The ancient curse “may you live in interesting times!” seems fitting right now. While the stay-at-home order has constrained our normally hectic lives, we have been able to spend more time with our families and participate in activities we didn’t take time to do before, like going for walks. Here in the U.S., the COVID-19 pandemic is occurring in months when the weather is more favorable for outdoor activities. This has led to some very positive developments, one of which is more people walking and exercising outdoors.

From a public health perspective, walking, biking or any outdoor physical activity is a great form of exercise. Walking, specifically, is very beneficial as evidenced by many studies.[1]^,[2]  Walking reduces blood pressure, heart rate, cholesterol and other cardiovascular risks; the risk of type II diabetes, preterm births and low-for-gestational-age births; as well as incidence of strokes, hypertension, dyslipidemia, asthma and coronary heart disease.  And, those are just the physical benefits!

Walking outside offers even more benefits. A summary of the research on this topic[3] indicates that exercising in the natural environment has direct and positive impact on wellbeing, including a greater reduction in blood pressure and cortisol (a hormone released during stress) compared to “synthetic” environments such as gyms, urban spaces and indoor exercise. It is thought that the outdoor environment reflects the role of nature in recovery from stress and mental fatigue. Also, exercising in nature might encourage starting and continuing health-enhancing behaviors like jogging on a path in a park. Interestingly, a review of outdoor versus indoor exercise[4] shows the greater benefit of exercising outside is on mental or emotional measures like better attention, higher energy and tranquility, as well as less anger, fatigue, sadness and depression.

Many communities and municipalities have invested in expanding trails and sidewalks for residents to utilize for exercise and commuting to nearby businesses. While these amenities add great benefits in terms of better health, desirability and home value, these are often near streets with vehicular traffic. This results in added stress from passing cars and trucks not to mention exposure to noise and fumes. Fortunately, some multipurpose trails in suburban and less-developed corridors have fewer adverse factors. State parks and recreation areas also include walking trails, offering more favorable places to exercise in stress-free, clean-air environments. Many residents in the U.S. have access to nearby trails in natural environments which would be ideal for exercising. Do you know of some nearby trails in parks or undeveloped areas that you can use? I’ll bet you do. In case you don’t, use this find a park resource to help.

Author: Terrell Zollinger

[1] https://www.sciencedirect.com/science/article/pii/S0091743506005172

[2] https://bjsm.bmj.com/content/42/4/238.short

[3] https://www.sciencedirect.com/science/article/pii/S0013935118303323

[4] https://bmcpublichealth.biomedcentral.com/articles/10.1186/1471-2458-10-456?dom=prime&src=syn

The American College of Sports Medicine (ACSM), in collaboration with philanthropic partner, Anthem Foundation, will delay the release of the 2020 American Fitness Index rankings until later this year. The Fitness Index evaluates and celebrates America’s 100 largest cities and their efforts to support healthy, active lifestyles.

Physical activity has always been one of the most effective ways to ensure good health. During the COVID-19 pandemic, staying active is increasingly important to both physical and mental health, including developing a strong immune system and building mental resilience. ACSM, the Anthem Foundation and the Fitness Index encourage all people to get and stay active while following safety recommendations by federal, state and local public health officials. For more resources on how to be active at home visit http://www.acsm.org/read-research/newsroom/news-releases/news-detail/2020/03/16/staying-physically-active-during-covid-19-pandemic.

This post will be updated with additional information as it becomes available. Please check back regularly.

The American College of Sports Medicine (ACSM) American Fitness Index is one of the most credible and reliable assessments of individual and community fitness across the United States. The indicators included in the report are timely, relevant, and valuable to address both unique and common factors between cities. In 2019, The Fitness Index added four new indicators: pedestrian fatalities, air quality, Bike Score, and Complete Street policies.

The advisory board added the indicators mentioned above to place more emphasis on the built environment and the role it plays on health for the population. It is doubtful that not being able to enjoy the outdoor facilities in your neighborhood would create an often-insurmountable barrier for additional physical activity.

With the new year in full swing, many have made a resolution to be more active and take better care of their health. Still, more than half of the country is in the middle of a cold winter, which can mean slippery roads and less daylight in the afternoon. The environment many Americans call home may not encourage a healthy behavior change. And sure, they may decide that they will brave the cold to take a walk. Still, as soon as they step outside on to the public sidewalk, they lose their footing because the city has not done such a great job of clearing the snow and ice from the last winter storm. Or stories of people falling victim to car accidents while walking may be discouraging. These factors are within the control of the local governments, and these indicators will allow them to have the information to create a space for a positive change. Being able to walk safely because the sidewalk is not slippery or more streetlights for better visibility may encourage more sustainable behavior.

Living a more active lifestyle has numerous benefits for people of all ages. The current recommendations for physical activity include 150 min/week of moderate-intensity aerobic physical activity or 75 min/week of vigorous aerobic physical activity, and at least two days of strength training that involves all major muscle groups. Increased physical activity has the potential of leading to long-term health benefits. There is substantial evidence of the positive effects associated with increased physical activity on physical health, mental health, and all-cause mortality. Look above and notice that exercise was never mentioned before this sentence. You can be active in any matter you choose.

According to data from the 2019 American Fitness Index, 51.2% of residents report meeting the aerobic activity guidelines. Of those, only 22% stated they were meeting both aerobic and strength recommendations. While there are many options for indoor fitness, they can be costly and inconvenient. Communities can encourage residents to meet both aerobic and resistance training recommendations by placing outdoor adult fitness gyms in local parks. Cities falling in the top 25 of the fittest cities in the U.S. have about 35% more residents living within a 10-minute walk to a local park than other cities. This proximity to parks provides greater opportunity for residents to be more active. A higher number of outdoor adult fitness parks, especially in underserved communities, may increase the likelihood of producing positive change in overall fitness and health.

On an individual level, finding ways to increase physical activity can be done everywhere you frequent. At home, choosing to do a few jumping jacks or squats during a commercial break will improve your physical activity when done for an hour-long television show. When at work, taking at least one minute every hour to walk around the office can make a big difference in a week. In your neighborhood, getting off the bus a stop early to walk will increase your physical activity. All these small changes can yield significant benefits to your health and fitness.

Whatever you can do to increase the amount of time you are moving is going to be the best thing you can do for your health. Please beware of trying to do something that you genuinely dislike, as these are the things you will most likely not do for very long. So, go for a walk or play with your kids. Either way you should aim to have fun and have an active new year.

And just for good measure, if you haven’t already, and it’s safe to do so, how about taking a short walk? Remember, health is wealth.

Author: Alvin Morton, III, M.S., is a doctoral student at the University of Tennessee, Knoxville and a member of the American Fitness Index Advisory Board.

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.

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? 

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