Frequently Asked Questions

What is the Healthiest Cities & Counties Challenge?

The Healthiest Cities & Counties Challenge is a collaboration between the Aetna Foundation, the American Public Health Association, and the National Association of Counties to encourage small to midsize U.S. cities, counties and federally recognized tribes to create a positive health impact. The Challenge will identify the best practices for achieving community and individual health, wellness and health equity. Additionally, the Challenge promotes collaboration and community-wide involvement and will identify nationally replicable models of health. Competing cities, counties and tribal nations will move the needle toward creating healthier and more equitable communities using measurable criteria over several years. The Challenge will award $1.5 million in prizes to cities and counties that build cross-sector teams around health issues of critical importance to their communities.

What is the goal of the Challenge?

The goal of the Challenge is to develop practical, evidence-based strategies to improve measurable social and health outcomes and promote health and wellness, equity and social interaction – community by community, block by block. Through the Challenge, we want to recognize and catalyze communities across the U.S. with the ideas and solutions that empower communities to be healthier; helping make the right choice the easy choice for their residents. By sharing measurable approaches and impact, we will create models for use nationwide.

How do you define "healthy city/county"?

We believe a healthy city/county is economically competitive, inclusive and equitable. At the Aetna Foundation, we believe positive change happens when we work side-by-side with people to implement sustainable changes at the community level. Every community is unique and may require something different to promote change by increasing opportunity and collective health, but all cities, counties and tribal nations have the power to create a positive impact. We want to meet communities where they are and look for measureable ways to improve health through the following:

  • Healthy Behaviors: tobacco use, nutrition, physical activity
  • Community Safety: community violence
  • Built Environment: food quality, walkability, bike ability and transit use
  • Social/Economic Factors: housing affordability, educational attainment, living wage
  • Environmental Exposures: children exposed to 2nd hand smoke in the home, air quality, water quality
How is the Healthiest Cities & Counties Challenge different from other prize competitions?

The Healthiest Cities & Counties Challenge focuses on public health and prevention approaches that are largely driven by the size of the population of the city or county. The goal is to make change not for a single condition or disease but with a more holistic approach to improving the overall health in a selected community. Also, the $1.5-million-dollar pool of prize monies is larger than other related projects. The Challenge is a two-phase competition in which many communities are continually engaged and in which they share best practices with each other through an ongoing learning network. As a result of its inclusive and interactive design, the Challenge can have a much greater impact than most prize competitions.

What is the "theory of change" for the Healthiest Cities & Counties Challenge?

The Healthiest Cities & Counties Challenge is trying to change the way a community thinks about health. Through a "health-in-all-policies", multi-sector and multidimensional approach, cities and counties can build an inclusive and economically vibrant community. The Challenge will use "a learning communities"approach to share best practices throughout the course of the competition and to help all cities and counties become healthier by developing and sharing scalable models. The Challenge will be transformative with respect to how cities and counties view the critical importance of designing, building, and sustaining healthy, equitable communities. As a result of the Challenge, communities throughout the country will develop practical, evidence-based strategies that will improve measurable health outcomes and promote health and wellness, physical activity and social interaction. The Challenge will spark the best city and county health and wellness ideas, accelerate collaboration and community-wide involvement, and achieve measurable impact that can be scaled nationally.

Who is participating?

Cities, counties and tribal nations within specific population parameters are eligible to participate. Two tiers of participants are defined based on population size: Tier 1 – cities, counties and tribal nations with populations between 65,000 and 250,000. Tier 2 – cities, counties and tribal nations with populations between 250,001 and 600,000. See our HealthyCommunity50 map to learn more about their projects.

Have other questions about the Challenge?

Primary contact for all questions related to The Challenge:

Learning Network questions, webinar suggestions and materials for posting on your webpage JeVonna Ephraim, Program Director, 202-777-2429

Media and communication questions: Katy Frame, BRG Communications, 703-739-8358

Download a copy of the archived FAQs for the general public (PDF)

Download a copy of the archived FAQs for the Challenge Finalists Cycle 2016-2018 (PDF)