Cities and counties provide an array of programs and services for their residents. These include direct services as well as constructing and maintaining public works and community facilities.

Many local programs and services administered by cities and counties create opportunities to provide health benefits to residents and users; for example, park and recreation services offer increased options for physical activity. Other examples of services provided by local agencies that improve health and safety include emergency planning, elder care, job creation and financial assistance programs, among others.

Local agencies are responsible for building and maintaining much of the infrastructure and public facilities in their communities. Such capital improvements typically include a variety of civic buildings, water and sewer lines and treatment facilities, parks and recreational facilities and an extensive network of local streets and sidewalks. These public facilities and infrastructure offer another way for local officials to integrate health considerations into their decisions.