The latest American Fitness Index rankings show more Americans are walking and biking to work. However, exercise levels, mental health concerns, and overall lack of sleep may be hampering physical health.
On July 23, the American College of Sports Medicine (ACSM) and the Elevance Health Foundation published the 17th annual ACSM American Fitness Index, ranking how well 100 of America's largest cities support healthy, active lifestyles.
The Index focuses on three primary areas associated with overall health and well being — the city's design for physical activity and active transportation, healthy food access initiatives, and community mental health services.
According to research, communities designed to provide optimal walking and biking access, and those with parks close to where people live, can help residents achieve better health and wellness.
In addition, cities with policies that enhance access to mental health services can help residents address conditions such as depression, which could impact physical well-being.
The Index results are based on 33 evidence-based indicators. ACSM President Stella Volpe, Ph.D., FACSM, ACSM-CEP, tells Healthnews that the indicators were initially selected by ACSM content experts and other nationally recognized fitness experts who understood the importance of community assets in improving health behaviors and outcomes. The analysts gathered city health indicator values from reputable, regularly updated, publicly available data sources.
The indicator values for the cities were ranked, weighted, and combined into a personal health subscore, a community/environment subscore, and a total score. The analysts used these scores to rank cities from the most fit (rank 1) to the least fit (rank 100).
Fitness Index results
Overall, Fitness Index findings showed that more people in the United States are walking and biking to work, spending more money at parks, and experiencing slightly improved food security.
However, the 100-city analysis also found that many Americans are not getting enough exercise to meet ACSM standards. These standards recommend that people get at least 150 minutes of moderate-intensity aerobic activity plus two days of muscle-strengthening activity per week.
In addition, Index results found that fewer individuals sleep seven or more hours per night, and fewer people reported they are in excellent/very good health. The analysis also showed an increase in residents reporting poor physical and mental wellbeing.
"There are a number of reasons why people are not getting enough sleep, exercising enough, and reporting poorer mental and physical health," Volpe tells Healthnews. "For example, some people may be working a number of jobs and do not have time in their day. Some people may not have access, either financial or physical access (that is, the built environment in their city is not conducive for promoting physical activity), and for some people, it is that they do not enjoy being active."
"Movement is walking, gardening, dancing, seated exercises, etc. The accumulation of minutes of physical activity per day is as effective as exercising/being physically active at one time," Volpe explains.
Moreover, people with sedentary jobs should try to get up and move every 30 minutes or every hour, as prolonged sitting may increase the risk of diabetes and obesity.
According to Volpe, lack of sleep and poor mental and physical health are also connected.
"If people are not getting the proper amount of sleep per night (8 to 9 hours for adults), their risk for diabetes mellitus, heart disease, and obesity increases," Volpe says. "In addition, being physically active has been shown to stave off chronic disease and can help with mental health."
Top 10 fittest cities
According to the Fitness Index findings, Arlington, Virginia, Washington, D.C., and Seattle, Washington, were the top three fittest cities.
Arlington clinched the number-one spot for several reasons. The city ranked high in community/environmental indicators and had the highest rate of residents exercising in the previous month (87.8%). Data also showed that Arlington had the highest number of residents getting seven or more hours of sleep a night (76.4%) and the lowest smoking rates (3.4%).
People living in Washington, D.C., had the highest rate of consuming two or more fruits a day (37.9%) and came in second at consuming three or more vegetables per day (21.4%). Moreover, Washington, D.C., was one of the top five cities for exercising in the previous month, walking or biking to work, and using public transportation.
In addition to having the third-highest rate of exercise in the previous month, Seattle, Washington, also had the third-highest park expenditures, at $321 per person.
Other top-ranking fit cities were:
- 4. San Francisco, CA
- 5. Madison, WI
- 6. Minneapolis, MN
- 7. Denver, CO
- 8. Atlanta, GA
- 9. Irvine, CA
- 10. St. Paul, MN
The top 10 lowest-ranked cities include:
- 90. Las Vegas, NV
- 91. Louisville, KY
- 92. Bakersfield, CA
- 93. Lubbock, TX
- 94. Indianapolis, IN
- 95. Tulsa, OK
- 96. North Las Vegas, NV
- 97. Wichita, KS
- 98. Memphis, TN
- 99. Port St. Lucie, FL
- 100. Oklahoma City, OK
Some city's rankings fell significantly
While Lexington, Kentucky's rankings jumped up 31 slots and Miami, Florida's rankings improved 26 places to land at the number 13 position, two other cities experienced significant drops in their Fitness Index rankings.
For example, Tampa, Florida, fell 21 slots to the 45th position. While the city's community/environmental indicators remained relatively stable, personal health indicators involving sleep duration and perceived health status decreased. A rise in reports of poor physical health and an uptick in obesity, asthma, stroke, diabetes, and pedestrian fatality rates also contributed to Tampa's lower ranking.
Moreover, Greensboro, North Carolina, dropped 18 places, landing at number 80 on the Index, likely due to fewer residents reporting seven or more hours of sleep and excellent/very good health. Index results also showed an increase in reports of poor mental well being.
Still, the ACSM notes that the biggest reason for a drop in ranking is that some cities scored slightly higher, bumping others down the list.
Fitness rankings drive change
Volpe says that while all health indicators are important, those that focus on helping people be more active, such as city designs that allow for better access to physical activity, are most critical.
"If people move more, that leads to better personal health indicators, so they all really are intertwined," Volpe explains.
Moreover, Fitness Index rankings can provide cities with a roadmap of their strengths and highlight areas that need improvement to boost the health of their citizens.
Volpe concludes, "It is not an easy task, and cities need resources to do so, but starting with small changes can go a long way in helping people be more active and lead to improved quality of life."
2 resources
- American College of Sports Medicine. American Fitness Index.
- Translational Journal of the ACSM. Association between Built Environment Policy and Good Health Status.
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