What makes a community healthy?

Let’s play a quick word association game - consider your initial reaction when reading the following city names - is the city “healthy” or “not healthy”?

• San Diego, CA
• New Orleans, LA
• Las Vegas, NV
• Denver, CO
• Detroit, MI
• Portland, OR

If you’re like me, you associated the cities San Diego, Denver, and Portland with “healthy” and the cities New Orleans, Las Vegas, and Detroit with “not healthy.”

Today the American College of Sports Medicine (ACSM) released the 2011 American Fitness Index (AFI) report.  The AFI report scores and ranks the 50 most populous US metropolitan areas in their overall level of health and fitness.  Notable rankings in the 2011 report include:

• Minneapolis/St. Paul, MN is the #1 ranked metropolitan area
• Two local metropolitan areas, Philadelphia and New York City, ranked #27 and #30 respectively
• Oklahoma City, OK is the #50 ranked metropolitan area

The AFI score is based on factors that suggest the level of “community fitness” for an area.  The index specifically excludes factors (such as climate) which cannot be modified by community effort.

Personal or individual factors that influence the ranking include:

• Preventive health behaviors such as physical activity, nutrition (healthy eating), other habits (smoking or alcohol consumption)
• Percent of population with chronic health problems such as obesity, asthma, coronary heart disease, and diabetes
• Percent of population with health insurance

Community or environmental factors that influence the ranking include:

• The “built environment” in which people live and work, including parkland, farmers markets, access to public transportation, and bicycle or pedestrian friendly areas
• The number of recreational facilities available
• Spending on parks and related areas
• State requirements for physical education
• Availability of health care providers

The ACSM AFI report is not the only research that aims to scientifically determine America’s healthiest cities.  There is a growing body of research into what makes a city healthy.  Another example is the Gallup-Healthways Well-Being Index, a daily assessment of US residents health and well-being, based on over 1,000 interviews each day.  The index categorizes data according to work experience, physical health, emotional health, life evaluation, healthy behavior, and basic access.  Readers can view health and well-being information at the congressional district level.

Considering these studies, it’s easy to understand how to improve the health of a community.  It’s mostly common sense:

• Influence individuals to adopt healthier behaviors
• Provide an environment that promotes health and fitness

While the steps to improving community health and fitness are easy to understand, they are much more difficult to implement.  Why?

• Changing individual behaviors is difficult.  I am continually reminded of this as I attempt to improve my eating habits (that’s the subject of a future post).
• Providing an environment that promotes health and fitness requires investment by government and/or private enterprise.  Investment is difficult to come by in these economic times.
• Even with the appropriate amount of investment, community health and fitness requires a public-private partnership and focus that is difficult to establish and maintain.  It takes the right coalitions with the right vision, strategy, and policies to make it work.

All of this leaves me wondering how Long Valley and surrounding areas rate in community health and fitness.  What are Long Valley’s strengths and weaknesses?  What can we do to improve?  Will the elements that foster community health for large metropolitan areas also work for smaller towns like Long Valley?

In addition to producing the AFI report, the ACSM AFI program includes resources to help local communities assess and improve their support for public health and fitness.  I look forward to reviewing these resources and using them to bring relevant topics to light in this blog.

In the meantime, I’m interested in your feedback.  Would Long Valley score well on the American Fitness Index?  Where is Long Valley strong and where is it weak?  Do you think we have the resources and partnership we need to get healthier?  Post a comment and let me know.