We can all agree that the COVID-19 pandemic had a major impact on our lives and lifestyle in 2020 and continues yet today. Millions were sickened by the virus and hundreds of thousands lost family members. However, not everyone’s lifestyle was affected the same way. Millions lost their jobs, while others saw reduction in their work hours that caused severe economic hardship. Still others started working or getting their education remotely. Most of these individuals spent much more time at home. On the other hand, the essential workers still needed to carry out their job functions and some occupations, such as health care workers and delivery staff, worked more hours at their job locations.
Solid research on the impact of the pandemic on the relative fitness of the cities and their residents is very limited at this time. Undoubtedly, more will be known as time goes by. For now, the American College of Sports Medicine is considering how the pandemic might have an impact on the Fitness Index indicators and the city rankings in future reports. Due to the nature of data collection and reporting cycles, surveillance data collected in 2020 will not be available for analysis until the 2022 Fitness Index report. It is anticipated that community and environmental assets will not be significantly impacted by the pandemic. However, reduced use of these resources is likely due to closures, restrictions and changing lifestyles in response to the pandemic. In addition, the individual health indicators collected during 2020 are expected to decline in general, reflecting the pandemic’s adverse impact on individuals, their activities, jobs and communities.
The Fitness Index indicators to watch in 2022 include:
- % exercising in the previous month
- % meeting aerobic activity guidelines
- % meeting aerobic & strength activity guidelines
- % bicycling or walking to work
- % using public transportation to work
- % consuming 2+ fruits/ day
- % consuming 3+ vegetables/ day
- % in excellent or very good health
- % with poor physical health in the previous month
- % with poor mental health in the previous month
- % with obesity
What does the evidence suggest at this point?
A large proportion of the population’s lifestyle became more sedentary during the pandemic. Exercise habits changed as gyms closed and folks stopped using public transportation and walking or biking to work; however, some individuals did begin exercising at home and started walking more in their neighborhoods. Overall, early research shows that for most individuals, physical activity reduced substantially as a result of the pandemic. The decrease in physical activity is expected to result in fewer individuals reporting exercising in the previous month, meeting the recommendations for strength and aerobic activities, as well as indicating that they had more days of poor physical or mental health in the previous month. The Fitness Index measure of self-assessed health status is also expected to decline in 2020.
Many families struggled to obtain nutritious food due to being out of work, having restricted ability to visit grocery stores and large groups of food items not being in stock caused by the pandemic. In addition, children receiving free and reduced meals at school were now kept home and consequently didn’t have access to that needed nutrition. However, to help meet the food need, community food resources expanded, including food pantries, SNAP benefits and ad hoc community food distribution centers. In any case, normal patterns of food access and food intake were negatively affected likely resulting in fewer individuals reporting eating the recommended number of servings of fruit and vegetables.
Data also show that the stress due to the pandemic in the form of the fear of getting the COVID-19 infection along with limited travel, lockdowns and lack of physical contact with extended family and friends, caused an increase in reported depression and mental health issues. An evidence of the anxiety caused by the pandemic was the well documented instances of panic buying and stockpiling of essential household items. Closely related Fitness Index indicators that are likely to be negatively impacted by anxiety are the reported number of days with poor mental health in the previous month and the number of hours of sleep respondents report getting each night on average.
Less physical activity, poorer diets and increased stress are known risk factors for weight gain. Thus, it is expected that the percent of city residents with obesity is likely to be one of the major consequences of the pandemic. The increase in obesity is expected to be seen in children as well as adults since children stopped attending school in person, thus missing physical activity classes and after-school sports programs. Instead, they spent more sedentary hours looking at screens to study, play video games and for entertainment.
The impact of the COVID-19 pandemic on the rankings of the cities in the 2022 Fitness Index is hard to anticipate. While all cities and their residents experienced the COVID-19 pandemic during 2020, the impact on the fitness indicators of the residents may not be the same across all cities since the rates of infection varied and the cities’ leaderships promulgated different restrictions and safety practices at different times during the year.
Analyzing the Fitness Index data for 2020 for next year’s report will yield answers to many questions, and it will certainly be interesting to see the results, so stay tuned! In the meantime, the 2021 Fitness Index is available now with data that describes the conditions present just before the pandemic started.
Jessie Fudge, M.D., FACSM, Kaiser Permanente and Terrell W. Zollinger, DrPH, Professor Emeritus, Indiana University