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:– 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

(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

(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 dataData related to:

–Healthy lifestyles–Health outcomes–Community resources

– Execute AFI data reportScientific- 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 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 Miami Milwaukee Minneapolis/St. Paul Nashville New York Oklahoma City Orlando Philadelphia Phoenix Pittsburgh Portland, OR Providence, RI Raleigh, NC

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