America's Fittest Cities
A new report looks at 30 different measures to determine which cities' residents are healthiest.
When it comes to healthy living, Washington, D.C., is seldom mentioned in the same breath as cities like San Francisco, Portland, Ore., and Seattle, all of which are known for their active, health-conscious residents.
But according to a new report, the city of pomp and politics is the healthiest in the nation. In the second annual American Fitness Index (AFI), a publication released by the American College of Sports Medicine, Washington, D.C., edged out Minneapolis-St. Paul, Minn., Denver, Boston and San Francisco.
Walter Thompson, a professor in the department of kinesiology and health at Georgia State University and chair of the AFI's advisory board, says the annual project is designed to give communities a data-driven picture of local health--and nudge residents in the right direction.
"I believe significant success in improving the fitness of the community can occur when the residents truly value healthy behaviors," says Thompson.
Behind the Numbers
The AFI is sponsored by the WellPoint Foundation, the nonprofit arm of the health benefits company WellPoint. The index ranks 45 metropolitan statistical areas (MSAs)--a geographical measurement defined by the U.S. Census Bureau used by federal agencies in collecting, tabulating and publishing federal statistics--that include the city and surrounding suburban area. It measures each city's performance on 30 indicators, including acres of parkland, death rate from cardiovascular disease, the number of primary care physicians per capita and the percent of residents who bicycle or walk to work. The metrics were gathered from government and non-profit organizations. (For the complete methodology, visit www.americanfitnessindex.org.)
According to the index, Washington, D.C., residents are healthier than other Americans for a number of reasons. They have increased access to farmers' markets, at 13 per 1 million residents, compared to a national average of 11. Fewer residents smoke and have diabetes, and nearly 90% have health insurance compared to a national average of 86%.
Still, Thompson was surprised to see the city rank first for the second consecutive year. "[It] is not mentioned in discussions of cities that have a strong fitness orientation," he says. But the data demonstrated only a handful of weaknesses, most of them having to do with the limited number of recreational facilities.
Lagging Behind
While such a shortcoming doesn't hurt D.C.'s ranking, it's par for the course for cities at the bottom of the list, such as Detroit, Oklahoma City and Birmingham, Ala.
Oklahoma City, which placed last, performed poorly in nearly every category. Only 17% of its residents eat five or more fruits and vegetables per day compared to a national MSA average of 24%. The death rate per 100,000 patients with cardiovascular disease was 289 compared to the average of 223.
Though Detroit residents exceeded the national average for physical activity, 40% reported one or more days when they experienced poor mental health, compared to a national average of 34%.
Jim Kauffman, national director of health and well-being for the YMCA of the USA, says the ability to compare such statistics can help community leaders improve in areas where they perform poorly.
Acting accordingly could pay significant dividends. Research has shown that investments in preventative health care can have financial rewards. A 2008 report issued by the nonprofit organization Trust for America's Health found that spending $10 per person on proven programs like smoking cessation and physical activity could save $16 billion annually in health costs.
The money to pay for these programs may come from the fittest city, Washington, D.C. Despite the recession, which has led to municipal budget-cutting in cities across the country, this year's stimulus act includes $650 million for "evidence-based clinical and community-based prevention and wellness strategies."
A spokeswoman for the Department of Health and Human Services said that how the stimulus money will be spent or distributed has yet to be determined, but that a decision should be forthcoming in the next several weeks. That's perfect timing for cities at the bottom of the AFI ranking, since they now know where money needs to be spent. It's up to them, however, to take advantage.
"The [index] is meant to build awareness of how residents must take personal responsibility for their health and get involved in their own community," says Thompson.
Top 5 Fittest Cities
1. Washington, D.C.
2. Minneapolis-St. Paul, Minn.
3. Denver, Colo.
4. Boston, Mass.
5. San Francisco, Calif.
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