Frequently Asked Questions

You have questions and we have answers. If you don’t find the answers to your questions here, contact us via email at afi@acsm.org.

What is the ACSM American Fitness Index (Fitness Index)?

The ACSM American Fitness Index was created to help improve the health of the nation and promote active lifestyles by supporting local policies and programs to develop a sustainable, healthy community culture.

The Fitness Index features an annual ranking that assigns a score to the 100 most populous cities in the United States. The Fitness Index rankings reflect a composite of preventive health behaviors, levels of chronic disease conditions, as well as community resources and policies that support physical activity. The intent of the rankings are to provide a valid and reliable measure of community fitness at the city level.

In addition to the rankings, the Fitness Index provides valuable resources that can help communities focus their policy and programming efforts as well as assist them in developing collaborative activities and partnerships with other organizations that contribute to health promotion.

Using the Fitness Index rankings, communities will be able to identify opportunities to improve the health status of their residents. Additionally, as communities implement targeted programs to improve health status and environmental resources, they will be able to measure their progress using the Fitness Index in future years.

What makes the Fitness Index unique?

The Fitness Index starts with research and understanding the scope of the problem. A better understanding of the prevalence rates for physical activity, obesity, and chronic disease related to physical inactivity as well as communities’ built environment and resources is the first step toward developing programs, initiatives, and policies to increase physical activity and reduce chronic diseases.

Moreover, moving a community toward increasing physical activity and improving community fitness involves an understanding of the individual and societal behaviors and social norms related to physical activity. The key fundamentals for improving physical activity behaviors involve increasing awareness and motivation at the personal level, providing a built environment and resources that encourage physical activity, as well as setting policies to better enable individuals and communities to engage in physical activity as part of a healthier lifestyle.

Other things that make the Fitness Index unique:

  • Personal health status indicators, as well as community and environmental indicators, are included in the Fitness Index rankings;
  • Data from reputable sources and scientific methodology were used to develop the Fitness Index rankings to increase its validity and reliability;
  • To help guide community action, areas of excellence for each city are shown, along with improvement priority areas;
  • ACSM will provide technical assistance to cities to initiate locally driven health improvement efforts.

The data included in the rankings must meet the following criteria to be included:

  • Related to the physical activity or health status of city residents, or city environment/community resources that support healthy behaviors
  • Reported by a reputable agency or organization
  • Available to the public
  • Measured routinely and provided in a timely fashion
  • Modifiable through community effort

Why is my community not included in the Fitness Index?

ACSM recognizes that numerous other U.S. cities and their surrounding communities are taking great steps toward improving their community health. All cities can use the resources provided by Fitness Index to improve their community’s health and fitness. Additionally, the Fitness Index has been designed so that any community, regardless of size, could locate the publicly available indicators and derive an assessment of their community’s health and fitness.

The Community Fitness Assessment was designed to help stakeholders in communities that were not included in the annual Fitness Index rankings apply a similar approach to assessing your community fitness, and build understanding of the individual and societal factors related to physical activity in the community. The Community Fitness Assessment will lead you through the steps to find data about your community, identify peer communities, and then assess your community’s areas of excellence and opportunities for improvement.

Is the Fitness Index a competition?

No, the ranking merely points out that relative to each other, some cities scored better on the indicators than the other. While ACSM recognizes that there will be a natural tendency to view comparisons as a competition, the Fitness Index rankings were created for cities to assess their level of health and fitness, assess areas that could use improvement, and to increase their scores over time.

It is important to consider both the Fitness Index score and rank for each city. While the ranking lists the cities from highest score to lowest, the scores for many cities are very similar, indicating that there is relatively little difference between them. While one of the 100 cities ranked #1 and another ranked #100, this doesn’t mean that the highest ranked city has excellent values across all indicators and the lowest ranked city has the lowest values on all indicators. Every city has room for improvement and every city has successes to celebrate.

Any words of encouragement for cities at the bottom of the rankings?

Yes, it’s good to remind people that the ranking merely points out that relative to each other, some cities scored better on the indicators than the other. The Fitness Index was created for communities to assess their level of health and fitness, assess areas that could use improvement, and to increase their scores over time.

Cities at the bottom of the ranking still have strengths and should be commended for their effort. We hope that the indicators presented in the Fitness Index will provide guidance and help identify opportunities for the individuals in these cities who are striving to improve the health status and environmental support for fitness behaviors. Obviously, other cities have been able to encourage healthier lifestyles and provide a better environment, but their experiences may be very useful to other cities wishing to create programs to evoke a similar response in their residents.

Additionally, the technical assistance program and collective impact efforts across the county are reason for optimism. Increasingly, health care providers and systems, local officials, community leaders and other experts are working together in communities across the U.S. to actively move their communities to better health.

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