How the ACSM American Fitness Index Can Help Cities Improve Community Health
Now in its 16th year, the ACSM American Fitness Index® has been a successful partnership between the Elevance Health Foundation and the American College of Sports Medicine® (ACSM). Each year, we provide the data and expert analysis individuals and communities can use to drive better fitness, health and quality of life.
The Fitness Index ranks the 100 largest cities in the United States using more than 30 fitness indicators, providing each city with a detailed view of where they are succeeding and where improvements are needed. In 2023, the Fitness Index highlighted the severity of chronic diseases and made the case for physical activity as an effective way to address them. While no city’s residents are immune to chronic disease, cities can contribute to creating healthier lifestyles.
Elevance Health hosted a discussion with ACSM representatives to highlight the ways city leaders can work with individuals and communities on improving fitness levels nationwide. Panelists included Dr. Shantanu Agrawal, chief health officer of Elevance Health; Dr. Melissa Roti, Fellow, American College of Sports Medicine and Fitness Index advisory board member; and Dr. Melissa Bopp, Fellow, American College of Sports Medicine and ACSM Health and Science Policy committee member. Jackie Joyner-Kersee, three-time Olympic champion, moderated the event.
Below are three main takeaways from this event:
Local policy influences a healthy community
Dr. Melissa Bopp said that local policy plays a significant role in a city’s ranking.
“Arlington, VA — which has ranked №1 for six consecutive years — has a robust complete streets policy, which prioritizes walking and biking as a form of transportation, and that can drive the planning of a community as well as funding decisions that help to facilitate this development of local infrastructure,” Dr. Bopp said. The way a city allocates its resources, such as Arlington’s provision of funds to allow access and upkeep of the many the recreational spaces, provides great access to green spaces and parks for all residents.
It’s not just park space that’s influenced by policy, said Dr. Melissa Roti. She talked about transportation policies that guide infrastructure development or address safety for pedestrians and cyclists.
“School districts set policies for physical education classes or maybe even the availability of recess within the schools that they serve, all presenting opportunities for kids to be more physically active,” Dr. Roti said.
Cities can address both health equity and fitness
Health equity is when everyone has a fair opportunity to be healthy, and this includes having access to physical activity resources, Roti said.
“Chronic disease and physical inactivity are often the result of poor social and economic factors that impact health behaviors and outcomes,” she said. “So it’s critical for any strategy aimed at increasing physical activity to address the social drivers of health. Everyone must have safe, affordable, and convenient places for physical activity.”
Policy at a local level drives the allocation of resources that can help support all the things that help make physical activity occur with improved access. Policy matters “whether it’s helping to find parks and recreation or helping to fund improvement or development of sidewalks, off-street trails, and more,” Roti said.
Why community health matters to a health insurance company
Dr. Shantanu Agrawal said that in order to help improve someone’s health, which is the company’s goal, there should be an understanding of physical health, mental health, social health and well-being.
“Trying to understand someone’s health really starts at understanding their whole health,” Agrawal said. “At its core, this is exactly what the Fitness Index is trying to achieve, and there are many things we can do as a society and as a local community to encourage everyone to improve their whole health.”
He also pointed out that there’s a connection between the choices we make as individuals and the policies of communities.
“It’s hard for me to choose to be active if there isn’t a safe place for me to engage in physical activity, if it’s not taught in the schools, or if it’s not made part of our daily lives,” Agrawal said. “What’s interesting about the lens of fitness is that it shows you the complexity of the idea at a very personal level — like how interrelated our physical health is with behavioral and social health. Six out of 10 Americans have a chronic condition, and we know that these physical conditions are also tied to mental health. Another example: if I’m depressed or anxious, it’s going to be hard for me to take care of things that may be producing those chronic conditions…fitness is really similar.”
To see how your city compares to others or to see a complete ranking, visit the Fitness Index’s City Comparison Tool.
