Category: In the News

male pedestrain about to cross a busy intersection

America’s Most Dangerous Cities for Pedestrians

Across America’s 100 largest cities an average of  2.2 pedestrians were killed per 100,000 residents in the last year.   With a total population of 64,504,498  in those cities,  that means approximately 1,419 lives were lost.

A variety of factors may contribute to pedestrian fatalities, including distracted driving, a lack of proper lighting, inadequate sidewalks and unsafe crossing and intersections.

America's Most Dangerous Cities for Pedestrians
America’s Most Dangerous Cities for Pedestrians

The most dangerous cities for pedestrians are (average deaths per 100,000 residents):

100. St. Louis, MO (5.8)

99. Albuquerque, NM (4.7)

98. St. Petersburg, FL (4.2)

97. (tie) Corpus Christi, TX (4.1)

97. (tie) Atlanta, GA (4.1)

95. Jacksonville, FL (4.0)

94. Orlando, FL (3.7)

93. (tie) Tampa, FL (3.6)

93. (tie) New Orleans, LA (3.6)

91. (tie) Bakersfield, CA (3.5)

91. (tie) San Antonio, TX (3.5)

How does your city rank? 

active transportation op-ed template blog

Advocate for Active Transportation in Your Community | Op-ed Template

A key step in increasing active transportation habits and avenues  in your community is working to increase awareness of the economical, personal health and environmental benefits of walking and biking. Submitting an op-ed to your local newspaper, magazine or television station can be a productive way to spread the word about these benefits.

The American Fitness Index and ACSM’s ActivEarth Task Force have partnered to supply an op-ed template that you can use to generate or renew interest in active transportation methods in your community. The template can be easily customized for your local community.  Click here to download the template!  

Include stats from the Fitness Index Rankings report  in your op-ed.

Want to learn more about supporting active transportation? Check out more ActivEarth resources here.

blog_afi_pedestrian safety

Pedestrian Safety Concerns Hinder Active Transportation

In 2018, 6,227 pedestrian fatalities occurred in the United States, the highest number in nearly three decades and a four percent increase from 2017 according to a report earlier this year from the Governors Highway Safety Association (GHSA). “While we have made progress reducing fatalities among many other road users in the past decade, pedestrian deaths have risen 35 percent,” noted GHSA Executive Director Jonathan Adkins. Pedestrians were projected to account for 16 percent of all traffic deaths in 2018, compared to 12 percent in 2008. The high rate of pedestrian fatalities is a growing public health issue that often gets little notice, but should, particularly now that more individuals are walking, running or biking for exercise and commuting.

Following advice from experts, such as those from the American College of Sports Medicine and perhaps their own physicians, many Americans are becoming more physically active to improve their health, reduce their risk for many diseases and increase their quality of life. As a result, individuals have taken to the streets to walk, jog, run and bike. The American Fitness Index incorporates several related measures, including the percent of residents bicycling or walking to work, the Walk Score and Bike Score for cities and the percent of residents using public transportation, as it calculates city fitness scores and rankings.

Despite knowing the health benefits, safety concerns can be a major barrier to physical activity for individuals who are uncomfortable exercising on or near city streets, since sharing the streets with motor vehicles poses a risk of injury or even death for pedestrians. For this reason, the Advisory Board of the Fitness Index added pedestrian fatality rates as a health outcome indicator in 2019. The Advisory Board believes the higher the pedestrian fatality rate, the more likely it will be a barrier for residents’ physical activity, leading to a less fit city.

In the 2019 Fitness Index rankings, four of the 10 cities with the highest pedestrian fatality rates were located in Florida (St. Petersburg, Jacksonville, Orlando and Tampa) and two more were also in the southeast region (Atlanta and New Orleans). On the other end of the spectrum, of the cities with the lowest rates, two were in Virginia (Arlington and Virginia Beach) and two others were in Nebraska (Lincoln and Omaha).

As you have been driving, perhaps you have worried about how to safely pass a walker, runner or cyclist on the street? This knowledge gap is a major problem for drivers when people are exercising or commuting on foot particularly in early morning, at dusk and especially at night when visibility is poor. Over the past 10 years, nighttime crashes accounted for more than 90 percent of the total increase in pedestrian deaths.

Next Steps

To reduce this trend, (which has been accomplished in some cities!) additional efforts need to focus on what the city, drivers and pedestrians can do to increase safety. For example, cities can adopt Complete Streets policies, one of the Fitness Index indicators, which focus on designing, constructing and maintaining streets to be safe for all users. These designs can help slow drivers and encourages them to be more cautious around pedestrians. Communities can also help reduce pedestrian fatalities by educating both drivers and pedestrians on following traffic rules and speed limits and safety measures when exercising or commuting on streets. For additional resources to improve pedestrian safety, visit the National Highway Traffic Safety Administration.

The bottom line is that attention to pedestrian safety by city leaders, drivers and pedestrians themselves are all needed to reduce pedestrian fatalities.

 

Author: Terrell W. Zollinger, Dr.P.H, MSPH

halloween safety tips

Halloween Safety Tips

Halloween can be a fun holiday for families if you follow these safety tips to keep trick-or-treaters and party goers safe at night!

Be Safe

• There is safety in numbers. Travel in pairs or groups.
• Use crosswalks and be predictable. Walk on the left side (against traffic) and bike on the right side of the road (with traffic).
• Avoid costumes with dragging or dangling materials and vision restricting masks.
• Wear comfortable shoes, layer clothing as needed, and carry water to stay hydrated.

Be Seen

• Wear blinking lights, glowsticks, and bright or reflective clothing.
• Carry flashlights or headlamps.
• Drivers may have poor visibility at night and during sunset. Use caution during these times.

Be Social

• Host events such as Trunk-or-Treat at schools or parks to incorporate games and physical activity.
• Invite friends and family to trick-or-treat in more walkable communities with sidewalks and streetlights (those with higher Walk Scores).
• Participating in neighborhood activities builds social capital which contributes to a safer community.

halloween safety tips

 

Have fun and enjoy a safe holiday!

Download the Infographic 

Author: Melissa Wehnert Roti, Ph.D., FACSM, ACSM-EP, GEI

American Fitness Index Anthem Foundation fresh food availability

Supporting Local Communities in the Fight Against Food Insecurity

The American Fitness Index serves as a tool and resource for community stakeholders to address conditions in the environments that negatively affect a person’s overall health and identifies target areas to create healthier, more active communities.

Eliminating food insecurity is a critical factor in improving the overall health and well-being of individuals in the communities we serve, which is why the Anthem Foundation recently partnered with The Food Trust. Our collaboration will expand The Food Trust’s community-based program, the Healthy Food Retail Initiative, aimed at increasing access to healthy food and promoting health equity in cites in Indiana, Ohio and California.

Through our work with ACSM and programs like the Indianapolis Healthy Food Retail Initiative with The Food Trust, the Anthem Foundation is committed to creating meaningful partnerships with organizations, targeting specific, preventable health concerns and addressing the conditions in our environments which negatively impact individuals within communities.

For example, the 2019 Fitness Index found that only 33.9 percent of Indianapolis residents are eating two or more fruits a day and just 15.1 percent of residents are eating three or more vegetables each day. Data also showed more than one in three Indianapolis residents live in low food access areas where fresh food is difficult to find. Through these findings, it was clear that far too many Hoosiers are living without reliable access to a sufficient supply of affordable, nutritious food.

Fortunately, our partnership with The Food Trust recently expanded the Healthy Food Retail Initiative into five additional communities on the Eastside of Indianapolis, with markets and convenience stores increasing inventory and promotion of fresh produce and other heart-healthy foods. These locations also serve as “community health hubs” by providing health screenings, nutrition education and cooking lessons.

We believe giving back is not only a privilege, but a responsibility that we all share. Since the Foundation’s inception, we have remained committed to improving health and strengthening local communities through contributions to organizations committed to empowering communities to create healthier generations.

 

Author: Stephen Friedhoff, MD, Chief Clinical Officer, Anthem, Inc.

Since 2006, the Anthem Foundation has awarded the American College of Sports Medicine (ACSM) over $1.2M as a founding partner to establish the American Fitness Index.

Seasonal shopping at your local farmers market

Eating a wide variety of colorful fruits and vegetables is the ideal way to get the necessary vitamins and minerals that your body needs. Planning meals around food that is in-season is a great way to stay healthy and keep variety in your diet!

Now that you know eating seasonally has great health benefits, how do you start planning your fresh meals? The first step is knowing where to buy ingredients. Your local farmers market is the perfect place to get seasonal produce because the sellers have likely traveled less than 50 miles from where they grow to get to the market. You can’t get fresher than that! An added bonus to shopping at your local farmers market is that you are supporting growers in your own community. This helps to build and maintain your local economy, as well as strengthen the ties of your neighborhood. Finally, many farmers markets also accept Supplemental Nutrition Assistant Program (SNAP) and Women, Infants, and Children (WIC) vouchers to make sure that fresh food is accessible to all. Not sure where the closest farmers market is located? The US Department of Agriculture (USDA) has a search tool!

The next step in planning fresh meals is knowing which produce is currently in-season in your area. This can vary depending on the climate in your hometown, but the below chart can be used as a basic reference.

seasonal produce chart

To find seasonal food in your area, use the Seasonal Food Guide.

Now it’s time to have fun and decide which foods you will eat! Try mixing in your favorites, as well as some new options to keep meals exciting and maximize your nutrient intake. Want to try a new food, but not sure the best way to prepare it? Ask the seller! As the one who has grown the food, they will be very familiar with its flavor and will be able to recommend what other foods pair well. Enjoy!

Download the above chart as a PDF. 

air quality and outdoor exercise blog post

Air Quality and Outdoor Exercise

There is incontrovertible evidence linking poor air quality to adverse health outcomes. This is especially true for people with pre-existing conditions such as heart disease, stroke, asthma and chronic obstructive pulmonary disease. However, healthy people are at risk too. Exposure to air pollution has been linked to a higher risk of developing asthma, and recent studies have identified links between air pollution and adverse pregnancy outcomes.

The American Fitness Index added air quality as an indicator of a healthy and fit city for the first time with the 2019 rankings release. The Fitness Index used the Air Quality Index (AQI) from the Environmental Protection Agency which measures major air pollutants, including particle pollution, ground level ozone, sulfur dioxide and nitrogen dioxide, and carbon monoxide. The Fitness Index’s 2019 Summary Report notes that the 100 largest cities in the U.S. average only 62 percent of the year with good air quality. That means for over a third of the year residents in these cities are breathing polluted air that is harmful to their health.

The AQI provides guidance as to the safety of the air quality. You can download the airnow.gov app for your smart phone or visit www.airnow.gov, and review the AQI for an entered zip code.

Air Quality Index Graphic
Source: Environmental Protection Agency’s Air Quality Index www.airnow.gov

Of course, we want people to be physically active, and better yet, to be active outdoors. While air pollution can affect your health, the health benefits of being physically active outweigh the risks of air pollution for most healthy individuals. However, it is important to keep in mind that an adult exercising at a moderate level of exertion exchanges about six liters of air per minute! An athlete running at 70 percent of their maximal oxygen uptake for the length of a marathon inhales the same volume of air as a sedentary person does in two days!

Tips to maintain an active lifestyle when air quality is poor:

  • Exercise earlier in the day. Both particulate pollution and ground level ozone tend to accumulate throughout the day.
  • The vast majority of air pollution comes from tailpipes – cars and trucks on the road – so avoid outdoor activity during commuting time (7:30 a.m. – 9:00 a.m., and 4:00 p.m. – 7:00 p.m.), and when possible avoid exercise next to heavily trafficked roadways.
  • Consider indoor activity opportunities like going to the gym, walking laps at the mall or working out along with an exercise video (local libraries often lend these for free).
  • It is important to note that a scarf or paper mask does not protect you from the poor air quality.

Finally, think about what you can do as an individual to reduce your contribution to poor air quality by using public transportation when possible, walking or biking to work or school, combining driving trips, eliminate idling, avoiding wood-burning and replacing or installing ultra-low nitrogen oxide water heaters. If we all do our part to clean the air, it will make the environment safer for the outdoor activities we love.

Author: Liz Joy, MD, MPH, FACSM

ACSM American Fitness Index and Anthem Foundation

Partnership Between American Fitness Index and Anthem Foundation is Twelve Years Strong

The Anthem Foundation is embedded in communities across the country where it supports programs that build awareness about the importance of active lifestyles and healthy behaviors. One of the many ways we are helping to increase awareness and improve overall health is through our partnership with the American College of Sports Medicine (ACSM). Since 2006, Anthem Foundation has granted over $1.2M to ACSM as a founding partner in an effort to establish the American Fitness Index, a tool and resource for community stakeholders to address conditions in the environments that negatively affect a person’s overall health and identifies to create healthier, more active communities.

For the second year in a row, Arlington, VA received the title of ‘Fittest City’ in America in the 2019 American Fitness Index rankings. The findings of the 2019 Fitness Index are not only a great indicator of how well communities are encouraging fitness among their residents, but also reveal how social, economic and physical conditions of health within communities directly impact the health and fitness levels of America’s largest cities.

According to Healthy People 2020, a science-based initiative launched by the U.S. Department of Health and Human Services, nearly everyone is impacted by conditions in the environment that negatively affect a wide range of health, functioning, quality of life outcomes and risks in one way or another. A way to look at the health of individuals and our communities starts in our homes, schools, workplaces, neighborhoods and communities. By taking a deeper look into these areas, we can understand why some Americans are healthier than others, and focus on interactions and relations to address why other Americans are not as healthy, and come up with opportunities and solutions on how to improve the problematic areas.

Part of our ongoing strategy at the Anthem Foundation is to create meaningful partnerships with organizations, targeting specific, preventable health concerns and addressing the conditions in our environments’ social determinants that can negatively impact them. Together with the ASCM and the Fitness Index, we can continue to look toward a brighter future by providing the necessary tools and resources to benefit people of all ages and backgrounds within our communities.

 

Author: Stephen Friedhoff, MD, Chief Clinical Officer, Anthem, Inc.

Changes in the 2019 ACSM American Fitness Index: What Impact Will They Have?

Since the creation of the ACSM American Fitness Index®, the data team constantly looks for ways to improve the rankings. Also, as data sources change the information they gather, we must make changes in the indicators that are used. Both improvements and data source changes took effect as we prepared the 2019 Fitness Index rankings.

The data team worked closely with the experts on the Fitness Index Advisory Board to add four new measures to make the Fitness Index more complete:

  • Complete Streets policy
  • Pedestrian fatality rate
  • Bike Score®
  • Air quality index

These new indicators reflect the importance of policy and built environment in supporting active living that will lead to improved personal health outcomes. For example, cities that successfully implement Complete Streets policies can reduce pedestrian fatalities. Likewise, cities with high Bike Scores help to ensure bicyclists are safe and comfortable riding for transportation and recreation, which improves physical and mental health. While air quality is not often thought of in relation to physical activity, poor air quality has been shown to discourage physically active lifestyles, especially among people with respiratory limitations like asthma or COPD.

The data team also removed three indicators to help balance the Fitness Index and removed one indicator that no longer had a reliable data source:

  • Parkland as percentage of city
  • Acres of parkland/1,000 residents
  • Dog parks/100,000 residents
  • Percentage of residents getting 7+ hours of sleep/day

The three park-related indicators were removed to focus on the built environment characteristics that have a measurable effect on physical activity behaviors and health outcomes. The Behavior Risk Factor Surveillance System stopped regularly asking how much sleep people got on average; as a result, the sleep measure was removed from the list of indicators.

The data team also made some adjustments in the placement and weight applied to a few indicators to improve balance and consistency. Even with these changes, the 2019 Fitness Index includes the same number of indicators as were used in 2018 (33), and most of the indicators did not change.

The data team and Fitness Index Advisory Board do not make decisions about changes in the Fitness Index lightly, because cities need to know if their level of “fitness” is getting better from year to year. A lot of discussion and debate occurs among our expert advisors whenever changes are considered. The experts must be convinced that the changes follow current scientific thinking and will make the Fitness Index better; however, we also realize substantial changes cause problems when comparing rankings and scores over time.

With these changes, you might be wondering, “How do these changes impact my city’s score and ranking for 2019?” We believe that the 2019 Fitness Index is a more accurate and fair measure of your city’s fitness, which is a really good thing. However, when you compare the rankings and scores in 2019 to those reported in 2018, part of the shift may be due to the changes in the methods. For example, cities that have invested in making their streets and neighborhoods safer for walking and biking may see a better ranking in 2019 compared to last year, while cities that have larger and more parks may see a drop in the rankings due to these changes.

Advice for interpreting your city’s rank and scores for 2019

Although it is a natural inclination, please don’t compare the overall ranking and scores to those of previous years. Part of the change in rankings could be due to the updates that were made this year. Instead, look at where your city falls generally in relation to the other cities on the list. Is your city in the top 25, in the bottom 25 or somewhere in the middle?

What you also can and should do, is compare your city’s individual indicators from 2018 to 2019 to see which ones improved. After all, the goal of the Fitness Index is to see if your city’s residents are getting healthier and if there have been improvements in your city’s infrastructure to encourage healthy behaviors.

As always, our team here at the American College of Sports Medicine supports and applauds your efforts to become more fit and healthy! We believe the 2019 Fitness Index rankings can help inform decisions that will make your city and its residents healthier.

The 2019 American Fitness Index rankings will be released on May 14, 2019. 

Sign up to get exclusive insights into the report on the day of the release.

 

Author: Terrell W. Zollinger, Dr.P.H, MSPH

From 50 to 100: Lessons Learned from the Expansion of the American Fitness Index

Two criticisms of the first decade of the ACSM American Fitness Index®and its annual report were that it was limited to only the 50 most populated cities in the USA and that the entire metropolitan area was counted among the data. These two observations had some merit. Cities protested that a certain suburb was not really a suburb (but based on the federal government definition of Metropolitan Statistical Area it was) and smaller cities like Arlington, Virginia and Madison, Wisconsin said “what about me?” The original approach to the rankings provided important and valuable general messages but limited the ability to provide targeted assistance to city and community leaders.

That all changed when the 2018 Fitness Index was released. The number of cities reported on grew to the top 100 largest cities based on population, and the definition of “city” was limited to the city limits. The updated approach provides city leaders with the local data that they need to make changes. The data are more in line with governing structures within a city and acknowledge the differences in health behaviors and community-level infrastructure between the city and surrounding suburban areas. The expanded rankings also provide a more inclusive approach by adding cities in states that weren’t previously represented.

With this new definition of city and the inclusion of the top 100, there are still opportunities for the Fitness Index to consider with future updates. For example, in my own hometown of Atlanta (ranked #20 in 2018), the reported population is 473,000 although there are three times that number working within the city limits each day (don’t try driving a car during rush hour!).

Some people might say that the Fitness Index should include the “near” suburbs. This idea may have merit, but the Fitness Index faces challenges with every update. For example, there is not a standardized approach for defining “near” suburbs. Absent of any way to standardize that approach for all cities (and to make fair comparisons), the definition of city was established for the 2018 report. Additionally, changes made to the Fitness Index must have reliable, regularly updated data sources. Currently there are limited data sets that include “near” suburbs.

The methodology for the 2019 rankings remains the same as was used in 2018. There are still 33 indicators divided almost equally between personal health indicators (health behaviors and health outcomes) and community/environmental indicators (built environment, recreational facilities, policy and funding). The city definition has not changed since 2018.

Effect on the rankings

Interestingly, while direct comparisons cannot be made between rankings for MSAs and the city proper, the 2018 rankings found that most cities ranked similar to their MSA ranking from 2017. The 2018 rankings indicate that for MSAs ranked high in the 2017 Fitness Index, the central cities of those MSAs also ranked high in the 2018 rankings. The 2017 rankings for MSAs in #1 Minneapolis, #2 Washington, D.C. and #3 San Francisco remained highly ranked after the 2018 expansion.

A similar pattern appeared in low ranking MSAs and their central cities. The cities ranked toward the bottom of the 2017 Fitness Index when 50 MSAs were reported included #48 Indianapolis, #49 Oklahoma City and #50 Louisville. In 2018, these cities remained among the lowest ranked cities (#98 Louisville, #99 Indianapolis and #100 Oklahoma City). Although these cities continue to be ranked the lowest among the top 100 most populated cities in the USA, there are some grassroots programs starting to take hold and some success has been achieved.

 

Author: Walt Thompson, Ph.D., FACSM