Cities face many challenges in the coming years. It is estimated that more than 70 percent of the world’s population will be living in cities by 2050. City residents face threats by infectious diseases like HIV/AIDS, pneumonia, TB, diarrheal diseases, and non-communicative diseases like asthma, heart disease, diabetes, cancer, violence, injuries and automobile accidents. At the moment, 50 percent of the world’s population live in cities – that’s 3.5 billion of us, folks.
Qualifiers in ferreting out the best and the worst in American city’s fitness were measured by these criteria: physical fitness takes into account chronic health problems, eating habits, disease rates, access to parks and recreational spaces and exercise rates; healthcare involves doctor access, the quality of care, and percentage of residents with healthcare insurance. Other factors include education and poverty levels as well as income and mortality levels.
The top American cities on the 2015 American Fitness Index, which uses the Centers for Disease Control and Prevention (CDC) information, are as follows:
- Washington, DC
- Minneapolis, MN
- San Diego, CA
- San Francisco, CA
- Sacramento, CA
- Denver, CO
- Portland, OR
- Seattle, WA
- Boston, MA
- San Jose, CA
Other notable cities include:
- Hartford, CT
- Pittsburgh, PA
- Salt Lake City, UT
- Cincinnati, OH
- Atlanta, GA
- Baltimore, MD
- St. Louis, MO
- Austin, TX
- Raleigh, NC
- Providence, RI
- Buffalo, NY
- Richmond, VA
- Chicago, IL
- New York, NY
- Philadelphia, PA
According to the 2015 American Fitness Index (AFI) report which uses CDC and the Trust for Public Lands data to determine the quality of each criteria, park expenditures per resident and park acres per 1,000 residents is 30 percent of each score. Another 30 percent of the score is the number, or percentage, of residents within a healthy weight. And lastly, the percentage of residents who exercised within the last 30 days, which is 40 percent of the scores. This is the first year the survey looked at populations within a 10-minute walk of a park. What the index revealed is that the top-ranked cities were close to parks.
"For example, 95 percent of the population in Washington, D.C. lives within a ten-minute walk to a park. On the other end of the spectrum, [in] Indianapolis, which is 50th on our list, only 31 percent live within a ten-minute walking distance of a park.” Walter R. Thompson, an AFI board member, said in an interview. "Another consideration is how much funding goes to parks. In Washington, D.C., the city spends $287.00 per person per year on parks. Indianapolis only spends $24.00 per person per year on parks. All of our top ranked cities all spend more money on parks than our lowest ranked cities."
Walkable Cities
Some of the most notable characteristics of healthy places to live is that many residents lived in mixed-use areas, which may be closer to their work, their domicile, places of worship, shopping and play. This discourages car usage and encourages affordable housing, bike paths, sidewalks, access to transit, parks, hospitals and healthy eating establishments such as grocery stores and restaurants.
“Emerging public health information suggests that to reach the U.S. Centers for Disease Control and Prevention’s goal to improve health and fitness, prevent disease and disability, and enhance quality of life for all Americans through physical activity, we must create a culture that integrates physical activity into our daily lives.” So states the AFI report.
Desired Qualities
When queried about the qualities that help create a healthy community, researchers found that the top five answers were: lack of disparities; strong economic opportunities; education; lack of poverty; healthcare services, and preventive services.
Often healthy communities included criteria not directly related to good health, such as employment opportunities or education. These factors are considered social determinants of health by researchers.
Mental Health in Metro Areas
One interesting fact to come out of this study is that half of all healthy cities reported lower recent episodes of depression in residents. Also cities with good physical health scores reported fewer negative emotional states such as anger, stress or sadness. Perhaps not coincidentally, seven of the least healthy metro areas had high poverty rates.
Education
It is well known that one’s physical health is influenced by personal health habits. Smoking and obesity is tied together many, many times. So, in a way, staying healthy can be considered a learned behavior. Nine of the least healthy cities had lower college education rates than the national average. As it so happens, residents of the eight healthiest areas were more likely to have a bachelor’s degree than Americans as a whole.
Speaking of education, did you know that medical school in Cuba is free? Despite all its social problems including poverty, and dealing with recently lifted embargoes, Cuba is perhaps one of the healthiest cities in the world. Its life expectancy is identical to the U.S. – 79 years old. America spends about $9,000.00 a year per person on health care. Cuba spends about $400.00 a year. Cuba’s infant mortality is better than the U.S.’s. The key, say WHO officials, is prevention. There is a near 100 percent vaccination rate and regular health screenings keep costs down. Every community has a network of doctors and small health clinics. Severe illnesses are treated by hospitals, but all citizens are taught to consider their own health from early on.
It seems that health education with an emphasis on personal responsibility is lacking in the U.S. The CDC estimates that chronic diseases account for 75 percent of all healthcare costs and 70 percent of deaths in this country. And diseases like heart disease, cancer, diabetes, and hypertension disproportionately affect lower-income people and minorities.
A future view?
And lastly, if this isn’t a warning, we don’t know what is. It is estimated that by 2030, fully 50 percent of Americans – yes, half of the U.S. population – will be obese. Not just overweight but obese. Something to think about.