityHealth created a Pre-K Learning Network in 2018 to help local leaders learn from each other to improve their early education options. San Antonio representatives joined national experts on an advisory team.
• CityHealth wrote in a case study that San Antonio "sets the bar" for pre-K education.

State of play: San Antonio moved up in the food purchasing policy category, from a bronze to a gold award this year.

• The top honor acknowledges cities that provide healthy food on public property.
• The city revised its Healthy Food and Beverage Procurement policy in October.

Yes, but: There's always room for improvement. The eco-friendly category refers to limiting exposure to toxic chemicals in city-owned buildings.

• San Antonio has an eco-friendly purchasing policy that requires annual reporting, but it does not apply to requests for proposals or contracts. It also doesn't meet independent standards for furnishings, food ware or cleaning supplies.

What they're saying: In 2020, Mayor Ron Nirenberg recognized that San Antonio "does not have a great history" in the area of community health but has improved.

• "Our priority is to make San Antonio a healthy city for all residents, and we can only do this if we address the disparities in public health that affect our communities," he said in an updated statement.