Before You Go - July 2012
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In Top Shape
Minneapolis-St. Paul Fittest Metro Area in the Country

By Deborah L. Vence

For a second year in a row, Minneapolis-St. Paul ranks as the fittest metropolitan area in the country.

This, according to the American College of Sports Medicine's (ACSM) annual American Fitness Index (AFI) 2012 report that recognizes the healthiest, fittest metropolitan areas in the United States. The 2012 AFI data report, dubbed the "Health and Community Fitness Status of the 50 Largest Metropolitan Areas," looked at the most populous city areas in order to identify the healthiest and fittest places in the United States. The Minneapolis-St. Paul-Bloomington area garnered the highest score of 76.4, out of a possible 100 points.

"Minneapolis ranks high in both personal health indicators and community/environmental indicators. Both will contribute to low rates of diabetes, especially type 2 diabetes, which accounts for over 90 percent of all cases," said Walter R. Thompson, Ph.D., FACSM, FAACVPR, Regents' Professor Department of Kinesiology and Health (College of Education) and Division of Nutrition (Byrdine F. Lewis School of Nursing and Health Professions), Executive Director, After-School All-Stars Atlanta, Georgia State University.

Factors that contributed to the Twin Cities' top score included high marks for physical activity levels; a low rate of diabetes; above-average quantity of recreational amenities; strong numbers of pedestrian, bike and transit commuters; and excellence in parkland as a percentage of the city land area, plus strong investment in park-related expenditures.

"There is also a fairly low rate of deaths due to cardiovascular disease, which also may be lifestyle-related. There is not only more parkland in Minneapolis as a percent of city land area, but the city spends twice as much money per capita (park-related expenditures per capita) than the target ($200 vs. $101.80)," he said. "So, the area not only boasts of healthier lifestyles, but also the built environment supports regular exercise and higher levels of physical activity."

Thompson noted that the data collected are from valid and reliable national databases, such as the CDC's Risk Factor Behavioral Surveillance Study, U.S. Census, FBI Uniform Crime Reporting Program and the Trust for Public Land.

"We use these data to develop the American Fitness Index, which is a compilation of those data," Thompson said. "… For example, in Minneapolis, 82.9 percent of the population reported any physical activity or exercise in the last 30 days. The target was established at 82.6 percent. Minneapolis is slightly higher than the target. You can do the same for each of the data points (smoking, diabetes, obesity, etc.)."

The AFI data report reflects a composite of preventive health behaviors, levels of chronic disease conditions, health care access, and community resources and policies that support physical activity. To boot, a benchmark for each data indicator to help identify areas that need improvement is new to the 2012 AFI data report.

Last year, the ACSM received a $171,880 grant from the WellPoint Foundation, the philanthropic arm of WellPoint Inc., to present the 2011 and 2012 AFI data reports and to pilot improvement efforts in Indianapolis and Oklahoma City, which both ranked in the bottom six.

Today, both Indianapolis and Oklahoma City are working with leaders in their areas to help make improvements in physical fitness.

For example, the YMCA of Greater Indianapolis and Health by Design, along with community leaders and organizations in Indianapolis, initiated a strategic plan based on a comprehensive review of in-depth interviews with key community leaders (key informant interviews) conducted last fall. The plan focuses on improving physical activity levels, promoting healthy eating, reducing the use of tobacco and fostering built environment initiatives. A long-term strategic plan will be released in early summer 2012. The public also will be asked for their input.

For Oklahoma City, which came in last in the rankings, the city's Mayor Mick Cornett and other local government leaders met with representatives from the ACSM and the AFI board in December 2011 to discuss the results of key informant interviews that were conducted earlier in the fall. The discussion centered on encouraging healthy eating and increasing physical activity. A plan of action for Oklahoma City also is in the works.

"Oklahoma City is trying very hard to move up the list. We have been meeting with Mayor Cornett regularly to figure out ways that he can promote increasing physical activity in his city," Thompson said. "They have a number of personal health indicators that need to be addressed including obesity that is now affecting over 30 percent of the Oklahoma City population. The mayor put 'the city on a diet' a few years ago, which has made remarkable progress. But smoking and chronic physical activity remains low. Oklahoma City ranks No. 48 in personal health indicators and 42nd in community/environmental indicators. The mayor and his leadership are addressing both."

Furthermore, in 2012, the ACSM will work with community organizations in four additional metropolitan areas that have low rankings to help drive health improvement efforts. Four other cities will be added in 2013, which will bring the total to 10 cities that are receiving tailored technical assistance.

"Cities need to pay attention to both personal health indicators and the community in which they live. Cities that do not do well in the index typically don't do well in either of these categories. Cities will need to establish, for example, no smoking policies that extend beyond sections of a restaurant or bar to outdoor sitting areas, or any area in which people would be exposed to secondhand smoke," Thompson said.

"Cities also need to increase funding for city parks, which also include making them safe for people who want to exercise. Beyond everything else, cities should look at the ACSM American Fitness Index as a way to improve the lives of their citizens and not to look at it as punitive," he added. "Every city has great places to exercise. We just need to make it better in some."