ACSM American Fitness Index™
Actively Moving America to Better Health
A program of the American College of
Sports Medicine (ASCM)
Presentation by First Last, Ph.D,
FACSM
Mo/Da/2009
ACSM American Fitness Index™
 Funded by the WellPoint Foundation
 Looks at health status of population
– Preventive health behaviors
– Levels of chronic disease conditions
– Access to health care
 Looks at community assets that support
healthy lifestyles
– Community supports
– Policies for physical activity
Need for Action
 Physical activity and obesity are at epidemic
proportions
– Increased prevalence of chronic diseases
– Increasing health expenditures
 Regular physical activity
– Therapeutic physical benefits
– Fewer health care needs
– Combats rising health care expenditures
Need for Action
 ACSM-commissioned 2007 Omnibus survey
– Solution to decreasing physical activity and
obesity lies at the local level
– Highlights:
 72% rated community’s efforts to encourage
physical activity as average or worse
 49% say lack of biking tails and 27% say lack
of public parks hinders physical activity
 94% acknowledged physical activity is key for
disease prevention
What Makes the AFI Unique?
 Many may ask, “Why do we need another study to
tell us to get more active?”
 Need an effective measure that captures:
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The state of health
The state of community fitness
Measure at the local level
Scientific- and evidence-based measure
Advisory Board
 Chair: Walter R. Thompson, Ph.D. FACSM
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(Georgia State University)
Vice-chair: Barbara Ainsworth, Ph.D. FASCM
(Arizona State University)
Steven N. Blair, P.E.D., FACSM
(University of South Carolina)
Ralph Bovard, M.D., MPH, FACSM
(HealthPartners Specialty Center)
Jacqueline Epping, M.Ed.
(U.S. Centers for Disease Control & Prevention)
John M. Jakicic, Ph.D., FACSM
(University of Pittsburgh)
Advisory Board (cont’d)
 Elizabeth Joy, M.D., MPH, FACSM
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(University of Utah)
NiCole Keith, Ph.D. FACSM
(Indiana University Purdue University-Indianapolis)
Roseann M. Lyle, Ph.D. FACSM
(Purdue University)
Melinda M. Manore, Ph.D, R.D., FACSM
(Oregon State University)
Angela Smith, M.D., FACSM
(Children’s Hospital of Philadelphia)
Stella Lucia Volpe, Ph.D., R.D. FACSM
(University of Pennsylvania)
Wes Wong, M.D., M.M.M
(Anthem Blue Cross Blue Shield-WellPoint)
AFI Program Goal
 Improve the health, fitness and quality
of life of Americans by promoting
physical activity.
AFI Program Components
 #1 - Data
– Collect, aggregate and report metropolitan
area data
Data related to:
–Healthy lifestyles
–Health outcomes
–Community resources
– Execute AFI data report
Scientific- and evidence-based snapshot
of the health status of major metro areas
AFI Program Components
 #2 - Resources
– Resources for practical application of
sports medicine and exercise science
– Conduct research
– Provide education
AFI Program Components
 #3 - Health Promotion Partners
– Link communities with organizations
and existing programs in their metro
area
– Promote collaboration on physical
activity and healthy lifestyle initiative
– Connect local, state and national
partners and resources
Implementation (Pilot)
 Pilot phase focused on data collection and
analysis (released May 2008)
– Download at AmericanFitnessIndex.org
 16 of the most populous U.S. metro areas
– Top 15 + Indianapolis
– Based on MSA data from U.S. Census
 Data collected, analyzed, weighted and
aggregated
Implementation (Expansion)
 The next phase focused on expanding the
data report to the top 50 most populous U.S.
metro areas
– Download at AmericanFitnessIndex.org
 Includes some newly available data
Methodology
 AFI uses scientific evidence, expert
opinion and statistical methodologies to
select, weigh and combine the elements
used in the data report.
Methodology
 Metro Areas Included
 Not city limits only
– Overlooks interaction of core city and
surrounding suburban areas
– Shared fitness-related resources
Top 50 Metro Areas
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Atlanta
Austin
Baltimore
Birmingham
Boston
Buffalo
Charlotte
Chicago
Cincinnati
Cleveland
Columbus, OH
 Dallas
 Denver
 Detroit
 Hartford
 Houston
 Indianapolis
 Jacksonville
 Kansas City
 Los Angeles
 Louisville
 Memphis
Top 50 Metro Areas
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Miami
Milwaukee
Minneapolis/St. Paul
Nashville
New York
Oklahoma City
Orlando
Philadelphia
Phoenix
Pittsburgh
Portland, OR
Providence, RI
Raleigh, NC
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Richmond, VA
Riverside, CA
Rochester, NY
Sacremento
St. Louis
Salt Lake City
San Antonio
San Francisco
San Jose
Seattle
Tampa
Virginia Beach
Washington, D.C.
Metro Area Breakdown
 Example:
– Atlanta
– AFI rank (5); AFI Score (285)
– Population rank (9)
– MSA: Atlanta-Sandy Springs-Marietta
– Nickname: Metro Atlanta
Indicators Selected for AFI
 Must be related to the level of health
status and/or physical activity
 Must be recently measured and
reported by a well-respected agency or
organization of the metro area
 Must be modifiable through community
efforts
– Example: smoking rate
Data sources and information
 Info gleaned from publicly available
federal reports and past studies
 Must be recent data with established
history
 Most data is from 2006
Data sources and information
 SMART BRFSS
 American Community Survey (by Trust
for Public Land)
 U.S. Census
 U.S. Dept of Agriculture
 State Report Cards
 HRSA Area Resource File
Data on Personal Health
 Health Behaviors
– % exercising in last 30 days
– % exercising at least moderately
– % eating 5+ fruit/veggies per day
– % currently smoking
Data on Personal Health
 Chronic Health Problems
– % obese
– % in excellent or very good health
– % with asthma
– % with diabetes
– Death rate/100,000 for CV disease
– Death rate/100,000 for diabetes
Data on Personal Health
 Health Care
– % with health insurance
Data - Community/Environment
 Built Environment
– Parkland as % of MSA land area
– Acres of parkland/1,000
– Farmers’ Markets/1,000,000
– #/10,000 using public transit to work
– #/10,000 biking or walking to work
Data - Community/Environment
 Recreational Facilities
– Ball diamonds/10,000
– Dog parks/10,000
– Park playgrounds/10,000
– Golf courses/100,000
– Park units/10,000
– Recreation centers/20,000
– Swimming pools/100,000
– Tennis Courts/10,000
Data - Community/Environment
 Park-related expenditures per capita
 Level of State requirement for PE classes
Data - Health Care Providers
 # of primary care providers/100,000
Data Limitations
 Based on self-reported responses
 Some missing data for some indicators
in some MSAs
– Example: Riverside community and
environmental indicators
Guiding Principles for Healthy
Communities
 Overall health improvement in U.S.
communities must focus on the prevention of
behavioral-linked diseases by effectively
addressing the underlying risk and
community factors
 The rise in chronic diseases attributable to
physical inactivity and unhealthy diets are a
“clear and present danger” to our health and
healthcare systems, our communities, our
nation and our future
Guiding Principles for Healthy
Communities (cont’d)
 All U.S. communities, irrespective of size and
current health status, can make powerful
advances in improving the health of their
people through simple, affordable, effective
steps.
 There is a need for even more synergy and
collaboration to assist U.S. communities in
actively making the moves toward better
health
Moving from pilot to full version
 Expanded and enhanced
– Expanded to the Top 50 MSAs
– Use combined MSAs for communities
with MSA divisions
– Expand data elements from BRFSS
– Obtain info about certified personal
trainers
– Update elements
Next Steps
 May 2009 data report
– Released during ACSM Annual
Meeting (Seattle, Wash.)
 Welcome suggestions and comments
– Send comments to afi@acsm.org
What can you do?
 Provide comments/suggestions
 Be a role model for good health and physical
activity
 Educate and bring awareness to the physical
inactivity epidemic in your community
– Media relations
– Engage community leaders
 Volunteer
– Check out www.americanfitnessindex.org
for local resources
Thank you
Questions?
www.AmericanFitnessIndex.org