What we have lacked is the political will to target intervention efforts where they have the best chance of making a real difference in restoring health and vitality. Cleveland and individual neighborhoods, in particular, have been in decline since the 1950s. Yet, political calculations have stood – and continue to stand – in the way of embracing Cleveland’s future as a smaller – but healthier – city. Decisions to redraw wards to better match population density, to limit resources and services to sparsely populated areas, and to offer isolated residents the choice of relocating to healthier neighborhoods, or even suburbs, come with potentially negative political ramifications.

In her critique of this neighborhood ‘triage’ approach, Mandy Metcalf, manager of Environmental Health Watch’s Affordable Green Homes program, offers a vision for ‘preventive care’ for cities. We think it could be a new Cleveland mission statement. She writes:

In some neighborhoods, investment will take the form of deconstructing homes, utilizing vacant lots for farming, natural habitat, and stormwater management, while maintaining transit-accessible pockets of homes and retail that function as small ecovillages. In other neighborhoods where small parcels have been assembled into large-scale redevelopment opportunities, intense investment in new homes and commercial development will occur. Development will be shaped by regional policies that guide investment away from fossil-fuel dependent exurbs and into the heart of the eco-city. A thriving locally-based economy will ensure that Cleveland residents get a fair share of the profit from development. Schools, safety, and jobs will be recognized as important elements of a sustainable community. And resources will be invested in ecologically sustainable design and infrastructure to ensure a clean lake and functioning greenspaces that increase our quality of life for all our residents and attract people from around the country.