The American College of Sports Medicine (ACSM) released a new report, “American Fitness Index" (AFI), ranking 50 of the largest US metropolitan areas by fitness and health. ACSM gathered information that identified population, health and the built environment and found what most of us can assume: that the physical built and planned environment of our cities has a profound impact on our physical health. "Cities near the top of the index," the executive summary reads, '" have more strengths that support healthy living and fewer challenges that hinder it... the opposite is true for cities near the bottom." Most of the metropolitan areas identified in the top ten are cities in the north, including areas of Washington, Minnesotta, Colorado, and cities within New England. California ranked the most metropolitan areas in the top ten. Cities near the bottom of the list were concentrated in the south, many of which are located in Texas. The report is the first step of the AFI to work towards its goal of promoting active lifestyles by identifying and supporting programming of sustainable, healthy community culture.
More details from the report and what tells us about our built environment.
The AFI assessed a variety of health indicators to produce the rankings of the 50 metropolitan areas. The program looked at levels of obesity, chronic disease rates, number of healthy care providers, the built environment, available resources, and policies that support community health. In conducting the study of metropolitan areas, the AFI was able to consider the interactions between city core and its surrounding suburban areas. It recognizes the dynamic interaction between resources available within the city limits, which may be limited to built up and intentioned programs such as community gyms and planned parks, as well as the suburban environment beyond which may include natural preserves of parks, rivers, or hiking trails. While access remains a critical component of the effectiveness of these planned and unplanned environmental characteristics, the study also considers the behaviors of interactions between the available resources and the population.
Each metropolitan area ranked in the index is given a well developed score assessment that outlines its ranking. The AFI identifies each metro's Area of Excellence, Improvement Priority Areas, a demographic outline of the city, health behaviors, chronic health problems, and access to health care. This data can be seen as a result of the community and environmental indicators that are focused on the built environment, recreational facilities, physical education policies for schools, and the availability of primary care.
In comparing the differences between the highest ranked metropolitan area Minneapolis-St. Paul-Bloomington, MN-WI with a score of 78.2 with the lowest ranked area of Oklahoma City, Oklahoma with a score of 31.2, we can note the differences in the statistical assessment of the built environment and its influence of behavior and health in these areas. MN-WI has 14.6% parkland within the city to OK's 5.6%. And despite Oklahoma City having nearly double the acres of parkland, the city spends less than a quarter per capita on park-related expenditure than OK and has no level of state requirement for physical education in its schools to MN-WA's 3.0. In general OK has fewer recreational facilities per capita. This indicates that the environment and geography is not the sole indicator of how people engage those resources, but is also a result of how the government and its public policies encourage their use and maintenance. These differences in environmental characteristics are reflected in the health behaviors of each metropolitan area. Where 76.7% of the population engage in moderate physical activity in MN-WI, OK has 67.1% engagement. Levels of chronic health problems are also generally lower in MN-WI than OK.
The range of scores from 31.2 to 78.2 indicate that each metropolitan area has ways in which to improve the fitness levels of its city to meet its target goals. These levels are a combination of the built environment, the policies that encourage its use and the way in which the population has developed behaviors of engagement with these spaces. It will take a city's physical attributes, the attitudes of the population and education in regards to health and fitness in order to achieve the target goals for each metropolitan area.