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With innovation and bold leadership, Portland can become
the healthiest city in the country.

Section Summary

In this chapter, Portlanders take a comprehensive view of health, addressing not just the healthcare system, but all of the factors that they believe contribute to healthy individuals and communities. Portlanders understand that the health of community members depends on the individual making good lifestyle choices and getting regular preventative healthcare, but also emphasize that government has a responsibility to support and promote good health.

Many Portlanders understand the relationship between the physical design of an urban environment and how it can encourage and lead to, or detract from, an individual’s health. These people praise Portland for being a clean, safe, user-friendly, walkable and bikable city that has “healthy infrastructure” in place. They feel that Portland “makes it easy to be healthy.” Some of these people also praise Portland’s compact urban form and concerted efforts to lessen our impacts on the environment – which they likewise view as good for human health.

While Portland does much to promote community health, much more can and should be done to ensure that all Portlanders are as healthy as they could be. Specifically, respondents want Portland to lead the nation by finding a way to provide healthcare for all community members. They want to see Portland become “the healthiest city in America” and believe this can only be accomplished if all community members have access to healthy living amenities, quality preventative care and medical attention when it is needed.

Summary of Main Ideas

  1. Both the individual and the community have a responsibility to promote health.
  2. Portland is a city that values, supports and promotes healthy living.
  3. Environmental conditions directly impact people’s health.
  4. Portland should strive to become the “healthiest city in the country.”

Summary of Tensions and Disagreements

  1. How easy is it to be healthy in Portland?


  1. Both the individual and the community have a responsibility to promote health.
  • When speaking about health, Portlanders do not limit their comments to the healthcare system, but rather address all the ingredients necessary for healthy living.
  • Portlanders generally believe that good health comes about as a result of individual choices as well as community and government actions.
  • Individual lifestyle choices that contribute to good health include:
    • Eating a healthy, balanced diet;
    • Leading a low-stress, balanced life; and
    • Avoiding risky behaviors such as smoking or substance abuse.
  • Government actions and decisions that support good health include:
    • Protecting the natural environment;
    • Reducing the presence of toxins in public places;
    • Providing access to parks, walking trails, biking trails and other places where community members can exercise for free;
    • Regulating the food supply to keep harmful substances out of people’s diets; and
    • Supporting alternate modes of transportation, thereby reducing dependence on automobiles.
  • Portlanders also believe that healthy individuals create healthier, safer and more productive communities, and that it is critical to invest in people’s health.
"The city of Portland is very valuable in its beauty and being very positive in helping people. I’ve only lived here for 2 ½ years. There are so many opportunities to advance yourself physically, financially, and socially and emotionally.”

"A compassionate health care system would actually make our city safer because people may engage in unsafe practices and risky behaviors when they feel disenfranchised, when they have nothing to lose. In other words, poor or underemployed folks may not feel invested in a community that does not value them. One way to prove we believe in the worth of every individual is to provide basic mental and physical healthcare for everyone.”

“[In the future there will be] increased numbers of people out of their homes and interacting – increased community involvement, less people staying inside. Natural environment has improved – it’s healthy and so are we. More outside gathering places.”

“Also a future commitment to less obesity – there are too many overweight people considering our outlets to the outdoors, fresh air, recreation, sports, etc.”

  1. Portland is a city that values, supports and promotes healthy living.
  • Portlanders know that health begins with a healthy lifestyle and are grateful that the city makes it easy to lead a health-conscious life.
  • Portland contributes to the overall health of its residents by offering access to the following:

    Exercise and Outdoor Activities:

  • Portlanders cherish the city’s parks and trails, seeing them as very special and convenient exercise opportunities (See Urban Livability: Parks and Open Spaces).
  • Portlanders appreciate local government’s commitment to building a connected system of bike and pedestrian trails (e.g., the 40-Mile Loop and the Eastbank Esplanade).
  • Many people like Portland for its geographic location and relish the fact that we live within a close drive to Mt. Hood and the coast. These are seen as enormous exercise and recreational treasures.
  • Portlanders appreciate urban design elements that contribute to active lifestyles, including:
    • Small, walkable city blocks downtown;
    • Compact neighborhoods with central hubs and amenities within walking/biking distance;
    • The integration of nature, parks and greenspaces into the urban landscape; and
    • The promotion of alternate forms of transit that get people out of their cars.
  • People appreciate access to many alternative exercise options, such as yoga and tai chi, which are not easily found in other locations.

    Healthy Food
  • People love being able to easily access fresh, local, healthy food through a variety of different outlets, including:
    • Neighborhood farmers markets;
    • Non-traditional, health-conscious grocery stores such as New Seasons and Whole Foods;
    • Community gardens located throughout the City; and
    • Community Supported Agriculture and farms near the city limits.
  • Portlanders emphasized the importance of everyone being able to access healthy, organic, locally grown and/or pesticide free food (for more on this topic, see Urban Livability: Urban Agriculture and Community Gardens).

    A Clean Environment:

  • Portlanders recognize the connection between a clean environment and good individual and community health.
  • Portlanders value the efforts the City makes to preserve and protect the environment, including:
    • Maintaining sources of clean, pure drinking water;
    • Managing stormwater and preventing overflow into the river;
    • Planting trees and taking other measures to improve air quality; and
    • Promoting cycling, walking and other measures to reduce air pollution. (for more on preserving a clean environment, see Environment: Natural Environment and Environment: Sustainability.)


  • Many Portlanders see the city’s emphasis on community as key to helping people start and sustain healthy lifestyle choices.
  • Community gathering places (such as parks and community colleges) provide support for people in exercise or sports classes, helping Portlanders stay connected while they improve their health.
  • Many feel that Portland’s focus on community building also helps reduce isolation, stress and other factors that contribute to mental and physical illness.
“I can eat healthy here—it’s accessible. Grassroots sensibility. People are resources—city recycles. People are positive and hopeful.”

“An exciting place—people are far more conscious about many things including food, food quality, and food access. Health and healthy food is part of everyday life.”

“Being a transplant, one of the most valuable things about the city is location to natural areas. Being a year-round outdoor activities person the location is ideal. The fact that the city supports the healthy lifestyle is refreshing.”

Sample Strategies:

  1. Invest in connecting and improving bicycle and pedestrian routes throughout the city.
  2. Locate public transit stops near neighborhoods so people get out of their cars and walk to and from transit.
  3. Subsidize farmers markets in lower-income neighborhoods to bring high-quality produce to people at affordable prices.

Note: For many more strategies on promoting active, healthy lifestyles, see:

  1. Environmental conditions directly impact people’s health.
  • Respondents are very concerned about the presence of environmental toxins and pollutants in the air, water, parks and other places they frequent (for a full description of their concerns, see Environment: Pollution, Environment: Air and Environment: Water).
  • In particular, many respondents complain about air pollution from the following sources:
    • Automobiles;
    • Heavy industry in the Northwest Portland (particularly ESCO);
    • Busses in downtown Portland and the Pearl; and
    • Smokers.
  • Many Portlanders advocate tightening restrictions on smoking, so as not to expose workers, customers and passing people to highly harmful cigarette smoke. Proposals include:
    • Banning smoking in bars;
    • Banning smoking around the outside of office buildings; and
    • Banning smoking throughout the entire city.
  • A number of Portlanders also call for toxic chemicals to be banned from parks and for the City to find organic or non-toxic products for park maintenance.
  • Respondents are also concerned that minorities and lower income Portlanders tend to live in or near the most polluted areas of the city, while wealthier Portlanders have access to cleaner and safer environments.
"[I value Portland's] green spaces, high degree of livability. I also like Portland’s progressive and forward thinking culture (e.g. current low emissions west coast corridor). I value this for the health of its citizens and its future citizens.”

“Fifty percent reduction in chemicals used on our greenway and in our air. We will breathe better and healthier.”

  1. Portland should strive to become “the healthiest city in the country.”
  • With its focus on healthy living, Portland has the opportunity to lead the county in regards to the health of its population.
  • Many people want to see Portland become a model city by meeting the health needs of all of its residents.
  • In particular, respondents call on the City to find a way to provide healthcare and/or health insurance to everyone. They state their faith in Portland’s ability to solve this challenge long before it is solved nationally.
  • Many Portlanders imagine a future in which:
    • Obesity and child obesity are drastically reduced;
    • All people lead active lifestyles and walking and cycling are the preferred modes of transportation;
    • Healthcare costs are low because everyone receives personalized, high-quality preventative care; and
    • No-one has to forgo necessary medical care because of income or ability to pay.
"We have the opportunity to create a McCall like legacy in building the components of a healthy city.”

“[In the future, Portland will be]…balanced. Healthier. An example for the rest of the country. A livable and happy place.”

"If it contributes to health, economic vitality, or a clean environment, support it. If it contributes to some but not others, adjust it. If it does not contribute, [get] rid of it.”

Sample Strategies:

  1. Solicit input from residents who have benefited from excellent healthcare and use their experiences to improve services for everyone.
  2. Invest heavily in prevention and alternate care.
  3. “Address root causes of the city’s ailments (crime, drugs, health issues, the break down of families) not the symptoms.”
  4. Guarantee that all community members have access to medical care when they need it. This could take the form of universal health care, a single-payer system or a local insurance program that covers everyone.


  1. How easy is it to be healthy in Portland?

    Many respondents believe that Portland is already doing an excellent job of promoting the health of community members. They point to the abundance of fresh, healthy food, the parks located throughout the city and the government’s investment in bicycle lanes, walking trails and other forms of “healthy infrastructure.” They also note the abundance of alternative healthcare options available in Portland, including many forms of preventative care that keep people from becoming sick in the first place.

    However, many other Portlanders have a very different view of health in the city. They are unable to access the care that they need because they don’t have insurance or they cannot afford to purchase it on their own. They experience pollution on a daily basis because they live near sources of pollution, suffer from asthma or have other health complications as a result of pollution. They lack access to high-quality, organic produce because it is not sold at the supermarkets where they shop, or it is out of their price range.

    Many other Portlanders also feel that the City is not doing enough when they see people with mental health issues living on the streets downtown. They hold the view that much more could be done to ensure that these individuals receive the care they need to prevent them from becoming homeless in the first place. They also find it morally unacceptable that so many children are uninsured and therefore unable to receive medical care when they need it. They point to high obesity rates and the mirroring of other national health trends to argue that Portland still has a long way to go before it can be seen as a healthy place for all its residents.

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