This review of the federal government's 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, their 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, between 1990 and 1999 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.

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 and the

challenges that persist.