This report contains an executive summary and is based on a survey of 278 American cities with populations over 50,000, concerns problems facing families and children. The survey focused on pressing needs of children and families as seen by city officials, the prominence of these needs in community life, the involvement of city governments in meeting these needs, and barriers to expanded involvement. Key findings include: (1) Child care overshadows all other needs for city children; (2) Substance abuse prevention and education rank second and third; (3) Housing tops the list of needs for many city families; (4) Child and family issues are at least moderatley visible in the public forums of many communities, and are likely to be more prominent in elections, news, and civic agendas in large cities; (5) Diverse organizations and individuals bring these issues to city halls' attention; (6) City halls are involved in a variety of areas relevant to children; (7) City hall programs work; (8) City halls are most involved in the area of recreational activities; (9) Cities carry out their involvement through a variety of means; (10) Involvement may increase in each of 34 identified areas; and (11) Lack of money is the greatest impediment to increased city involvement in family and children's issues, and overshadows all other problems in the nation's largest cities. (RJC)