Interact for Health

American Fitness Index: Why the gap between our healthy environment and our personal health?

(Jul 4th, 2016)

Recently the American College of Sports Medicine released its 2016 American Fitness Index (AFI). Each year the index looks at the health status and community fitness of the 50 largest metropolitan areas in the United States. For our region, 2016 was not a good year: the Cincinnati Metropolitan Statistical Area (MSA) dropped seven spots to number 23.

The AFI ranks cities on both personal health and the community/environment. There is a striking gap in how our region ranks in each category. For personal health, we rank nearly last at number 48. But for the community/environment, we are in first place! What is causing this gap?

First let’s look at community/environment. We know that being physically active and eating a healthy diet are vital to maintaining good health, but we are unlikely to make these healthy choices if we’re in an environment that makes them difficult or impossible. The community/environment ranking looks at the availability of parkland, swimming pools, playgrounds, farmers markets, etc. Cincinnati does great on these measures, and has ranked in the top three since the AFI started in 2009.

But it’s important to note that to calculate our community/environment ranking, the AFI looked at the parks, pools and farmers markets in the city of Cincinnati only, not our suburban or rural areas. So this ranking does not tell us if our excellent city resources are reflected in outlying counties.

So let’s look at personal health. This ranking is calculated based on results from adults throughout our 15-county MSA. Unfortunately, we’ve worsened in obesity, self-reported health, smoking, diabetes, asthma and more. We dropped 10 spots in this category alone since 2015.

Again, why the gap between environment and personal health? We know a healthy built environment is vital to create opportunities for good health. But the AFI rankings indicate that there are other critical elements, such as policies, culture, knowledge, cost and time. The Robert Wood Johnson Foundation talks about creating a culture of health where the healthy choice is the easy choice. What might we add to our environment to support these healthy choices? Some ideas:

  • Social events that are active events: walking with friends, playing with kids, swimming, dancing and more
  • Workplaces that encourage us to move throughout the day through support for active commuting, on-site exercise facilities or incentives for healthy choices
  • Policies that make healthier foods cheaper and easier to find than unhealthy ones
  • Schools that teach our children to enjoy a healthy diet and regular physical activity through exposure to nutritious foods and fun exercise opportunities
  • Tobacco policies that help us avoid secondhand smoke
  • Opportunities to choose healthy ways to cope with our stress, such as mindfulness, exercise or connecting with friends
  • A community that collectively values and prioritizes wellness for everyone

What’s your experience? What most helps you to make the healthy choice?