This report offers policy recommendations on 35 wide-ranging topics from 50 national experts, from pandemic preparedness and health care to conducting sound elections and adapting immigration policy. Designed to advise leaders at the federal, state and local level, the report presents a timely examination of policy challenges and opportunities in light of the pandemic.

Medicaid is at the core of the opioid overdose epidemic. Both state and federal government reactions continue to shape the outcomes of this epidemic while death rates in some states continue to increase. There is a strong correlation between those suffering from opioid use disorder and those eligible for Medicaid. Most significantly, individuals with opioid use disorder enrolled in their state’s Medicaid program experience greater positive health outcomes compared to those without coverage.

The United States currently ranks last among high‑income countries for life expectancy. Since 2014, U.S. life expectancy has declined. By now, these alarming trends are well known to researchers, the public, and policymakers. Nevertheless, there is no consensus among researchers on the causes of the trends, and there has been no serious and effective bipartisan effort to solve the problem. The dominant narrative has implicated Americans’ behaviors, such as smoking, illicit drug use, and suicide; yet, this narrative is misguided and counterproductive.

Policy is a powerful tool that can improve health and wellbeing by addressing specific risks or impacting social conditions that are drivers of health and quality of life. But governmental policies can vary immensely from one jurisdiction to another. Surveillance of policies at the local level can help facilitate evidence‑based policy adoption between cities, states, and beyond. This essay highlights the CityHealth model, which has successfully influenced policy change by illuminating the quality and quantity of nine key city policies in the forty most populous U.S. metropolitan areas.