Category: Best Practices

Parks, Trails and Greenways Plus Programming Can Increase Physical Activity

Parks, trails, and greenways are an important part of a community. They are places where people can move, relax, and enjoy time with others. A new Community Preventive Services Task Force (CPSTF) recommendation shows that science backs up the idea that these places can help people be physically active.

But simply having these community spaces is not enough. Additional efforts are needed to help people use these spaces to increase their physical activity.

What is the new recommendation?

To increase physical activity, CPSTF recommends park, trail, and greenway infrastructure interventions when combined with additional interventions. Infrastructure interventions include improvements to built and natural environments. Additional interventions include structured programs, like walking groups, fitness classes, and organized sports, as well as efforts to improve community engagement, enhance access, or increase awareness.

When these interventions are combined, the number of people who use parks, trails, and greenways—and use them specifically to get moderate-to-vigorous physical activity—increases.

CPSTF also suggests that communities work with partners across sectors to identify barriers to access and use of green spaces and ensure equity, engagement, safety, and accessibility for all populations.

What are the benefits of physical activity and green spaces?

Physical activity is one of the best things people can do to improve their health. And being active in nature has physical, mental, and social benefits. For example, people who have more access to green environments tend to move more than people with limited access. Specifically, people who live close to a park and feel safe there are more likely to walk, roll, or bike to the park and use it for physical activity.

Outdoor recreation areas also provide places where people can observe or interact with nature, reduce stress, and improve their mental health. They provide places where families can play and neighbors can meet, which can improve family and community connections.

Parks can also provide environmental benefits by reducing air and water pollution, protecting areas from inappropriate development (for example, on flood plains or steep slopes), and mitigating urban heat islands. They help reduce the risk of illness and injury by providing safe spaces where people can play and be active away from busy streets and commercial zones.

Although everyone should have access to these benefits, long-standing, systemic social inequities have led to some populations living in areas with limited park, trail, or greenway access. This inequity may increase their risk of being physically inactive and having associated chronic disease conditions.

Cross-sector partnerships can help address inequities and barriers to physical activity through interventions that enhance community engagement, raise awareness of natural environments, and improve access to safe opportunities for outdoor activity in these environments.

How is the CPSTF recommendation relevant to the American Fitness Index?

Several indicators in the American Fitness Index address recreational and natural environments. By developing new, high-quality parks, trails, and greenways, especially in historically underserved areas, communities could improve their score in two areas: parks per 10,000 residents and the percentage of residents within a 10-minute walk to a park. Communities could also improve their community/environment score by enhancing their park-based recreational facilities. They could improve their personal health score by improving park access, which will help residents be more physically active and have strong personal fitness.

How does the CPSTF recommendation support Active People, Healthy Nation?

Active People, Healthy NationSM is a national initiative led by CDC to help 27 million people become more physically active by 2027. Creating or enhancing access to places for physical activity—such as building walking trails or providing access to existing nearby facilities—and providing information to encourage their use is one of the initiative’s core strategies to increase physical activity.

The new CPSTF recommendation reinforces this strategy by providing evidence of the relationship between parks, trails, and greenways and increased physical activity.

Visit the Active People, Healthy Nation website to subscribe to the monthly newsletter, share success stories, and learn how to get involved.

Additional Resources

Disclaimer: The findings and conclusions in this blog post are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.

Kaitlin Graff, MSW, MPH, Program Coordinator, McKing Consulting Corporation/Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention

Akimi Smith, MPH, Evaluation Fellow, Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention

David Brown, PhD, FACSM, Senior Behavioral Scientist, Physical Activity and Health Branch, Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention

Moving More to Improve Mental Health: What City Officials Need To Know

One of the personal health indicators selected for inclusion into ACSM’s American Fitness Index is a measure of the mental health status of city residents. Mental health and physical health are both important components of overall health and are themselves closely connected. Mental health plays a major role in maintaining good physical health. Mental health issues, such as depression and anxiety, are known to reduce people’s ability and desire to participate in health-promoting behaviors. In addition, poor mental health increases the risk of developing a chronic physical health problem such as diabetes, heart disease and stroke.

Given the importance of good mental health to overall health, investing in resources to increase physical activity would be one way community leaders could improve their residents’ overall health and fitness. There is a growing body of evidence that recognizes the positive effects of exercise on reducing anxiety, stress and depression.

Current research shows why physical exercise is essential to mental health. In addition to other biochemical mechanisms, exercise is well known to stimulate the body to produce endorphins and enkephalins, the body’s natural “feel-good” hormones, which can improve an individual’s mood and make problems seem more manageable. Psychological mechanisms influence the effects of exercise on mood states, as suggested by both the distraction hypothesis and the self-efficacy hypothesis. The simple act of focusing on exercise can give us a break from current concerns and damaging self-talk.

Other research has shown that physical activity may play an important role in the prevention, treatment and management of mild to moderate mental health illnesses, especially depression and anxiety. Although people with depression tend to be less physically active than non-depressed individuals, increasing their participation in aerobic exercise and/or strength training has been shown to reduce depressive symptoms significantly. Anxiety symptoms and panic disorder also improve with regular exercise, and beneficial effects appear to equal that found with meditation or relaxation. Data suggests that acute anxiety responds particularly well to physical activity.

While participating in exercise generally is beneficial for both physical and mental health, it is important to note that people have widely varying preferences for the types of activity in which they may want to engage. Clearly, the mental health benefits are associated with physical activities that people want to do and enjoy doing. Consequently, cities should provide access to a variety of types of activity so that residents can choose those that are most attractive to them and that would be of greatest benefit to both their mental health and physical health.

Increasing access to physical activity resources like parks, trails and community centers is particularly important now that the COVID-19 pandemic has increased the need for mental health care in an already strained mental health system. The most recent published literature has documented a notable increase in reported depression and anxiety as a result of the COVID-19 pandemic. At the same time, there has been increased demand for public spaces to be physically active. Being physically active outdoors is particularly beneficial for mental health.

In addition to improving access to physical activity resources, city officials must partner together with business and community leaders to increase access to mental health services and reduce mental health stigma. Innovative initiatives are particularly important now to help those in need of mental health care access the care they need, including:

  • Using public service announcements to decrease mental health stigma,
  • Expanding access to community mental health centers,
  • Co-locating mental health services with primary health care services,
  • Supporting the use of telemedicine to increase the availability of mental health services,
  • Improving health care providers’ and first responders’ awareness and use of mental health referral networks, and
  • Expanding evidence-based training for mental health providers.

Many cities have implemented initiatives like these to improve access to mental health care for their residents. ACSM applauds their efforts and encourages other cities to adopt programs that have been shown to be effective elsewhere.


Author:  Terrell W. Zollinger, DrPH, Professor Emeritus, Indiana University

three people riding bikes in a park

Addressing Fitness Index FOMO | Resources for Cities Not Included on the Rankings Report

The American Fitness Index assesses key indicators and ranks the largest 100 U.S. cities by population and names one as the fittest city annually. What do you do if your community wasn’t large enough to be included in the rankings? How can you evaluate your community’s health and fitness? We can help you with that too! The  Community Fitness Assessment  was designed to help stakeholders in communities that were not included in the Fitness Index rankings by applying a similar approach to assessing their city’s community fitness and build understanding of the individual and societal factors related to physical activity in their community.

The  Community Fitness Assessment  will lead you through the steps to find data about your community, identify peer communities and then identify your community’s areas of excellence and opportunities for improvement.

 Community Fitness Assessment Steps

    1. Describe your community
    2. Identify the communities you want to compare with your own
    3. Search for personal health indicator data
    4. Search for community/environment indicator data
    5. Consider the option of a Mini Community Fitness Assessment
    6. Interpret the results
    7. Use the Community Fitness Assessment  profile to advocate for improved health and fitness

The  Community Fitness Assessment  is designed with collaboration in mind. That is, your community will likely need to build a team that represents multiple city departments and community organizations, including the health department, parks and recreation, transportation, planning and zoning, as well as other key community-based organizations and businesses. Members of this team can gather the most current local data needed to conduct the Community Fitness Assessment.  This team can also engage community members to share the results and collect feedback on their priorities for addressing areas needing improvement.

Throughout the process of conducting the assessment, leadership and engagement from elected officials like mayors and city councilors will be vital to success. These elected officials play a key role in allocating funding and passing ordinances that can advance the community-identified priorities. For example, community members may need new streetlights installed in their neighborhood to make it safer and easier to walk or bike home from work in the evening. City officials can work with local utilities to develop a plan for funding and installing new streetlights starting in areas with the highest need.

The results of your  Community Fitness Assessment  won’t be directly comparable to the scores and rankings for the 100 American Fitness Index cities due to proprietary weighting of the indicators in the national index, but you will have a better idea of where your community is doing well and where there’s room for improvement. Using the American Fitness Index rankings, you can also identify cities that perform well on specific indicators to contact for advice in addressing your community’s needs.

If your community needs a little extra help getting  your team started, you can also use the  Community Action Guide  which outlines the  steps to build an effective team to advocate for healthy changes in your community.

We’d love to hear your feedback. Let us know how you used the  Community Fitness Assessment  here.

Infographic: The Path to a Culture of Health


Many communities develop programs and events as part of its strategic plan for improving residents health, but a more sustainable approach to gain traction is known as “Policy, Systems and Environmental Change” (PSE). The major difference between PSE compared to traditional approaches such as events and programs is that the PSE approach is aimed at long-term, sustainable and ongoing behavioral change.

The reason PSE is useful for improving health in a community is because encouraging people to live healthier lives isn’t just about changing individual behaviors and creating good habits. Communities need to be places that encourage and promote healthy choices. A PSE approach makes healthier choices a real, feasible option for every member of the community by looking at the laws, rules and environments that impact behavior.

PSE Definitions:

  • Policy interventions are laws, ordinances, resolutions, mandates, regulations or rules (both formal and informal).
  • Systems interventions are changes that affect all elements of an organization, institution or system.
  • Environmental interventions involve physical or material changes to the economic, social or physical environment.

The infographic, The Path to a Culture of Health: The Policy, Systems and Environmental Change Approach for Community-Based, Healthy Eating and Physical Activity, highlights examples of PSE interventions designed to increase the number of residents eating healthy foods as well as engaging in more physical activity.  Learn more by visiting the Community Action Guide.

You can download the full version in PDF format by clicking on the image above and saving to your computer.  You can also download the individual Healthy Eating and Physical Activity infographics by clicking on the images below.

ACSM_PSE_Healthy_Eating_Graphic_final ACSM_PSE_Physical_Activity_Graphic_final

Case Studies in Action: Charlotte, NC

 Charlotte Case Study_web 2

Healthy Charlotte Annual Report 2014

The Healthy Charlotte effort is well on its way to leading a change in Charlotte’s culture from being a wonderful, vibrant community for families and business to thrive to being a wonderful, vibrant and healthy community where the health, fitness and wellness of citizens is the top priority.   celebrates the progress made by the Healthy Charlotte initiative in 2014 and looks forward to seeing the quality of life continue to improve as the effort expands in the future.

Below is a snapshot of Healthy Charlotte’s successes in 2014.  To learn more about the initiative, visit or

Healthy Charlotte 2014 Report_1Healthy Charlotte 2014 Report_2


(Click the image above to open a pdf version.)