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May 6, 2014 - AMeriCAn CoLLeGe oF SportS MediCine StAFF ... ACSM American Fitness Index™ Guiding Principles for Healthy Communities . ..... Los Angeles, CA . ..... This year, we are pleased to announce the addition of new data ...
2014

Actively Moving America to Better Health Health and Community Fitness Status of the 50 Largest Metropolitan Areas

ACKNOWLEDGEMENTS This report is supported by a grant from the WellPoint Foundation. The opinions expressed in this report are those of the authors and do not necessarily reflect the views of the WellPoint Foundation.

ACSM American Fitness Index™ Advisory Board Chair: Walter R. Thompson, Ph.D., FACSM (Georgia State University)

NiCole Keith, Ph.D., FACSM (Indiana University/Regenstrief Institute, Inc.)

Vice-Chair: Barbara E. Ainsworth, Ph.D., M.P.H., FACSM, FNAK (Arizona State University)

Roseann M. Lyle, Ph.D., FACSM (Purdue University)

Steven N. Blair, P.E.D., FACSM (University of South Carolina)

Melinda M. Manore, Ph.D., R.D., FACSM (Oregon State University)

Jacqueline Epping, M.Ed., FACSM (U.S. Centers for Disease Control and Prevention)

Kenneth E. Powell, M.D., M.P.H., FACSM (Epidemiologic and Public Health Consultant)

John M. Jakicic, Ph.D., FACSM (University of Pittsburgh)

Angela Smith, M.D., FACSM (Nemours/Alfred I. duPont Hospital for Children)

Liz Joy, M.D., M.P.H., FACSM (Intermountain Healthcare/ University of Utah School of Medicine)

Stella Lucia Volpe, Ph.D., R.D., LDN, FACSM (Drexel University)

Report Authors Brenda E. Chamness, M.S., MCHES Senior Director, Strategic Health Programs Terrell W. Zollinger, Dr.P.H. Professor Emeritus, Indiana University Richard M. Fairbanks School of Public Health Principal, T. Zollinger and Associates, LLC Jessica M. Coffing, M.P.H. Research Associate, T. Zollinger and Associates, LLC

Walter R. Thompson, Ph.D., FACSM Regents Professor, Georgia State University Chair, ACSM American Fitness Index™ Advisory Board Barbara E. Ainsworth, Ph.D., M.P.H., FACSM, FNAK Regents Professor, Arizona State University Vice-Chair, ACSM American Fitness Index™ Advisory Board Marie Lewis, CHES Program Coordinator, American Fitness Index

ACSM American Fitness Index™ Research Team Terrell W. Zollinger, Dr.P.H. Professor Emeritus, Indiana University Richard M. Fairbanks School of Public Health Principal, T. Zollinger and Associates, LLC

Jessica M. Coffing, M.P.H. Research Associate, T. Zollinger and Associates, LLC Derek A. Zollinger, MS Research Associate, T. Zollinger and Associates, LLC

American College of Sports Medicine Staff Brenda E. Chamness, M.S., MCHES Senior Director, Strategic Health Programs

Marie Lewis, CHES Program Coordinator, American Fitness Index

Questions and comments on the report should be directed to the American College of Sports Medicine at [email protected].

Report design by Kern Graphic Design, Indianapolis, Indiana (www.kerngraphicdesign.com).

ACSM AMERICAN FITNESS INDEX™ HEALTH AND COMMUNITY FITNESS STATUS OF THE 50 LARGEST METROPOLITAN AREAS 2014 Edition

Table of Contents Executive Summary........................................................................................................................................................................................ 7 Background and Need for Action.............................................................................................................................................................9 ACSM American Fitness Index™ Program........................................................................................................................................... 10 ACSM American Fitness Index™ Program Components......................................................................................................... 10 Implementation........................................................................................................................................................................................ 10 ACSM American Fitness Index™ Advisory Board....................................................................................................................... 11 ACSM American Fitness Index™ Guiding Principles for Healthy Communities.............................................................12 Methodology.....................................................................................................................................................................................................12 Why Choose MSAs Over Cities?........................................................................................................................................................12 How Were the Indicators Selected for the Data Index?..........................................................................................................12 What Data Sources Were Used to Create the Data Index?....................................................................................................13 How Was the Data Index Built?..........................................................................................................................................................13 How Should the Scores and Ranks Be Interpreted?................................................................................................................ 14 How Were the Areas of Excellence and Improvement Priority Areas Determined?................................................. 14 What Are the Limitations of the AFI Data Report?.................................................................................................................. 14 References...................................................................................................................................................................................................15 Metropolitan Area Snapshots Atlanta, GA................................................................................................................................................................................................ 16 Austin, TX................................................................................................................................................................................................... 18 Baltimore, MD........................................................................................................................................................................................... 20 Birmingham, AL.......................................................................................................................................................................................22 Boston, MA................................................................................................................................................................................................ 24 Buffalo, NY................................................................................................................................................................................................. 26 Charlotte, NC........................................................................................................................................................................................... 28 Chicago, IL................................................................................................................................................................................................ 30 Cincinnati, OH...........................................................................................................................................................................................32 Cleveland, OH.......................................................................................................................................................................................... 34 Columbus, OH.......................................................................................................................................................................................... 36 Dallas, TX................................................................................................................................................................................................... 38 Denver, CO................................................................................................................................................................................................40 Detroit, MI................................................................................................................................................................................................. 42 Hartford, CT..............................................................................................................................................................................................44 Houston, TX.............................................................................................................................................................................................. 46

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Metropolitan Area Snapshots (continued) Indianapolis, IN........................................................................................................................................................................................ 48 Jacksonville, FL....................................................................................................................................................................................... 50 Kansas City, MO-KS................................................................................................................................................................................52 Las Vegas, NV ......................................................................................................................................................................................... 54 Los Angeles, CA..................................................................................................................................................................................... 56 Louisville, KY............................................................................................................................................................................................. 58 Memphis, TN.............................................................................................................................................................................................60 Miami, FL.................................................................................................................................................................................................... 62 Milwaukee, WI......................................................................................................................................................................................... 64 Minneapolis-St. Paul, MN .................................................................................................................................................................... 66 Nashville, TN............................................................................................................................................................................................ 68 New Orleans, LA..................................................................................................................................................................................... 70 New York, NY............................................................................................................................................................................................72 Oklahoma City, OK..................................................................................................................................................................................74 Orlando, FL.............................................................................................................................................................................................. 76 Philadelphia, PA........................................................................................................................................................................................78 Phoenix, AZ...............................................................................................................................................................................................80 Pittsburgh, PA.......................................................................................................................................................................................... 82 Portland, OR............................................................................................................................................................................................. 84 Providence, RI.......................................................................................................................................................................................... 86 Raleigh, NC............................................................................................................................................................................................... 88 Richmond, VA..........................................................................................................................................................................................90 Riverside, CA............................................................................................................................................................................................ 92 Sacramento, CA...................................................................................................................................................................................... 94 Saint Louis, MO-IL.................................................................................................................................................................................. 96 Salt Lake City, UT.................................................................................................................................................................................... 98 San Antonio, TX.................................................................................................................................................................................... 100 San Diego, CA.........................................................................................................................................................................................102 San Francisco, CA................................................................................................................................................................................ 104 San Jose, CA........................................................................................................................................................................................... 106 Seattle, WA............................................................................................................................................................................................. 108 Tampa, FL..........................................................................................................................................................................................110 Virginia Beach, VA................................................................................................................................................................................. 112 Washington, DC......................................................................................................................................................................................114 Appendix A – Data Sources......................................................................................................................................................................116 Appendix B – Members of the Expert Panel.....................................................................................................................................119 Appendix C – U.S. Values, MSA Averages and MSA Ranges for AFI Indicators................................................................. 121 Appendix D – Counties in MSAs............................................................................................................................................................ 123

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May 2014

Dear Colleagues, As the founding sponsor of the American College of Sports Medicine (ACSM) American Fitness Index™ (AFI), the WellPoint Foundation is proud to continue its support of this healthy lifestyle measurement and improvement guide. Developed by some of the leading sports medicine professionals and exercise scientists in the country, AFI’s scientific, data-driven report provides an effective measure of health and community fitness in America’s 50 most populous metropolitan areas. The report is designed to help leaders assess their city’s strengths and challenges and advocate for policy changes and investments necessary to make improvements. This year, we are pleased to announce the addition of new data indicators that further strengthen the science behind the report. Walk Score® promotes walkable neighborhoods, one of the best solutions for our health, the environment and economic improvement of urban areas. Walkability of neighborhoods has been shown to have a positive impact on health, including reducing obesity, diabetes, and cardiovascular disease. As the philanthropic arm of WellPoint, Inc., the Foundation has granted more than $146 million to organizations such as ACSM that support healthy living and health improvement across generations. We are committed to being America’s valued health partner by aiding awareness and education endeavors. Please visit AmericanFitnessIndex.org and WellPointFoundation.org to learn more about how we can foster positive change in the health and wellness of our communities and our country. Best regards,

Sam Nussbaum Executive Vice President, Clinical Health Policy and Chief Medical Officer

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Executive Summary With support and funding from the WellPoint Foundation in 2007, the American College of Sports Medicine (ACSM) launched the ACSM American Fitness IndexTM (AFI) program in 2008 to help communities identify opportunities to improve the health of their residents and expand community assets to better support active, healthy lifestyles. The AFI reflects a composite of personal health measures, preventive health behaviors, levels of chronic disease conditions, as well as environmental and community resources and policies that support physical activity. In addition, demographic and economic diversity are included for each metropolitan area to illustrate the unique attributes of each city. Communities with the highest AFI scores are considered to have strong community fitness, a concept analogous to individuals having strong personal fitness. The 50 largest metropolitan areas in the United States, as defined by the U.S. Office of Management and Budget using data from the U.S. Census Annual Estimates of Population, were included in this 2014 data report for the AFI program. Metropolitan Statistical Areas (MSAs) were chosen as the unit of measurement because they represent the group of counties comprising the larger urban areas where residents live, work and access community resources. The AFI program is unique for several reasons: • Cities are defined by MSAs; •P  ersonal health indicators, as well as community and environmental indicators, are included in the data report; •D  ata come from reputable sources, and scientific methodologies are used to ensure validity and reliability; •U  nique areas of strength and opportunities for improvement are included for each MSA to help guide community action; •M  aterials, resources and connections to health promotion partners are provided by the AFI program to help cities improve their indicators; and •L  ocal, state and national health promotion partners form a network to support collaborative program efforts. The first step in creating the report for the AFI program involved developing a strategy to identify, gather, analyze and present MSA-level data on the population, health and built environment of the communities. Measures were identified, assessed and scored by a national expert panel for inclusion into an index to compare each MSA’s attributes with the overall U.S. values and with the other large metropolitan areas. Based on the comparisons to benchmarks, suggested areas of excellence and improvement priority areas for each MSA were noted. There was considerable diversity in community fitness levels among the 50 MSAs. Cities that ranked near the top of the index have more strengths that support healthy living and fewer challenges that hinder it. The opposite is true for cities near the bottom of the index. All cities are commended for their areas of excellence and encouraged to focus future efforts on their improvement priority areas to achieve a healthy and active population.

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Rank

Metropolitan Area

SCORE

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50

Washington-Arlington-Alexandria, DC-VA-MD-WV Minneapolis-St. Paul-Bloomington, MN-WI Portland-Vancouver-Hillsboro, OR-WA Denver-Aurora-Broomfield, CO San Francisco-Oakland-Fremont, CA San Jose-Sunnyvale-Santa Clara, CA Seattle-Tacoma-Bellevue, WA San Diego-Carlsbad-San Marcos, CA Boston-Cambridge-Quincy, MA-NH Sacramento-Arden-Arcade-Roseville, CA Salt Lake City, UT Hartford-West Hartford-East Hartford, CT Raleigh-Cary, NC Austin-Round Rock-San Marcos, TX Chicago-Joliet-Naperville, IL-IN-WI Atlanta-Sandy Springs-Marietta, GA Pittsburgh, PA Cincinnati-Middletown, OH-KY-IN Los Angeles-Long Beach-Santa Ana, CA Philadelphia-Camden-Wilmington, PA-NJ-DE-MD Richmond, VA Virginia Beach-Norfolk-Newport News, VA-NC Providence-New Bedford-Fall River, RI-MA New York-Northern New Jersey-Long Island, NY-NJ-PA Baltimore-Towson, MD Miami-Fort Lauderdale-Pompano Beach, FL Charlotte-Gastonia-Rock Hill, NC-SC Riverside-San Bernardino-Ontario, CA Buffalo-Niagara Falls, NY Jacksonville, FL Tampa-St. Petersburg-Clearwater, FL Milwaukee-Waukesha-West Allis, WI Cleveland-Elyria-Mentor, OH Kansas City, MO-KS Houston-Sugar Land-Baytown, TX Phoenix-Mesa-Glendale, AZ Las Vegas-Paradise, NV Dallas-Fort Worth-Arlington, TX New Orleans-Metairie-Kenner, LA Columbus, OH Saint Louis, MO-IL Orlando-Kissimmee-Sanford, FL Detroit-Warren-Livonia, MI Birmingham-Hoover, AL San Antonio-New Braunfels, TX Nashville-Davidson-Murfreesboro-Franklin, TN Indianapolis-Carmel, IN Oklahoma City, OK Louisville/Jefferson County, KY-IN Memphis, TN-MS-AR

77.3 73.5 72.1 71.7 71.0 69.4 69.3 69.2 69.1 66.9 65.7 63.8 61.5 60.6 56.6 56.0 54.8 54.5 53.4 52.9 52.3 52.0 51.6 51.5 50.8 49.0 48.1 47.5 47.2 46.6 46.0 45.7 45.4 45.1 44.0* 44.0* 43.7 42.6 42.4 41.3* 41.3* 40.8 37.3 35.9 35.6 32.5 32.3 31.6 25.7 24.8

*T  he scores shown have been rounded to the nearest tenth of a point resulting in some apparent ties; however, the rankings are based on the full calculated score values that were not equal in those cases. This 2014 edition report used revised methods from the first six full-edition reports released in 2008 to 2013, including additional measures not included in the earlier reports; consequently, comparisons of scores for 2014 should not be made with earlier AFI reports. However, many of the individual personal health and community/environmental indicators did not change and can be compared to individual measures included in the earlier AFI reports. The long-range vision for the AFI program is to provide annual updates to the indicators and scores so cities can monitor their progress in improving their health and active living fitness indicators.

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Background and Need for Action Physical activity for all!

Being physically active is one of the most important ways adults and children can improve and maintain their overall health.1-5 For adults, regular exercise can reduce the risk of premature death, heart disease, stroke, high blood pressure, type 2 diabetes, breast cancer, colon cancer and the risk of falls. For children and adolescents, regular physical activity can decrease body fat and improve bone health, cardiorespiratory fitness and muscular strength. Physical activity can also decrease the risk of depression in adults and reduce depression symptoms in young people.2-5 Emerging public health information suggests that to reach the 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.1 The ACSM American Fitness Index™ (AFI) program developed a valid and reliable measure of health and community fitness at a metropolitan level to: •p  rovide community leaders with information to understand the personal, community, societal and environmental influences on physical activity and healthy eating; •d  evelop strategies to promote physical activity at multiple levels of influence; • t ake action through local community mobilization with the AFI Community Action Guide, health promotion partners and other best practices;6 and • monitor changes in the measures as a result of community programs and other factors. While the AFI data report provides detailed information for cities at the MSA level, the My AFI (http://americanfitnessindex.com/my-afi/) community application tool integrates the components of the AFI program into a health promotion approach that can be used by other communities not included in the AFI data report. Using this tool, leaders can understand the individual, societal and behavioral factors related to physical activity in their own community and implement culturally focused activities that are meaningful to their residents. Overall, the goal of the AFI program is to help improve the health of the nation and promote active lifestyles by supporting local programming to develop a sustainable, healthy community culture. To accomplish this goal, community leaders and health planners need to be aware of their community’s health status and behaviors; key indicators, such as obesity and chronic disease rates and number of health care providers, related to physical inactivity; built environment and resources; and policies that support a healthy community. The AFI program is specifically designed to provide these data and other valuable assistance to cities to further their efforts to improve the health and quality of life of residents, promote healthier lifestyles and encourage community resource development to support physical activity.

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ACSM American Fitness Index™ Program With support and funding from the WellPoint Foundation (www.wellpointfoundation.org), the AFI program was created to develop a valid and reliable measure of the health and community fitness at the metropolitan level in the United States. The AFI program provides valuable resources that can help communities focus their programming efforts as well as assist them in developing collaborative activities and partnerships with other organizations that contribute to health promotion. Using the AFI data report, 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 relevant AFI elements in future reports.

ACSM American Fitness Index™ Program Components

The AFI program improves the health, fitness and quality of life of citizens through three key components: • Data: Collect, aggregate and report metropolitan-level data related to healthy lifestyles, health outcomes and community resources that support a physically active society. Disseminate the AFI data report to give an accurate snapshot of the health status and contributing factors in major metropolitan areas across the nation. • Resources: Serve as a resource for promoting and integrating research, education and practical applications of sports medicine and exercise science to maintain and enhance physical performance, fitness, health and quality of life. • Health Promotion Partners: Help communities connect and partner with existing organizations and local, state and national programs on physical activity and healthy lifestyles initiatives.

Implementation

This seventh full-edition data report for the AFI program focuses on data collection and analysis for the 50 largest metropolitan areas in the United States. The program’s data report shows the results of identifying, collecting, analyzing, weighing, and aggregating relevant data at the metropolitan level. The metropolitan areas in this report represent the 50 largest Metropolitan Statistical Areas (MSAs) defined by the U.S. Office of Management and Budget using data from the U.S. Census Annual Estimates of Population. They are the cities and surrounding metropolitan areas of: • Atlanta-Sandy Springs-Marietta, GA • Austin-Round Rock-San Marcos, TX • Baltimore-Towson, MD • Birmingham-Hoover, AL • Boston-Cambridge-Quincy, MA-NH • Buffalo-Niagara Falls, NY • Charlotte-Gastonia-Rock Hill, NC-SC • Chicago-Joliet-Naperville, IL-IN-WI • Cincinnati-Middletown, OH-KY-IN • Cleveland-Elyria-Mentor, OH • Columbus, OH • Dallas-Fort Worth-Arlington, TX • Denver-Aurora-Broomfield, CO • Detroit-Warren-Livonia, MI • Hartford-West Hartford-East Hartford, CT • Houston-Sugar Land-Baytown, TX • Indianapolis-Carmel, IN • Jacksonville, FL • Kansas City, MO-KS • Las Vegas-Paradise, NV • Los Angeles-Long Beach-Santa Ana, CA • Louisville/Jefferson County, KY-IN • Memphis, TN-MS-AR

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• • • • • • • • • • • • • • • • • • • • • • • • • • •

Miami-Fort Lauderdale-Pompano Beach, FL Milwaukee-Waukesha-West Allis, WI Minneapolis-St. Paul-Bloomington, MN-WI Nashville-Davidson-Murfreesboro-Franklin, TN New Orleans-Metairie-Kenner, LA New York-Northern New Jersey-Long Island, NY-NJ-PA Oklahoma City, OK Orlando-Kissimmee-Sanford, FL Philadelphia-Camden-Wilmington, PA-NJ-DE-MD Phoenix-Mesa-Glendale, AZ Pittsburgh, PA Portland-Vancouver-Hillsboro, OR-WA Providence-New Bedford-Fall River, RI-MA Raleigh-Cary, NC Richmond, VA Riverside-San Bernardino-Ontario, CA Sacramento-Arden-Arcade-Roseville, CA Saint Louis, MO-IL Salt Lake City, UT San Antonio-New Braunfels, TX San Diego-Carlsbad-San Marcos, CA San Francisco-Oakland-Fremont, CA San Jose-Sunnyvale-Santa Clara, CA Seattle-Tacoma-Bellevue, WA Tampa-St. Petersburg-Clearwater, FL Virginia Beach-Norfolk-Newport News, VA-NC Washington-Arlington-Alexandria, DC-VA-MD-WV

ACSM American Fitness Index™ Advisory Board

The AFI program would not be possible without direction from the knowledgeable volunteers who make up the AFI Advisory Board. The AFI Advisory Board is comprised of experts with a vested interest in the fields of health and physical activity who volunteer their time to support the mission of the AFI program. The AFI Advisory Board was created in 2007 to assist in the development of the AFI program and continues to offer on-going guidance to the program. Members of the AFI Advisory Board assure the AFI data report and overall program adhere to the ACSM Guiding Principles for Healthy Communities and the goals of the AFI program by: • translating the science into practice; • actively participating in strategic planning for the program; • critically reviewing all program documentation and collateral materials; and • providing expert guidance and feedback to communities. ACSM greatly appreciates the contributions of our AFI Advisory Board members: • Chair: Walter R. Thompson, Ph.D., FACSM (Georgia State University) • Vice-Chair: Barbara Ainsworth, Ph.D., M.P.H., FACSM, FNAK (Arizona State University) • Steven N. Blair, P.E.D., FACSM (University of South Carolina) • Jacqueline Epping, M.Ed., FACSM (U.S. Centers for Disease Control and Prevention) • John M. Jakicic, Ph.D., FACSM (University of Pittsburgh) • Liz Joy, M.D., M.P.H., FACSM (Intermountain Healthcare/University of Utah School of Medicine) • NiCole Keith, Ph.D., FACSM (Indiana University/Regenstrief Institute, Inc.) • Roseann M. Lyle, Ph.D., FACSM (Purdue University) • Melinda M. Manore, Ph.D., R.D., FACSM (Oregon State University) • Kenneth E. Powell, M.D., M.P.H., FACSM (Epidemiologic and Public Health Consultant) • Angela Smith, M.D., FACSM (Nemours/Alfred I. duPont Hospital for Children ) • Stella Lucia Volpe, Ph.D., R.D., LDN, FACSM (Drexel University)

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ACSM American Fitness Index™ Guiding Principles for Healthy Communities

•O  verall health improvement in U.S. cities requires a focus on the prevention of behavioral-linked diseases by effectively addressing the underlying unhealthy behaviors 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 health care systems, our cities, our nation and our future. • All cities in the U.S., irrespective of size and current health status, can make significant 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. cities in actively making the moves toward better health. The AFI program will contribute to the Guiding Principles for Healthy Communities by creating effective partnerships and alliances at the national and local levels; by providing tools, strategies and expertise to cities and communities desiring to improve the health of their residents; and by supporting practices and policies that have proven to be effective.

Methodology Scientific evidence, expert opinion and statistical methodologies were employed to select, weigh and combine the elements used to produce the AFI data report.

Why Choose MSAs Over Cities?

Defining a “city” by its city limits overlooks the interaction between the core of the city and the surrounding suburban areas. Residents outside the city limits have access to fitness-related resources in their suburban area as well as the city core; likewise, the residents within the city limits may access resources in the surrounding areas. Thus, the metropolitan area, including both the city core and the surrounding suburban areas, act as a unit to support the wellness efforts of residents of the area. Consequently, the MSA data were used where possible in constructing the AFI. It is understood that various parts of the central city and surrounding suburban area may have very different demographic and health behavior characteristics, as well as access to community-level resources to support physical activity. Currently, the nationally available data needed to measure these characteristics and resources are not available to allow comparisons of all of the smaller geographical levels in the MSAs. However, it would be possible for communities within the MSA to collect local data using the measurements and strategy outlined in My AFI (http://americanfitnessindex.com/ my-afi/) to identify opportunities and to monitor improvements occurring as a result of their initiatives. In February 2013, the U.S. Office of Management and Budget (OMB) released a bulletin pertaining to how MSAs were to be identified based on the 2010 census. Previous to that, MSAs were still being identified based on the 2000 census and standards. As the data for the MSAs were collected prior to the OMB bulletin, and the understanding that the bulletin was meant for future data collections, we decided to utilize the previous MSA definitions as they were defined by the most recent OMB bulletin prior to this one, released in December 2009.7

How Were the Indicators Selected for the Data Index?

Elements included in the data index must have met the following criteria to be included: • Be related to the level of health status and/or physical activity environment for the MSA; • Be measured recently and reported by a reputable agency or organization; • Be available to the public; • Be measured routinely and provided in a timely fashion; and • Be modifiable through community effort (for example, smoking rate is included, climate is not).

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What Data Sources Were Used to Create the Data Index?

The most current publicly available data at the time of analysis from federal reports and past studies provided the information used in this version of the data index. The largest single data source for the personal health indicators was the Behavioral Risk Factor Surveillance System (BRFSS) provided by the U.S. Centers for Disease Control and Prevention. Through a survey, conducted by the Center for City Park Excellence, the Trust for Public Land provided many of the community/environmental indicators, and the U.S. Census American Community Survey was the source for most of the MSA descriptions. The U.S. Department of Agriculture; State Report Cards (School Health Policies and Programs Study by the CDC); and the Federal Bureau of Investigation’s (FBI) Uniform Crime Reporting Program also provided data used in the MSA description and index. The data index elements and their data sources are shown in Appendix A.

How Was the Data Index Built?

Potential initial elements for the AFI data index were scored for relevance by a panel of 26 health and physical activity experts in 2008 (listed in Appendix B). Two Delphi method–type rounds of scoring were used to reach consensus on whether each item should be included in the data index and the weight it should carry in the calculations. From this process, 31 currently available indicators were identified and weighted for the index and 16 description variables were selected. The description elements were not included in the data index calculation, but were shown for cities to use for comparison purposes. A weight of 1 was assigned to those elements that were considered to be of little importance by the panel of experts; 2 for those items considered to be of moderate importance; and 3 to those elements considered of high importance to include in the data index. Each item used in the scoring was first ranked (worse value = 1) and then multiplied by the weight assigned by consensus of the expert panel. The weighted ranks were then summed by indicator group to create scores for the personal health indicators and community/environmental indicators. Finally, the MSA scores were standardized to a scale with the upper limit of 100 by dividing the MSA score by the maximum possible value and multiplying by 100. Note that the changes made in the measures for 2014 reduced the number of indicators by 1 for a total of 30 indicators. The following formula summarizes the scoring process: n MSA Scorek = ((∑ rki wki)/MSA Scoremax)*100 i=1 r = MSA rank on indicator w = weight assigned to indicator k = indicator group n = 15 for personal health indicators and 16 for community/environmental indicators MSA Scoremax = hypothetical score if an MSA ranked best on each of the elements The individual weights also were averaged for both indicator groups to create the total score. Both the indicator group scores and the total scores for the 50 cities were then ranked (best = 1) as shown on the Metropolitan Area Snapshots.

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How Should the Scores and Ranks Be Interpreted?

It is important to consider both the score and rank for each city. While the ranking lists the MSAs from the highest score to the lowest score, the scores for many cities are very similar, indicating that there is relatively little difference among them. For example, the score for San Jose was 69.4 while the score for Seattle was 69.3. While San Jose was ranked higher than Seattle, these two metropolitan areas were actually very similar across all of the indicators; thus, there is little difference in the community wellness levels of the two MSAs. Also, while one city carried the highest rank (Washington, DC) and another carried the lowest rank (Memphis, TN), this does not necessarily mean that the highest ranked city has excellent values across all indicators and the lowest ranked city has the lowest values on all the indicators. The ranking merely indicates that, relative to each other, some cities scored better than others. The data elements used in AFI were reviewed and updated in 2014. Specifically, BRFSS made significant changes in the survey items used to determine food intake information and physical activity level. In addition, percent covered by health insurance and primary care provider to population ratio measures were removed because the experts felt these measures did not significantly impact fitness levels. Finally, a new environmental/community measure, Walk Score ranking, was added. Consequently, comparisons between the 2014 AFI individual elements that did not change can be compared with earlier years’ data, but the overall score and the sub-scores for 2014 are not comparable to earlier years.

How Were the Areas of Excellence and Improvement Priority Areas Determined?

The Areas of Excellence and Improvement Priority Areas for each MSA were listed to assist communities in identifying potential areas where they might focus their efforts using approaches adopted by those cities that have strengths in the same area. This process involved comparing the data index elements of the MSA to a newly developed target goal. The target goals for the personal health indicators were derived by generating the 90th percentile from the pooled 2008-2012 AFI data. For those new personal health indicators, the target goal was 90% of the 2014 values. The target goals for the community health indicators were derived by calculating the average from the pooled 2008-2012 AFI data. New community indicators target goals were an average from the 2014 values. Data indicators with values equal to or better than the target goal were considered “Areas of Excellence.” Data indicators with values worse than 20% of the target goal were listed as “Improvement Priority Areas.”

What Are the Limitations of the AFI Data Report?

The items used for the personal health indicators were based on self-reported responses to the Behavioral Risk Factor Surveillance Survey and are subject to the well-known limitations of self-reported data. Since this limitation applies to all metropolitan areas included in this report, the biases should be similar across all areas, so the relative differences should still be relatively valid. In addition, the BRFSS data collection method changed in 2011 relative to weighting methodology and the addition of the cell phone sampling frame; thus measures before and after 2011 are not exactly comparable. As per advice provided on the FBI Uniform Crime Reporting Program website, violent crime rates were not compared to U.S. values or averages of all MSAs. As indicated on the FBI website, data on violent crimes may not be comparable across all metropolitan areas because of differences in law enforcement policies and practices from area to area. The Trust for Public Land community/environmental indicators only includes city-level data, not data for the complete MSA. Consequently, most of the community/environmental indicators shown on the MSA tables are for the main city in the MSA and do not include resources in the rest of the MSA.

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AC S M Am e rican Fitn e ss I nd ex ™ 2 014 : Active ly Mov i n g A me r i c a to B e t te r H e al t h

References

1. N  ational Physical Activity Plan. (May 2010). Retrieved from http://www.physicalactivityplan.org/ NationalPhysicalActivityPlan.pdf 2. C  enters for Disease Control and Prevention (2010, Dec 29). Physical Activity. Retrieved from http://www.cdc.gov/physicalactivity/ 3. A  merican College of Sports Medicine. (2007). About ACSM. Retrieved from http://www.acsm.org/am/ template.cfm?section=about_acsm 4. U  .S. Department of Health and Human Services, Healthy People 2020. (n.d.). Physical Activity. Retrieved from http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=33 5. U  .S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. Physical activity guidelines advisory committee report, 2008. Washington: HHS, 2008. 6. S  allis, J. F., Cervero, R. B., Ascher, W., Henderson, K. A., Kraft, M. K., & Kerr, J. (2006). An ecological approach to creating active living communities. Annual Review of Public Health, 27, 297-322. doi: 10.1146/annurev.publhealth.27.021405.102100 7. U  .S. Office of Management and Budget. (2009) Update of Statistical Area Definitions and Guidance on Their Uses. (OMB Bulletin No. 10-02). Retrieved from http://www.whitehouse.gov/sites/default/files/ omb/assets/bulletins/b10-02.pdf

Health and Community Fitness Status of the 50 Largest Metropolitan Areas

15

ATLANTA, GA

(Atlanta-Sandy Springs-Marietta, GA MSA)

Ranking: Total Score = 56.0; Rank = 16 Areas of Excellence (at or better than target goal): • Lower death rate for diabetes • More golf courses per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent consuming 2+ fruits per day • Higher percent currently smoking • Higher percent obese • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Fewer dog parks per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Atlanta-Sandy Springs-Marietta, GA MSA Population 5,457,831 Percent less than 18 years old 25.9% Percent 18 to 64 years old 64.3% Percent 65 years old and older 9.9% Percent male 48.7% Percent high school graduate or higher 87.8% Percent White 56.1% Percent Black or African American 32.8% Percent Asian 5.1% Percent Other Race 6.0% Percent Hispanic/Latino 10.6% Percent unemployed 11.1% Median household income $54,628 Percent of households below poverty level 13.2% Violent crime rate/100,000* 408.6 Percent with disability 9.6% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

16

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 63.9; Rank = 14

Atlanta Target Goal*

Health Behaviors

Chronic Health Problems 81.6%

Percent any physical activity or exercise in the last 30 days

Percent obese

82.6%

32.2%

21.8%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

30.4%

Any days when mental health was not good during the past 30 days

29.2%

28.0% Percent with angina or coronary heart disease

35.6%

Percent with diabetes

15.7%

Percent consuming 3+ vegetables per day

61.0%

Any days when physical health was not good during the past 30 days

Percent with asthma

Percent consuming 2+ fruits per day

54.6%

Percent in excellent or very good health

27.2%

Percent meeting CDC aerobic activity guidelines

27.1% 21.3%

32.4%

33.3%

7.9% 6.5% 4.3% 2.8% 9.5% 6.4%

19.6% 189.0 17.8%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

189.0

Death rate/100,000 for cardiovascular disease

167.1 15.4 17.0

Community/Environmental Indicators – Score = 48.2; Rank = 29 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

5.7%

Acres of parkland/1,000

8.8

Percent bicycling or walking to work

Recreational Facilities

Dog parks/100,000 18.6

0.4 0.9 2.0 2.3

Park playgrounds/10,000

11.5

Golf courses/100,000

13.1 2.9%

1.1 0.9 6.6

Park units/10,000

4.1

4.3%

Recreational centers/20,000

1.5% 2.8%

1.3 1.0 4.1

Swimming pools/100,000

3.1

46.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.5 1.9

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Atlanta Target Goal**

Tennis courts/10,000

3.2 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$67.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

17

AUSTIN, TX

(Austin-Round Rock-San Marcos, TX MSA)

Ranking: Total Score = 60.6; Rank = 14 Areas of Excellence (at or better than of target goal): • Higher percent consuming 3+ vegetables per day • Lower death rate for cardiovascular disease • Lower death rate for diabetes • Higher percent of city land area as parkland • More acres of parkland per capita • More farmers’ markets per capita • Higher percent bicycling or walking to work • More dog parks per capita • More swimming pools per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent obese • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with diabetes • Lower percent using public transportation to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer recreation centers per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita Description of Austin-Round Rock-San Marcos, TX MSA Population 1,834,303 Percent less than 18 years old 24.9% Percent 18 to 64 years old 66.4% Percent 65 years old and older 8.7% Percent male 50.1% Percent high school graduate or higher 88.1% Percent White 80.2% Percent Black or African American 7.4% Percent Asian 4.9% Percent Other Race 7.5% Percent Hispanic/Latino 31.9% Percent unemployed 7.1% Median household income $59,433 Percent of households below poverty level 10.6% Violent crime rate/100,000* 292.7 Percent with disability 9.7% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

18

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 72.0 Rank = 9

Austin Target Goal*

Health Behaviors

Chronic Health Problems 78.9%

Percent any physical activity or exercise in the last 30 days

82.6%

23.3%

Percent with asthma

32.7%

Percent with angina or coronary heart disease

35.6%

19.6%

Percent consuming 3+ vegetables per day

51.0% 61.0% 36.0% 30.4%

Any days when mental health was not good during the past 30 days

22.1%

Percent consuming 2+ fruits per day

21.3%

Any days when physical health was not good during the past 30 days

32.2%

Percent meeting both CDC aerobic and strength activity guidelines

26.4%

Percent in excellent or very good health

27.1%

Percent meeting CDC aerobic activity guidelines

Percent with diabetes

35.3% 29.2% 7.9% 6.5% 3.0% 2.8% 8.0% 6.4%

19.6% 189.0

Percent currently smoking

Percent obese

167.1

14.0%

Death rate/100,000 for diabetes

13.1%

151.5

Death rate/100,000 for cardiovascular disease

167.1 12.4 17.0

Community/Environmental Indicators – Score = 49.5 Rank = 27 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

18.2%

Parkland as a percent of city land area

Austin Target Goal**

Ball diamonds/10,000

1.9

10.6% Dog parks/100,000

37.2

Acres of parkland/1,000

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

2.3%

Percent bicycling or walking to work

2.9%

1.4 2.3 0.6 0.9 3.4

Park units/10,000

4.3% Recreational centers/20,000 2.8%

WalkScore®

1.4 0.9

Park playgrounds/10,000

11.5 18.0

Farmers’ markets/ 1,000,000

4.1 0.6 1.0 4.5

Swimming pools/100,000 35.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

0.9

Tennis courts/10,000

3.1 1.4 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$68.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

19

BALTIMORE, MD (Baltimore-Towson, MD MSA)

Ranking: Total Score = 50.8; Rank = 25 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More park playgrounds per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Fewer acres of parkland per capita • Fewer dog parks per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Baltimore-Towson, MD MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

2,753,149 22.5% 64.2% 13.3% 48.1% 89.3% 62.0% 28.8% 4.9% 4.3% 4.9% 8.6% $66,970 7.9% 621.2 11.0%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

20

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 41.5 Rank = 33

Baltimore Target Goal*

Health Behaviors

Chronic Health Problems 75.6%

Percent any physical activity or exercise in the last 30 days

Percent obese

82.6%

23.3%

Percent with asthma

30.0%

Percent with angina or coronary heart disease

35.6%

13.3%

Percent consuming 3+ vegetables per day

Percent with diabetes

19.6% 189.0 18.4%

Percent currently smoking

61.0% 33.3% 30.4%

Any days when mental health was not good during the past 30 days

18.3%

Percent consuming 2+ fruits per day

52.8%

Any days when physical health was not good during the past 30 days

32.2%

Percent meeting both CDC aerobic and strength activity guidelines

21.3%

Percent in excellent or very good health

25.2%

Percent meeting CDC aerobic activity guidelines

28.5%

167.1

29.2% 10.3% 6.5% 4.7% 2.8% 10.5% 6.4% 208.5

Death rate/100,000 for cardiovascular disease Death rate/100,000 for diabetes

13.1%

32.6%

167.1 20.0 17.0

Community/Environmental Indicators – Score = 60.0 Rank = 13 (note: most of these data were available only for the main city in the MSA) Built Environment

Acres of parkland/1,000

Percent bicycling or walking to work

Dog parks/100,000

7.7 18.6

1.9 0.3 0.9 3.1

Park playgrounds/10,000

22.9 Golf courses/100,000

13.1 6.5%

2.3 0.8 0.9 6.6

Park units/10,000

4.1

4.3% Recreational centers/20,000

3.0% 2.8%

1.7 1.0 3.5

Swimming pools/100,000 66.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

3.2

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Recreational Facilities

9.5%

Parkland as a percent of city land area

Baltimore Target Goal**

3.1 1.7 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$56.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

21

BIRMINGHAM, AL (Birmingham-Hoover, AL MSA)

Ranking: Total Score = 35.9; Rank = 44 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Lower park-related expenditures per capita Description of Birmingham-Hoover, AL MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability 22

1,136,650 23.6% 62.6% 13.7% 48.1% 86.6% 66.8% 28.5% 1.4% 3.3% 4.3% 8.7% $46,763 13.4% 565.1 14.6%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 23.6 Rank = 47

Birmingham Target Goal*

Health Behaviors

Chronic Health Problems 74.8%

Percent any physical activity or exercise in the last 30 days

Percent obese

34.6% 21.3%

82.6% 45.2%

Percent in excellent or very good health

61.0%

24.1%

Percent meeting CDC aerobic activity guidelines

32.2%

16.6%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

Percent with asthma 23.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

14.8%

Percent consuming 3+ vegetables per day

36.8%

38.8%

7.8% 6.5% 4.9% 2.8% 11.1% 6.4%

19.6% 189.0 167.1

22.1%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

224.9

Death rate/100,000 for cardiovascular disease

167.1 20.4 17.0

Community/Environmental Indicators – Score = 48.0 Rank = 31 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

10.6% Dog parks/100,000

10.4 18.6

0.4 0.9 3.5

Park playgrounds/10,000 24.6 Golf courses/100,000

13.1 0.6%

2.3 0.9 0.9 4.7

Park units/10,000

4.3% Recreational centers/20,000

1.1% 2.8%

WalkScore®

4.1 1.6 1.0 7.4

Swimming pools/100,000

3.1

33.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

1.7 1.9

Ball diamonds/10,000

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

2.5%

Acres of parkland/1,000

Percent using public transportation to work

Birmingham Target Goal**

3.9

Tennis courts/10,000

2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$1.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

23

BOSTON, MA

(Boston-Cambridge-Quincy, MA-NH MSA)

Ranking: Total Score = 69.1; Rank = 9 Areas of Excellence (at or better than target goal): • Lower death rate for cardiovascular disease • Lower death rate for diabetes • Higher percent of city land as parkland • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More park playgrounds per capita • More park units per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer dog parks per capita • Fewer golf courses per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita Description of Boston-Cambridge-Quincy, MA-NH MSA Population 4,640,802 Percent less than 18 years old 21.0% Percent 18 to 64 years old 65.2% Percent 65 years old and older 13.7% Percent male 48.5% Percent high school graduate or higher 90.7% Percent White 78.2% Percent Black or African American 7.9% Percent Asian 6.9% Percent Other Race 7.0% Percent Hispanic/Latino 9.6% Percent unemployed 7.9% Median household income $71,738 Percent of households below poverty level 7.5% Violent crime rate/100,000* 355.2 Percent with disability 10.5% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

24

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 75.2 Rank = 6

Boston Target Goal*

Health Behaviors

Chronic Health Problems 21.5%

Percent obese

80.4%

Percent any physical activity or exercise in the last 30 days

21.3%

82.6% 59.7%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

Percent with asthma 33.4%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

15.9%

34.6% 29.2% 9.7% 6.5% 4.0% 2.8% 7.9% 6.4%

19.6% 189.0

Percent currently smoking

34.8% 30.4%

Any days when mental health was not good during the past 30 days

21.9%

Percent meeting both CDC aerobic and strength activity guidelines

Percent consuming 3+ vegetables per day

61.0%

28.4%

Percent meeting CDC aerobic activity guidelines

167.1

14.3%

Death rate/100,000 for diabetes

13.1%

158.7

Death rate/100,000 for cardiovascular disease

167.1 12.1 17.0

Community/Environmental Indicators – Score = 63.0 Rank = 10 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000 Farmers’ markets/ 1,000,000 Percent using public transportation to work Percent bicycling or walking to work

Recreational Facilities

15.8%

2.3 1.9

Ball diamonds/10,000

10.6% Dog parks/100,000

7.6 18.6

0.5 0.9 3.4

Park playgrounds/10,000 34.0 Golf courses/100,000

13.1 12.2%

2.3 0.3 0.9 5.7

Park units/10,000

4.3% Recreational centers/20,000

6.4% 2.8%

WalkScore®

Swimming pools/100,000 80.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Boston Target Goal**

4.1 0.0 1.0 1.1 3.1 1.5 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$110.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

25

BUFFALO, NY

(Buffalo-Niagara Falls, NY MSA)

Ranking: Total Score = 47.2; Rank = 29 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Fewer dog parks per capita • Fewer recreation centers per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Buffalo-Niagara Falls, NY MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability 26

1,134,210 20.9% 62.9% 16.2% 48.4% 90.4% 80.9% 12.1% 2.6% 4.4% 4.3% 7.8% $50,269 10.6% 442.5 12.8%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 40.7 Rank = 34

Buffalo Target Goal*

Health Behaviors

Chronic Health Problems 77.7%

Percent any physical activity or exercise in the last 30 days

Percent obese

26.6% 21.3%

82.6% 50.3%

Percent in excellent or very good health

61.0%

28.4%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

18.0%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Percent with asthma 34.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

13.2%

Percent consuming 3+ vegetables per day

38.6% 30.4% 36.2% 29.2% 10.2% 6.5% 4.1% 2.8% 12.2% 6.4%

19.6% 189.0 21.2%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

218.2

Death rate/100,000 for cardiovascular disease

167.1 17.9 17.0

Community/Environmental Indicators – Score = 53.7 Rank = 23 (note: most of these data were available only for the main city in the MSA) Built Environment

Acres of parkland/1,000

Recreational Facilities

7.1%

Parkland as a percent of city land area

2.3 1.9

Ball diamonds/10,000

10.6% Dog parks/100,000

6.9 18.6

Golf courses/100,000

13.1

Percent using public transportation to work

3.0%

Percent bicycling or walking to work

3.4%

0.4 0.9 2.3 2.3

Park playgrounds/10,000

23.8

Farmers’ markets/ 1,000,000

1.5 0.9 7.7

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.8%

0.7 1.0 3.7

Swimming pools/100,000 65.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Buffalo Target Goal**

3.1 2.0 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$32.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

27

CHARLOTTE, NC

(Charlotte-Gastonia-Rock Hill, NC-SC MSA)

Ranking: Total Score = 48.1; Rank = 27 Areas of Excellence (at or better than target goal): • Lower percent of days when physical health was not good during the past 30 days • Lower death rate for diabetes • More acres of parkland per capita • More farmers’ markets per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Higher percent currently smoking • Higher percent obese • Higher percent with diabetes • Lower percent of city land area as parkland • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita Description of Charlotte-Gastonia-Rock Hill, NC-SC MSA Population 2,296,569 Percent less than 18 years old 25.5% Percent 18 to 64 years old 63.8% Percent 65 years old and older 10.7% Percent male 48.5% Percent high school graduate or higher 87.6% Percent White 66.9% Percent Black or African American 23.9% Percent Asian 3.4% Percent Other Race 5.8% Percent Hispanic/Latino 10.2% Percent unemployed 10.3% Median household income $52,470 Percent of households below poverty level 11.9% Violent crime rate/100,000* N/A‡ Percent with disability 9.9% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

28

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 62.5 Rank = 16

Charlotte Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

80.7%

Percent any physical activity or exercise in the last 30 days

27.5% 21.3%

82.6% 54.7%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

Percent with asthma 24.4%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

16.7%

Percent consuming 3+ vegetables per day

29.6% 30.4%

Any days when mental health was not good during the past 30 days

18.1%

Percent meeting both CDC aerobic and strength activity guidelines

31.0% 29.2% 7.4% 6.5% 3.4% 2.8% 10.4% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

26.7%

Percent meeting CDC aerobic activity guidelines

167.1

18.2%

Death rate/100,000 for diabetes

13.1%

173.7

Death rate/100,000 for cardiovascular disease

167.1 14.9 17.0

Community/Environmental Indicators – Score = 34.0 Rank = 46 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Recreational Facilities

5.5%

Ball diamonds/10,000

0.8 1.9

10.6% Dog parks/100,000

20.3

Acres of parkland/1,000

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

2.1%

Percent bicycling or walking to work

1.8%

0.9 1.3 2.3 0.5 0.9 2.6

Park units/10,000

4.3% Recreational centers/20,000

2.8%

WalkScore®

0.7

Park playgrounds/10,000

13.9

Farmers’ markets/ 1,000,000

Swimming pools/100,000 24.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

Charlotte Target Goal**

Tennis courts/10,000

4.1 0.5 1.0 0.5 3.1 1.5 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$64.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

29

CHICAGO, IL

(Chicago-Joliet-Naperville, IL-IN-WI MSA)

Ranking: Total Score = 56.6; Rank = 15 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More recreation centers per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer dog parks per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer swimming pools per capita • Lower level of state requirement for Physical Education classes Description of Chicago-Joliet-Naperville, IL-IN-WI MSA Population 9,522,434 Percent less than 18 years old 24.5% Percent 18 to 64 years old 63.5% Percent 65 years old and older 12.0% Percent male 48.9% Percent high school graduate or higher 86.8% Percent White 66.9% Percent Black or African American 17.1% Percent Asian 5.9% Percent Other Race 10.1% Percent Hispanic/Latino 21.3% Percent unemployed 10.8% Median household income $59,261 Percent of households below poverty level 11.1% Violent crime rate/100,000* N/A‡ Percent with disability 9.9% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

30

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 58.3 Rank = 19

Chicago Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

78.6%

Percent any physical activity or exercise in the last 30 days

27.4% 21.3%

82.6% 51.3%

Percent in excellent or very good health

61.0%

27.2%

Percent meeting CDC aerobic activity guidelines

32.2%

21.5%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

Percent with asthma 33.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

15.7%

Percent consuming 3+ vegetables per day

40.9%

38.4%

7.9% 6.5% 3.5% 2.8% 8.2% 6.4%

19.6% 189.0 17.7%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

193.7

Death rate/100,000 for cardiovascular disease

167.1 19.1 17.0

Community/Environmental Indicators – Score = 54.9 Rank = 21.5 (note: most of these data were available only for the main city in the MSA) Built Environment

Acres of parkland/1,000

Percent bicycling or walking to work

Dog parks/100,000

4.4 18.6

1.9 0.6 0.9 1.8

Park playgrounds/10,000

22.3 13.1

Golf courses/100,000

11.1%

Park units/10,000

2.3 0.4 0.9 2.0 4.1

4.3% Recreational centers/20,000

3.9% 2.8%

Swimming pools/100,000 75.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

2.5

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Recreational Facilities

8.6%

Parkland as a percent of city land area

Chicago Target Goal**

1.8 1.0 2.0 3.1 2.0 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$149.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

31

CINCINNATI, OH

(Cincinnati-Middletown, OH-KY-IN MSA)

Ranking: Total Score = 54.5; Rank = 18 Areas of Excellence (at or better than target goal): • Higher percent of city land area as parkland • More acres of parkland per capita • More farmers’ markets per capita • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for diabetes • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower level of state requirement for Physical Education classes Description of Cincinnati-Middletown, OH-KY-IN MSA Population 2,128,603 Percent less than 18 years old 24.4% Percent 18 to 64 years old 62.7% Percent 65 years old and older 12.8% Percent male 48.8% Percent high school graduate or higher 89.3% Percent White 83.0% Percent Black or African American 12.1% Percent Asian 2.0% Percent Other Race 2.9% Percent Hispanic/Latino 2.7% Percent unemployed 8.3% Median household income $52,439 Percent of households below poverty level 11.2% Violent crime rate/100,000* 284.5 Percent with disability 11.8% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

32

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 34.9 Rank = 41

Cincinnati Target Goal*

Health Behaviors

Chronic Health Problems 76.1%

Percent any physical activity or exercise in the last 30 days

Percent obese

28.5% 21.3%

82.6% 54.0%

Percent in excellent or very good health

61.0%

28.3%

Percent meeting CDC aerobic activity guidelines

32.2%

17.6%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

Percent with asthma 28.3%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

12.4%

Percent consuming 3+ vegetables per day

35.2%

34.4%

10.0% 6.5% 5.2% 2.8% 12.0% 6.4%

19.6% 189.0 22.6%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

189.9

Death rate/100,000 for cardiovascular disease

167.1 22.9 17.0

Community/Environmental Indicators – Score = 73.8 Rank = 3 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

13.7%

Parkland as a percent of city land area

Cincinnati Target Goal**

Ball diamonds/10,000

10.6% Dog parks/100,000

20.5

Acres of parkland/1,000

18.6

1.2 0.9 4.5

Park playgrounds/10,000

2.3

22.1

Farmers’ markets/ 1,000,000

Golf courses/100,000

13.1

Percent using public transportation to work

1.8%

Percent bicycling or walking to work

2.1%

2.1 0.9 10.9

Park units/10,000

4.3% Recreational centers/20,000 2.8%

4.1 1.5 1.0 7.8

Swimming pools/100,000

3.1

50.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

3.6 1.9

Tennis courts/10,000

3.8 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$225.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

33

CLEVELAND, OH

(Cleveland-Elyria-Mentor, OH MSA)

Ranking: Total Score = 45.4; Rank = 33 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher Walk Score® • More ball diamonds per capita • More park playgrounds per capita • More golf courses per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Fewer dog parks per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Cleveland-Elyria-Mentor, OH MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

2,063,535 22.4% 61.7% 15.9% 48.1% 88.5% 74.5% 20.4% 2.0% 3.1% 5.0% 9.9% $46,944 12.0% N/A‡ 13.6%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

34

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 37.5 Rank = 38

Cleveland Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

76.0%

Percent any physical activity or exercise in the last 30 days

27.6% 21.3%

82.6% 51.9%

Percent in excellent or very good health

61.0%

26.6%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

21.5%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

29.2% 11.2% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

13.0%

Percent consuming 3+ vegetables per day

37.2%

Percent with asthma 30.9%

Percent consuming 2+ fruits per day

34.9% 30.4%

5.2%

12.0% 6.4%

19.6% 189.0 22.2%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

208.8

Death rate/100,000 for cardiovascular disease

167.1 23.1 17.0

Community/Environmental Indicators – Score = 53.3 Rank = 25 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

6.3%

Parkland as a percent of city land area

3.2

Ball diamonds/10,000

1.9

10.6% Dog parks/100,000

7.3

Acres of parkland/1,000

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

3.2%

Percent bicycling or walking to work

2.6%

0.9 2.6 2.3 0.9 0.9 3.8 4.1

Park units/10,000

4.3% Recreational centers/20,000

2.8%

Swimming pools/100,000 57.0

WalkScore®

0.2

Park playgrounds/10,000

21.3

Farmers’ markets/ 1,000,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Cleveland Target Goal**

Tennis courts/10,000

1.1 1.0 9.7 3.1 2.6 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$69.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

35

COLUMBUS, OH (Columbus, OH MSA)

Ranking: Total Score = 41.3; Rank = 40 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • More golf courses per capita • More park units per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Columbus, OH MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

1,944,002 24.4% 64.4% 11.2% 49.2% 90.5% 77.3% 14.9% 3.3% 4.5% 3.8% 7.2% $53,699 10.8% N/A‡ 11.6%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

36

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 39.7 Rank = 35

Columbus Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

76.9%

Percent any physical activity or exercise in the last 30 days

30.4% 21.3%

82.6% 52.6%

Percent in excellent or very good health

61.0%

25.0%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

19.8%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

29.2% 9.3% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

13.3%

Percent consuming 3+ vegetables per day

37.8%

Percent with asthma 28.8%

Percent consuming 2+ fruits per day

36.1% 30.4%

5.1%

9.4% 6.4%

19.6% 189.0 167.1

19.7%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

190.9

Death rate/100,000 for cardiovascular disease

167.1 19.7 17.0

Community/Environmental Indicators – Score = 42.9 Rank = 36 (note: most of these data were available only for the main city in the MSA) Built Environment

Dog parks/100,000

14.1 18.6

Golf courses/100,000

13.1 1.6% 4.3% 2.5% 2.8%

Swimming pools/100,000 40.0

WalkScore®

0.9 1.9 2.3 0.9 0.9 5.2

Park units/10,000 Recreational centers/20,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9 0.4

Park playgrounds/10,000 27.3

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

1.2

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

8.1%

Parkland as a percent of city land area

Columbus Target Goal**

Tennis courts/10,000

4.1 0.7 1.0 0.9 3.1 1.8 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$64.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

37

DALLAS, TX

(Dallas-Fort Worth-Arlington, TX MSA)

Ranking: Total Score = 42.6; Rank = 38 Areas of Excellence (at or better than target goal): • Higher percent of city land area as parkland Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer farmers’ markets per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Lower park-related expenditures per capita Description of Dallas-Fort Worth-Arlington, TX MSA Population 6,700,991 Percent less than 18 years old 27.3% Percent 18 to 64 years old 63.3% Percent 65 years old and older 9.4% Percent male 49.4% Percent high school graduate or higher 83.9% Percent White 69.9% Percent Black or African American 15.3% Percent Asian 5.7% Percent Other Race 9.1% Percent Hispanic/Latino 28.0% Percent unemployed 7.6% Median household income $56,954 Percent of households below poverty level 11.8% Violent crime rate/100,000* 344.7 Percent with disability 9.3% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

38

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 46.7 Rank = 27

Dallas Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

73.9%

Percent any physical activity or exercise in the last 30 days

28.3% 21.3%

82.6% 47.4%

Percent in excellent or very good health Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

32.5% 30.4%

Any days when mental health was not good during the past 30 days

16.9%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

33.5% 29.2% 7.9%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

28.5%

Percent consuming 2+ fruits per day

35.6%

Percent with diabetes

15.1%

Percent consuming 3+ vegetables per day

3.6%

10.2% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

26.8%

16.7%

167.1

Death rate/100,000 for diabetes

13.1%

193.5

Death rate/100,000 for cardiovascular disease

167.1 18.0 17.0

Community/Environmental Indicators – Score = 38.7 Rank = 40 (note: most of these data were available only for the main city in the MSA) Built Environment

Dog parks/100,000

18.0 18.6

1.9

Golf courses/100,000

13.1 1.5%

Percent bicycling or walking to work

1.4%

0.9 1.6 2.3 0.5 0.9 2.8

Park units/10,000

4.3% Recreational centers/20,000

2.8%

WalkScore®

0.2

Park playgrounds/10,000

4.6

Percent using public transportation to work

Swimming pools/100,000 44.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

0.9

Ball diamonds/10,000

10.6%

Acres of parkland/1,000 Farmers’ markets/ 1,000,000

Recreational Facilities

10.6%

Parkland as a percent of city land area

Dallas Target Goal**

Tennis courts/10,000

4.1 0.7 1.0 1.3 3.1 1.9 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$70.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

39

DENVER, CO

(Denver-Aurora-Broomfield, CO MSA)

Ranking: Total Score = 71.7; Rank = 4 Areas of Excellence (at or better than target goal): • Higher percent of any physical activity or exercise in the last 30 days • Higher percent meeting both CDC aerobic and strength activity guidelines • Lower percent obese • Lower death rate for cardiovascular disease • Lower death rate for diabetes • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Lower percent of city land area as parkland • Fewer acres of parkland per capita Description of Denver-Aurora-Broomfield, CO MSA Population 2,645,209 Percent less than 18 years old 24.4% Percent 18 to 64 years old 64.8% Percent 65 years old and older 10.8% Percent male 49.8% Percent high school graduate or higher 89.9% Percent White 82.2% Percent Black or African American 5.7% Percent Asian 3.8% Percent Other Race 8.3% Percent Hispanic/Latino 22.8% Percent unemployed 7.5% Median household income $61,453 Percent of households below poverty level 9.0% Violent crime rate/100,000* 337.5 Percent with disability 9.2% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

40

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 77.9 Rank = 5

Denver Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

82.6%

Percent any physical activity or exercise in the last 30 days

20.4% 21.3%

82.6% 57.2%

Percent in excellent or very good health Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

25.2%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

36.8% 29.2% 9.8%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

15.6% 19.6% 189.0

Percent currently smoking

34.0% 30.4%

31.6%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

61.0%

31.3%

17.2%

167.1

7.4% 6.4% 137.1

Death rate/100,000 for cardiovascular disease Death rate/100,000 for diabetes

13.1%

2.9%

167.1 13.8 17.0

Community/Environmental Indicators – Score = 65.6 Rank = 8 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

6.0%

Acres of parkland/1,000

9.7

Percent bicycling or walking to work

Recreational Facilities

Dog parks/100,000 18.6

1.9 1.5 0.9 2.4 2.3

Park playgrounds/10,000

18.9 Golf courses/100,000

13.1 4.4%

1.1 0.9 4.2

Park units/10,000

4.3% Recreational centers/20,000

3.5% 2.8%

WalkScore®

4.1 1.0 1.0 4.8

Swimming pools/100,000

3.1

56.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

2.4

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Denver Target Goal**

Tennis courts/10,000

2.5 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$146.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

41

DETROIT, MI

(Detroit-Warren-Livonia, MI MSA)

Ranking: Total Score = 37.3; Rank = 43 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher Walk Score® • More ball diamonds per capita • More park playgrounds per capita • More park units per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Fewer dog parks per capita • Fewer golf courses per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita Description of Detroit-Warren-Livonia, MI MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

4,292,060 23.4% 62.6% 13.9% 48.5% 88.3% 70.2% 22.6% 3.4% 3.8% 4.1% 12.2% $50,310 13.4% 574.4 13.8%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

42

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 38.4 Rank = 37

Detroit Target Goal*

Health Behaviors

Chronic Health Problems 75.7%

Percent any physical activity or exercise in the last 30 days

Percent obese

32.0% 21.3%

82.6% 48.4%

Percent in excellent or very good health

32.2%

19.4%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

30.4%

Any days when mental health was not good during the past 30 days

29.2%

36.2%

38.9%

10.4%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

15.3%

4.1%

9.8% 6.4%

19.6% 189.0

Percent currently smoking

Any days when physical health was not good during the past 30 days

33.3%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

61.0%

28.8%

Percent meeting CDC aerobic activity guidelines

24.0%

167.1

Death rate/100,000 for diabetes

13.1%

240.7

Death rate/100,000 for cardiovascular disease

167.1 25.0 17.0

Community/Environmental Indicators – Score = 36.2 Rank = 43 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000

Recreational Facilities

6.7%

2.4

Ball diamonds/10,000

1.9

10.6% Dog parks/100,000

6.5 18.6

Golf courses/100,000

13.1

Percent using public transportation to work

1.6%

Percent bicycling or walking to work

1.6%

0.0 0.9 3.4

Park playgrounds/10,000

17.9

Farmers’ markets/ 1,000,000

2.3 0.5 0.9 4.3

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.8%

WalkScore®

Swimming pools/100,000 52.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

Detroit Target Goal**

Tennis courts/10,000

0.3 1.0 1.0 3.1 1.3 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$25.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

43

HARTFORD, CT

(Hartford-West Hartford-East Hartford, CT MSA)

Ranking: Total Score = 63.8; Rank = 12 Areas of Excellence (at or better than target goal): • Higher percent consuming 2+ fruits per day • Lower death rate for diabetes • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Lower percent consuming 3+ vegetables per day • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer dog parks per capita • Lower park-related expenditures per capita Description of Hartford-West Hartford-East Hartford, CT MSA Population 1,214,400 Percent less than 18 years old 21.5% Percent 18 to 64 years old 63.5% Percent 65 years old and older 15.0% Percent male 48.6% Percent high school graduate or higher 89.9% Percent White 78.2% Percent Black or African American 10.8% Percent Asian 4.2% Percent Other Race 6.8% Percent Hispanic/Latino 13.2% Percent unemployed 9.3% Median household income $66,732 Percent of households below poverty level 7.7% Violent crime rate/100,000* 285.8 Percent with disability 10.8% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

44

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 61.9 Rank = 17

Hartford Target Goal*

Health Behaviors

Chronic Health Problems 78.1%

Percent any physical activity or exercise in the last 30 days

32.2%

20.3% 23.3%

35.6%

30.4%

Any days when mental health was not good during the past 30 days

29.2%

38.2%

36.5%

10.3%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

14.1%

61.0%

Any days when physical health was not good during the past 30 days

35.6%

Percent consuming 2+ fruits per day

56.9%

Percent in excellent or very good health

29.5%

Percent meeting both CDC aerobic and strength activity guidelines

4.0%

9.0% 6.4%

19.6% 189.0

Percent currently smoking

21.3%

82.6%

Percent meeting CDC aerobic activity guidelines

Percent consuming 3+ vegetables per day

27.4%

Percent obese

15.6%

167.1

Death rate/100,000 for diabetes

13.1%

178.0

Death rate/100,000 for cardiovascular disease

167.1 12.1 17.0

Community/Environmental Indicators – Score = 65.7 Rank = 7 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Hartford Target Goal** Recreational Facilities

19.9%

1.9

10.6% Dog parks/100,000

17.7

Acres of parkland/1,000

18.6

0.0 0.9 2.2 2.3

Park playgrounds/10,000 46.1

Farmers’ markets/ 1,000,000

Golf courses/100,000

13.1

Percent using public transportation to work

3.4%

Percent bicycling or walking to work

2.9%

4.3%

2.8%

WalkScore®

1.6 0.9 4.4 4.1

Park units/10,000 Recreational centers/20,000

1.0 1.0 4.8

Swimming pools/100,000 68.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

3.7

Ball diamonds/10,000

3.1 2.2 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$37.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

45

HOUSTON, TX

(Houston-Sugar Land-Baytown, TX MSA)

Ranking: Total Score = 44.0; Rank = 35 Areas of Excellence (at or better than target goal): • Lower percent with asthma • Higher percent of city land area as parkland • More acres of parkland per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer farmers’ markets per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita Description of Houston-Sugar Land-Baytown, TX MSA Population 6,177,035 Percent less than 18 years old 27.4% Percent 18 to 64 years old 63.4% Percent 65 years old and older 9.2% Percent male 49.7% Percent high school graduate or higher 81.1% Percent White 66.2% Percent Black or African American 17.1% Percent Asian 6.8% Percent Other Race 9.9% Percent Hispanic/Latino 35.9% Percent unemployed 8.4% Median household income $55,910 Percent of households below poverty level 13.0% Violent crime rate/100,000* 561.5 Percent with disability 9.8% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

46

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 51.8 Rank = 22

Houston Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

73.0%

Percent any physical activity or exercise in the last 30 days

27.0% 21.3%

82.6% 46.4%

Percent in excellent or very good health

61.0%

25.8%

Percent meeting CDC aerobic activity guidelines

32.2%

19.6%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

23.3%

33.3%

31.4%

Percent with asthma

4.9%

Percent with angina or coronary heart disease

4.2%

6.5%

30.0%

Percent consuming 2+ fruits per day

35.6%

Percent with diabetes

16.8%

Percent consuming 3+ vegetables per day

2.8% 11.4% 6.4%

19.6% 189.0 167.1

16.0%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

188.8

Death rate/100,000 for cardiovascular disease

167.1 17.7 17.0

Community/Environmental Indicators – Score = 36.4 Rank = 42 (note: most of these data were available only for the main city in the MSA) Built Environment

Percent using public transportation to work Percent bicycling or walking to work

Dog parks/100,000

22.0 18.6

1.9 0.6 0.9 1.2

Park playgrounds/10,000

2.8 Golf courses/100,000

13.1 2.6%

2.3 0.4 0.9 1.9

Park units/10,000

4.1

4.3% Recreational centers/20,000

1.7% 2.8%

WalkScore®

0.6 1.0 1.8

Swimming pools/100,000 44.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

1.1

Ball diamonds/10,000

10.6%

Acres of parkland/1,000 Farmers’ markets/ 1,000,000

Recreational Facilities

13.4%

Parkland as a percent of city land area

Houston Target Goal**

Tennis courts/10,000

3.1 1.0 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$38.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

47

INDIANAPOLIS, IN (Indianapolis-Carmel, IN MSA)

Ranking: Total Score = 32.3; Rank = 47 Areas of Excellence (at or better than target goal): • Lower death rate for diabetes • More farmers’ markets per capita • More golf courses per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Indianapolis-Carmel, IN MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability 48

1,928,982 25.8% 62.8% 11.4% 48.7% 88.9% 76.7% 15.1% 2.1% 6.1% 6.4% 8.6% $51,808 10.5% 599.5 11.3%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 33.7 Rank = 44

Indianapolis Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

76.1%

Percent any physical activity or exercise in the last 30 days

30.1% 21.3%

82.6% 51.3%

Percent in excellent or very good health

61.0%

24.2%

Percent meeting CDC aerobic activity guidelines

32.2%

17.0%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

9.2% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

13.4%

Percent consuming 3+ vegetables per day

38.6%

Percent with asthma 28.4%

Percent consuming 2+ fruits per day

37.0%

4.4%

9.9% 6.4%

19.6% 189.0 167.1

21.6%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

210.1

Death rate/100,000 for cardiovascular disease

167.1 13.4 17.0

Community/Environmental Indicators – Score = 31.0 Rank = 50 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Recreational Facilities

4.8%

Ball diamonds/10,000

10.6%

Dog parks/100,000

13.8

Acres of parkland/1,000

18.6

0.7 1.9 0.5 0.9 1.6

Park playgrounds/10,000

2.3

18.1

Farmers’ markets/ 1,000,000

Golf courses/100,000

13.1

Percent using public transportation to work

1.2%

Percent bicycling or walking to work

1.9%

1.6 0.9 2.6

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.8%

0.6 1.0 2.7 3.1

Swimming pools/100,000 29.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

Indianapolis Target Goal**

Tennis courts/10,000

1.4 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$36.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

49

JACKSONVILLE, FL (Jacksonville, FL MSA)

Ranking: Total Score = 46.6; Rank = 30 Areas of Excellence (at or better than target goal): • Higher percent of city land area as parkland • More acres of parkland per capita • More ball diamonds per capita • More park playgrounds per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Fewer golf courses per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Jacksonville, FL MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

1,377,850 23.2% 63.7% 13.1% 48.7% 88.7% 70.8% 21.1% 3.6% 4.5% 7.4% 11.4% $48,118 12.1% 513.4 12.9%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

50

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 42.4 Rank = 31

Jacksonville Target Goal*

Health Behaviors

Chronic Health Problems 79.1%

Percent any physical activity or exercise in the last 30 days

Percent obese

29.9% 21.3%

82.6% 55.1%

Percent in excellent or very good health

61.0%

28.8%

Percent meeting CDC aerobic activity guidelines

32.2%

17.9%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

9.6% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

16.6%

Percent consuming 3+ vegetables per day

35.0%

Percent with asthma 28.8%

Percent consuming 2+ fruits per day

37.7%

5.1%

12.0% 6.4%

19.6% 189.0 167.1

20.6%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

203.6

Death rate/100,000 for cardiovascular disease

167.1 25.0 17.0

Community/Environmental Indicators – Score = 50.7 Rank = 26 (note: most of these data were available only for the main city in the MSA) Built Environment

72.5 18.6

Percent bicycling or walking to work

WalkScore®

1.9 0.1 0.9 3.5

Park playgrounds/10,000 Golf courses/100,000

13.1 1.3%

2.3 0.4 0.9 5.2

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.0% 2.8%

1.4 1.0 4.4

Swimming pools/100,000

3.1

26.0

2.0 2.0

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Dog parks/100,000

10.9

Farmers’ markets/ 1,000,000

3.5

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

11.0%

Parkland as a percent of city land area

Jacksonville Target Goal**

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$4.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

51

KANSAS CITY, MO (Kansas City, MO-KS MSA)

Ranking: Total Score = 45.1; Rank = 34 Areas of Excellence (at or better than target goal): • Lower death rate for diabetes • More acres of parkland per capita • More farmers’ markets per capita • More ball diamonds per capita • More golf courses per capita • More park units per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Fewer recreation centers per capita • Lower level of state requirement for Physical Education classes Description of Kansas City, MO-KS MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

2,038,724 25.1% 62.2% 12.7% 49.0% 91.2% 79.2% 12.4% 2.4% 6.0% 8.4% 7.8% $54,519 9.6% 488.2 11.8%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

52

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 44.5 Rank = 30

Kansas City Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

78.9%

Percent any physical activity or exercise in the last 30 days

28.1% 21.3%

82.6% 54.3%

Percent in excellent or very good health

61.0%

27.5%

Percent meeting CDC aerobic activity guidelines

32.2%

16.7%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

6.5%

24.3% Percent with angina or coronary heart disease

35.6%

Percent with diabetes

12.6%

Percent consuming 3+ vegetables per day

33.8%

9.4%

Percent with asthma Percent consuming 2+ fruits per day

32.2%

4.4% 2.8% 10.8% 6.4%

19.6% 189.0 21.7%

Percent currently smoking

167.1

183.6

Death rate/100,000 for cardiovascular disease

167.1 16.4

Death rate/100,000 for diabetes

13.1%

17.0

Community/Environmental Indicators – Score = 45.7 Rank = 34 (note: most of these data were available only for the main city in the MSA) Built Environment

Dog parks/100,000

36.1 18.6

0.2 0.9 2.1 2.3

Park playgrounds/10,000 1.2

Golf courses/100,000

13.1 1.1%

0.9 4.7

Park units/10,000

4.1

4.3% Recreational centers/20,000

1.5% 2.8%

Swimming pools/100,000 32.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9

30.9

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

3.0

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

8.7%

Parkland as a percent of city land area

Kansas City Target Goal**

Tennis courts/10,000

0.4 1.0 2.5 3.1 2.2 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$113.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

53

LAS VEGAS, NV (Las Vegas-Paradise, NV MSA)

Ranking: Total Score = 43.7; Rank = 37 Areas of Excellence (at or better than target goal): • Lower death rate for diabetes • More dog parks per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent of days when mental health was not good during the past 30 days • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Fewer farmers’ markets per capita • Lower Walk Score® • Fewer ball diamonds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower level of state requirement for Physical Education classes Description of Las Vegas-Paradise, NV MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

2,000,759 24.5% 63.2% 12.3% 50.3% 84.5% 64.5% 10.7% 9.0% 15.8% 29.8% 12.7% $49,546 12.6% 696.5 11.8%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

54

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 46.6 Rank = 28

Las Vegas Target Goal*

Health Behaviors

Chronic Health Problems 78.0%

Percent any physical activity or exercise in the last 30 days

Percent obese

82.6% Percent in excellent or very good health

47.1%

Any days when physical health was not good during the past 30 days

36.0% 30.4%

Any days when mental health was not good during the past 30 days

29.2%

32.2%

18.6%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Percent with asthma 30.3%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

14.8%

36.5%

7.0% 6.5% 4.5% 2.8% 9.6% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

25.5%

Percent meeting CDC aerobic activity guidelines

Percent consuming 3+ vegetables per day

28.1% 21.3%

167.1

17.1%

Death rate/100,000 for diabetes

13.1%

202.8

Death rate/100,000 for cardiovascular disease

167.1 10.4 17.0

Community/Environmental Indicators – Score = 40.9 Rank = 38 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000

Recreational Facilities

4.2%

Ball diamonds/10,000

Dog parks/100,000

5.4 18.6 5.5

Percent using public transportation to work

3.8%

1.9 4.4 0.9 2.0

Park playgrounds/10,000 Golf courses/100,000

13.1

Park units/10,000

4.3% Recreational centers/20,000

2.3% 2.8%

2.3 0.7 0.9 1.3 4.1 0.8 1.0 2.1

Swimming pools/100,000 39.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

0.8

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Las Vegas Target Goal**

Tennis courts/10,000

3.1 1.1 2.0

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$234.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

55

LOS ANGELES, CA

(Los Angeles-Long Beach-Santa Ana, CA MSA)

Ranking: Total Score = 53.4; Rank = 19 Areas of Excellence (at or better than target goal): • Higher percent consuming 2+ fruits per day • Lower percent currently smoking • Higher percent of city land area as parkland • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More recreation centers per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita Description of Los Angeles-Long Beach-Santa Ana, CA MSA Population 13,052,921 Percent less than 18 years old 23.7% Percent 18 to 64 years old 64.6% Percent 65 years old and older 11.7% Percent male 49.3% Percent high school graduate or higher 78.8% Percent White 55.9% Percent Black or African American 6.7% Percent Asian 15.0% Percent Other Race 22.4% Percent Hispanic/Latino 44.9% Percent unemployed 10.9% Median household income $57,271 Percent of households below poverty level 13.7% Violent crime rate/100,000* 393.0 Percent with disability 9.2% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

56

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 62.7 Rank = 15

Los Angeles Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

74.9%

Percent any physical activity or exercise in the last 30 days

24.7% 21.3%

82.6% 50.0%

Percent in excellent or very good health

32.2%

21.2%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

38.9%

40.2%

23.3% Percent with asthma 35.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

18.8%

Percent consuming 3+ vegetables per day

6.9% 6.5% 2.9% 2.8% 10.6% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

30.7%

Percent meeting CDC aerobic activity guidelines

11.4%

167.1

Death rate/100,000 for diabetes

13.1%

182.9

Death rate/100,000 for cardiovascular disease

167.1 19.6 17.0

Community/Environmental Indicators – Score = 44.2 Rank = 35 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000 Farmers’ markets/ 1,000,000 Percent using public transportation to work Percent bicycling or walking to work

Recreational Facilities

14.1%

Ball diamonds/10,000

0.7 1.9

10.6% Dog parks/100,000

11.0 18.6

0.3 0.9 1.0

Park playgrounds/10,000

10.8 Golf courses/100,000

13.1 6.0%

2.3 0.4 0.9 1.4

Park units/10,000

4.1

4.3% Recreational centers/20,000

3.5% 2.8%

WalkScore®

1.2 1.0 1.7

Swimming pools/100,000 64.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Los Angeles Target Goal**

3.1 0.9 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$59.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

57

LOUISVILLE, KY

(Louisville/Jefferson County, KY-IN MSA)

Ranking: Total Score = 25.7; Rank = 49 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • More golf courses per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent of city land area as parkland • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Louisville/Jefferson County, KY-IN MSA Population 1,251,351 Percent less than 18 years old 23.6% Percent 18 to 64 years old 63.0% Percent 65 years old and older 13.5% Percent male 48.7% Percent high school graduate or higher 88.1% Percent White 81.2% Percent Black or African American 13.7% Percent Asian 1.7% Percent Other Race 3.4% Percent Hispanic/Latino 4.2% Percent unemployed 9.0% Median household income $48,895 Percent of households below poverty level 11.6% Violent crime rate/100,000* 425.3 Percent with disability 14.6% 58

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 15.2 Rank = 50

Louisville Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

73.8%

Percent any physical activity or exercise in the last 30 days

32.8% 21.3%

82.6% 45.3%

Percent in excellent or very good health

32.2%

16.3%

Percent meeting both CDC aerobic and strength activity guidelines

30.4%

Any days when mental health was not good during the past 30 days

29.2%

42.8%

37.9%

35.6%

6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

12.0%

12.1%

Percent with asthma 23.6%

6.7%

10.2% 6.4%

19.6% 189.0

Percent currently smoking

Any days when physical health was not good during the past 30 days

23.3%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

61.0%

25.9%

Percent meeting CDC aerobic activity guidelines

167.1

26.1%

Death rate/100,000 for diabetes

13.1%

202.5

Death rate/100,000 for cardiovascular disease

167.1 17.9 17.0

Community/Environmental Indicators – Score = 36.0 Rank = 44 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Dog parks/100,000

18.1 18.6

1.9 0.6 0.9 1.6

Park playgrounds/10,000

2.3

24.0 Golf courses/100,000

13.1 1.8%

1.2 0.9 1.7

Park units/10,000

4.3% Recreational centers/20,000

2.0% 2.8%

Swimming pools/100,000 31.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.2

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

5.3%

Acres of parkland/1,000

Percent using public transportation to work

Louisville Target Goal**

Tennis courts/10,000

4.1 0.5 1.0 0.8 3.1 2.4 2.0

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$38.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

59

MEMPHIS, TN

(Memphis, TN-MS-AR MSA)

Ranking: Total Score = 24.8; Rank = 50 Areas of Excellence (at or better than target goal): • Lower percent of days when physical health was not good during the past 30 days • Lower percent of days when mental health was not good during the past 30 days • More golf courses per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent consuming 2+ fruits per day • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer park units per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Memphis, TN-MS-AR MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

60

1,341,690 26.1% 62.8% 11.1% 48.1% 86.2% 48.2% 46.0% 1.9% 3.9% 5.2% 10.9% $45,687 15.5% 1056.8 12.5%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas.

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 17.2 Rank = 49

Memphis Target Goal*

Health Behaviors

Chronic Health Problems 71.7%

Percent any physical activity or exercise in the last 30 days

Percent obese

35.0% 21.3%

82.6% 42.6%

Percent in excellent or very good health

61.0%

19.9%

Percent meeting CDC aerobic activity guidelines

32.2%

12.5%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

7.7% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

9.4%

Percent consuming 3+ vegetables per day

27.5%

Percent with asthma 19.3%

Percent consuming 2+ fruits per day

29.4%

7.5%

14.0% 6.4%

19.6% 189.0 23.1%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

247.1

Death rate/100,000 for cardiovascular disease

167.1 31.2 17.0

Community/Environmental Indicators – Score = 32.2 Rank = 47 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

5.1%

Parkland as a percent of city land area

1.7 1.9

Ball diamonds/10,000

10.6% Dog parks/100,000

13.5

Acres of parkland/1,000

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

1.2%

Percent bicycling or walking to work

1.3%

0.9 1.7 2.3 1.3 0.9 2.9

Park units/10,000

4.3% Recreational centers/20,000

2.8%

4.1 0.9 1.0 2.7

Swimming pools/100,000 33.0

WalkScore®

0.3

Park playgrounds/10,000

11.2

Farmers’ markets/ 1,000,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Memphis Target Goal**

Tennis courts/10,000

3.1 1.2 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$26.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

61

MIAMI, FL

(Miami-Fort Lauderdale-Pompano Beach, FL MSA)

Ranking: Total Score = 49.0; Rank = 26 Areas of Excellence (at or better than target goal): • Lower percent currently smoking • Lower percent with asthma • Higher Walk Score® • More recreation centers per capita • More swimming pools per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent in excellent or very good health • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Fewer farmers’ markets per capita • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Miami-Fort Lauderdale-Pompano Beach, FL MSA Population 5,762,717 Percent less than 18 years old 21.0% Percent 18 to 64 years old 62.6% Percent 65 years old and older 16.4% Percent male 48.5% Percent high school graduate or higher 84.5% Percent White 71.8% Percent Black or African American 21.2% Percent Asian 2.4% Percent Other Race 4.6% Percent Hispanic/Latino 42.0% Percent unemployed 11.6% Median household income $46,648 Percent of households below poverty level 13.9% Violent crime rate/100,000* 565.2 Percent with disability 10.6% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas.

62

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 60.1 Rank = 18

Miami Target Goal*

Health Behaviors

Chronic Health Problems 75.2%

Percent any physical activity or exercise in the last 30 days

Percent obese

22.9% 21.3%

82.6% 48.3%

Percent in excellent or very good health

61.0%

26.3%

Percent meeting CDC aerobic activity guidelines

32.2%

20.9%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

Percent with asthma 31.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

16.5%

Percent consuming 3+ vegetables per day

33.8%

33.8%

5.9% 6.5% 4.3% 2.8% 10.3% 6.4%

19.6% 189.0 167.1

12.3%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

177.9

Death rate/100,000 for cardiovascular disease

167.1 18.1 17.0

Community/Environmental Indicators – Score = 38.1 Rank = 41 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000

Miami Target Goal** Recreational Facilities

5.2%

Ball diamonds/10,000

10.6%

0.6 1.9 0.7

Dog parks/100,000

2.8

0.9

18.6

1.3

Park playgrounds/10,000 Farmers’ markets/ 1,000,000 Percent using public transportation to work Percent bicycling or walking to work

9.5 Golf courses/100,000

13.1 4.2%

0.2 0.9 2.7

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.4% 2.8%

1.5 1.0 3.5

Swimming pools/100,000 76.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

2.3

3.1 1.3 2.0

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$13.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

63

MILWAUKEE, WI

(Milwaukee-Waukesha-West Allis, WI MSA)

Ranking: Total Score = 45.7; Rank = 32 Areas of Excellence (at or better than target goal): • Higher percent meeting both CDC aerobic and strength activity guidelines • More farmers’ markets per capita • Higher percent bicycling or walking to work • Higher Walk Score® • More golf courses per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower level of state requirement for Physical Education classes Description of Milwaukee-Waukesha-West Allis, WI MSA Population 1,566,981 Percent less than 18 years old 24.2% Percent 18 to 64 years old 62.7% Percent 65 years old and older 13.1% Percent male 48.6% Percent high school graduate or higher 89.9% Percent White 74.3% Percent Black or African American 16.6% Percent Asian 3.0% Percent Other Race 6.1% Percent Hispanic/Latino 9.9% Percent unemployed 8.0% Median household income $52,608 Percent of households below poverty level 11.6% Violent crime rate/100,000* 575.6 Percent with disability 11.7% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

64

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 48.6 Rank = 25

Milwaukee Target Goal*

Health Behaviors

Chronic Health Problems 80.8%

Percent any physical activity or exercise in the last 30 days

Percent obese

31.6% 21.3%

82.6% 54.4%

Percent in excellent or very good health

61.0%

29.6%

Percent meeting CDC aerobic activity guidelines

32.2%

23.3%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

8.3% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

10.0%

Percent consuming 3+ vegetables per day

37.9%

Percent with asthma 30.0%

Percent consuming 2+ fruits per day

39.9%

4.7%

9.0% 6.4%

19.6% 189.0 167.1

20.2%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

197.2

Death rate/100,000 for cardiovascular disease

167.1 18.1 17.0

Community/Environmental Indicators – Score = 42.7 Rank = 37 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

9.8%

Parkland as a percent of city land area

1.1

Ball diamonds/10,000

1.9

10.6% Dog parks/100,000

15.9

Acres of parkland/1,000

18.6

0.5 0.9 1.2

Park playgrounds/10,000

2.3

26.8

Farmers’ markets/ 1,000,000 3.7%

Percent bicycling or walking to work

3.5%

1.6

Golf courses/100,000

13.1

Percent using public transportation to work

0.9 1.6

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.8%

0.3 1.0 1.4

Swimming pools/100,000 59.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Milwaukee Target Goal**

3.1 0.9 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$90.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

65

MINNEAPOLIS, MN

(Minneapolis-St. Paul-Bloomington, MN-WI MSA)

Ranking: Total Score = 73.5; Rank = 2 Areas of Excellence (at or better than target goal): • Higher percent of any physical activity or exercise in the last 30 days • Lower death rate for cardiovascular disease • Lower death rate for cardiovascular disease • Lower death rate for diabetes • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent with asthma • Fewer acres of parkland per capita • Fewer swimming pools per capita • Lower level of state requirement for Physical Education classes Description of Minneapolis-St. Paul-Bloomington, MN-WI MSA Population 3,422,264 Percent less than 18 years old 24.5% Percent 18 to 64 years old 64.1% Percent 65 years old and older 11.4% Percent male 49.5% Percent high school graduate or higher 93.2% Percent White 81.2% Percent Black or African American 7.6% Percent Asian 6.0% Percent Other Race 5.2% Percent Hispanic/Latino 5.5% Percent unemployed 6.6% Median household income $66,282 Percent of households below poverty level 7.4% Violent crime rate/100,000* N/A‡ Percent with disability 9.1% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡ This measure was not available

66

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 75.1 Rank = 7

Minneapolis Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

84.1%

Percent any physical activity or exercise in the last 30 days

24.0% 21.3%

82.6% 60.8%

Percent in excellent or very good health

61.0%

30.7%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

20.8%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Percent with asthma 30.9%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

13.1%

Percent consuming 3+ vegetables per day

32.4% 30.4% 34.1% 29.2% 8.6% 6.5% 3.2% 2.8% 6.5% 6.4%

19.6% 189.0 167.1

17.6%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

118.8

Death rate/100,000 for cardiovascular disease

167.1 14.5 17.0

Community/Environmental Indicators – Score = 72.0 Rank = 5 (note: most of these data were available only for the main city in the MSA) Built Environment

Dog parks/100,000

13.3 18.6

1.6 0.9 2.9

Park playgrounds/10,000 Golf courses/100,000

13.1 4.3%

2.3 1.8 0.9 4.7

Park units/10,000

4.1

4.3% Recreational centers/20,000

3.2% 2.8%

Swimming pools/100,000

2.6 1.0 1.0 3.1

65.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9

28.3

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

5.1

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

14.6%

Parkland as a percent of city land area

Minneapolis Target Goal**

4.7 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$227.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

67

NASHVILLE, TN

(Nashville-Davidson-Murfreesboro-Franklin, TN MSA)

Ranking: Total Score = 32.5; Rank = 46 Areas of Excellence (at or better than target goal): • Lower percent of days when mental health was not good during the past 30 days • More farmers’ markets per capita • More golf courses per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent eating 2+ fruits per day • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent of city land area as parkland • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Fewer park units per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Nashville-Davidson-Murfreesboro-Franklin, TN MSA Population 1,726,693 Percent less than 18 years old 24.0% Percent 18 to 64 years old 64.5% Percent 65 years old and older 11.5% Percent male 48.8% Percent high school graduate or higher 88.2% Percent White 77.2% Percent Black or African American 15.6% Percent Asian 2.4% Percent Other Race 4.8% Percent Hispanic/Latino 6.8% Percent unemployed 7.7% Median household income $51,500 Percent of households below poverty level 10.8% Violent crime rate/100,000* 665.9 Percent with disability 11.4% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

68

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 29.3 Rank = 45

Nashville Target Goal*

Health Behaviors

Chronic Health Problems 74.0%

Percent any physical activity or exercise in the last 30 days

Percent obese

29.5% 21.3%

82.6% 50.9%

Percent in excellent or very good health

61.0%

21.8%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

11.6%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Percent with asthma 19.3%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

7.6%

Percent consuming 3+ vegetables per day

31.3% 30.4% 28.7% 29.2% 6.7% 6.5% 5.2% 2.8% 9.5% 6.4%

19.6% 189.0 167.1

23.1%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

213.6

Death rate/100,000 for cardiovascular disease

167.1 19.8 17.0

Community/Environmental Indicators – Score = 35.7 Rank = 45 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Recreational Facilities

3.4%

1.5

Ball diamonds/10,000

1.9

10.6% Dog parks/100,000

17.8

Acres of parkland/1,000

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

1.1%

Percent bicycling or walking to work

1.3%

0.5 0.9 2.0 2.3

Park playgrounds/10,000

13.3

Farmers’ markets/ 1,000,000

1.2 0.9 1.9

Park units/10,000

4.3% Recreational centers/20,000

2.8%

4.1 0.9 1.0 2.5

Swimming pools/100,000

3.1

27.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

Nashville Target Goal**

Tennis courts/10,000

2.8 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$56.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

69

NEW ORLEANS, LA

(New Orleans-Metairie-Kenner, LA MSA)

Ranking: Total Score = 42.4; Rank = 39 Areas of Excellence (at or better than target goal): • Lower percent with asthma • Higher percent of city land area as parkland • More acres of parkland per capita • Higher percent bicycling or walking to work • Higher Walk Score® • More park playgrounds per capita • More golf courses per capita • More park units per capita • More swimming pools per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent eating 2+ fruits per day • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Lower percent using public transportation to work • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer recreation centers per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of New Orleans-Metairie-Kenner, LA MSA Population 1,227,096 Percent less than 18 years old 23.0% Percent 18 to 64 years old 64.1% Percent 65 years old and older 12.8% Percent male 48.6% Percent high school graduate or higher 84.8% Percent White 58.4% Percent Black or African American 34.5% Percent Asian 2.8% Percent Other Race 4.3% Percent Hispanic/Latino 8.2% Percent unemployed 9.5% Median household income $44,379 Percent of households below poverty level 14.6% Violent crime rate/100,000* 483.1 Percent with disability 14.0% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

70

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 27.8 Rank = 46

New Orleans Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

73.0%

Percent any physical activity or exercise in the last 30 days

28.9% 21.3%

82.6% 49.6%

Percent in excellent or very good health

32.2%

12.4%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

23.3%

33.2%

32.4%

6.0%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

6.4%

20.7%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

61.0%

26.4%

Percent meeting CDC aerobic activity guidelines

35.6%

7.7%

4.6%

13.0%

19.6% 189.0 167.1

21.9%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

220.6

Death rate/100,000 for cardiovascular disease

167.1 17.1 17.0

Community/Environmental Indicators – Score = 56.8 Rank = 18 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

25.8%

Parkland as a percent of city land area

Ball diamonds/10,000

0.3 1.9

10.6% 84.1

Acres of parkland/1,000

18.6

Dog parks/100,000

0.3 0.9 2.6 2.3

Park playgrounds/10,000

12.2

Farmers’ markets/ 1,000,000

Golf courses/100,000

13.1

Percent using public transportation to work

2.7%

Percent bicycling or walking to work

3.5%

2.3 0.9 6.7

Park units/10,000

4.3% Recreational centers/20,000

2.8%

4.1 0.6 1.0 3.7

Swimming pools/100,000 56.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

New Orleans Target Goal**

3.1 1.5 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$20.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

71

NEW YORK, NY

(New York-Northern New Jersey-Long Island, NY-NJ-PA MSA)

Ranking: Total Score = 51.5; Rank = 24 Areas of Excellence (at or better than target goal): • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More dog parks per capita • More park units per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent eating 3+ vegetables per day • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Fewer acres of parkland per capita • Fewer ball diamonds per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower level of state requirement for Physical Education classes Description of New York-Northern New Jersey-Long Island, NY-NJ-PA MSA Population 19,831,858 Percent less than 18 years old 22.3% Percent 18 to 64 years old 64.0% Percent 65 years old and older 13.6% Percent male 48.2% Percent high school graduate or higher 84.8% Percent White 59.1% Percent Black or African American 17.4% Percent Asian 10.3% Percent Other Race 13.2% Percent Hispanic/Latino 23.5% Percent unemployed 9.6% Median household income $63,982 Percent of households below poverty level 11.8% Violent crime rate/100,000* N/A‡ Percent with disability 9.7% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

72

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 54.1 Rank = 21

New York Target Goal*

Health Behaviors

Chronic Health Problems 22.9%

Percent obese

74.1%

Percent any physical activity or exercise in the last 30 days

21.3%

82.6% 51.0%

Percent in excellent or very good health

61.0%

25.6%

Percent meeting CDC aerobic activity guidelines

32.2%

19.8%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.2%

33.6%

23.3% Percent with asthma 32.5%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

14.9%

Percent consuming 3+ vegetables per day

8.2% 6.5% 4.2% 2.8% 9.3% 6.4%

19.6% 167.1

14.1%

Percent currently smoking

213.4

Death rate/100,000 for cardiovascular disease

189.0

Death rate/100,000 for diabetes

13.1%

167.1 18.7 17.0

Community/Environmental Indicators – Score = 48.9 Rank = 28 (note: most of these data were available only for the main city in the MSA) Built Environment

Acres of parkland/1,000

Percent bicycling or walking to work

1.9 1.6

Dog parks/100,000

4.6 18.6

0.9 1.2

Park playgrounds/10,000

16.8 Golf courses/100,000

13.1 31.0%

2.3 0.2 0.9 5.3

Park units/10,000

4.3% Recreational centers/20,000

6.7% 2.8%

Swimming pools/100,000 88.0

WalkScore®

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

0.9

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Recreational Facilities

19.6%

Parkland as a percent of city land area

New York Target Goal**

4.1 0.1 1.0 0.7 3.1 0.9 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$162.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

73

OKLAHOMA CITY, OK (Oklahoma City, OK MSA)

Ranking: Total Score = 31.6; Rank = 48 Areas of Excellence (at or better than target goal): • More acres of parkland per capita • More farmers’ markets per capita • More golf courses per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent eating 2+ fruits per day • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Lower percent of city land area as parkland • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park units per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Oklahoma City, OK MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

74

1,296,565 24.8% 62.9% 12.3% 49.3% 87.7% 74.5% 9.9% 3.0% 12.6% 11.9% 5.6% $48,557 11.9% 548.6 13.3%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 22.8 Rank = 48

Oklahoma City Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

73.9%

Percent any physical activity or exercise in the last 30 days

32.6% 21.3%

82.6% 48.1%

Percent in excellent or very good health

32.2%

16.1%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

9.7%

30.4%

Any days when mental health was not good during the past 30 days

29.2%

37.2%

35.9%

10.3%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

6.4%

4.5%

10.9%

19.6% 189.0

Percent currently smoking

Any days when physical health was not good during the past 30 days

18.3%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

61.0%

26.5%

Percent meeting CDC aerobic activity guidelines

167.1

20.0%

Death rate/100,000 for diabetes

13.1%

229.8

Death rate/100,000 for cardiovascular disease

167.1 26.0 17.0

Community/Environmental Indicators – Score = 40.3 Rank = 39 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Ball diamonds/10,000

Dog parks/100,000

39.0 18.6

1.9 0.4 0.9 2.0 2.3

Park playgrounds/10,000

15.4 Golf courses/100,000

13.1 0.4%

1.4 0.9 2.8

Park units/10,000

4.3% Recreational centers/20,000

2.0% 2.8%

4.1 0.9 1.0 2.0

Swimming pools/100,000 32.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

0.6

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

5.6%

Acres of parkland/1,000

Percent using public transportation to work

Oklahoma City Target Goal**

Tennis courts/10,000

3.1 1.3 2.0

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$61.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

75

ORLANDO, FL

(Orlando-Kissimmee-Sanford, FL MSA)

Ranking: Total Score = 40.8; Rank = 42 Areas of Excellence (at or better than target goal): • More park units per capita • More recreation centers per capita • More swimming pools per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent of days when physical health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Fewer farmers’ markets per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Fewer golf courses per capita • Lower level of state requirement for Physical Education classes Description of Orlando-Kissimmee-Sanford, FL MSA Population 2,223,674 Percent less than 18 years old 22.8% Percent 18 to 64 years old 64.2% Percent 65 years old and older 13.0% Percent male 49.0% Percent high school graduate or higher 87.6% Percent White 71.7% Percent Black or African American 16.7% Percent Asian 4.0% Percent Other Race 7.6% Percent Hispanic/Latino 26.7% Percent unemployed 11.4% Median household income $46,020 Percent of households below poverty level 13.0% Violent crime rate/100,000* 546.1 Percent with disability 11.2% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

76

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 34.6 Rank = 42

Orlando Target Goal*

Health Behaviors

Chronic Health Problems 75.3%

Percent any physical activity or exercise in the last 30 days

29.8%

Percent obese

21.3%

82.6% 46.0%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

Percent with asthma 30.1%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

14.4%

Percent consuming 3+ vegetables per day

39.6% 30.4%

Any days when mental health was not good during the past 30 days

19.1%

Percent meeting both CDC aerobic and strength activity guidelines

33.7% 29.2% 8.5% 6.5% 7.4% 2.8% 11.9% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

25.8%

Percent meeting CDC aerobic activity guidelines

167.1

16.4%

180.7

Death rate/100,000 for cardiovascular disease

167.1 24.2

Death rate/100,000 for diabetes

13.1%

17.0

Community/Environmental Indicators – Score = 47.0 Rank = 32 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Dog parks/100,000

12.7 18.6

0.0 0.9 2.2 2.3

Park playgrounds/10,000

8.5 Golf courses/100,000

13.1 2.0%

0.4 0.9 5.0 4.1

Park units/10,000

4.3% Recreational centers/20,000

1.8% 2.8%

1.8 1.0 4.7

Swimming pools/100,000 39.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.7 1.9

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

5.0%

Acres of parkland/1,000

Percent using public transportation to work

Orlando Target Goal**

Tennis courts/10,000

3.1 1.8 2.0

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$110.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

77

PHILADELPHIA, PA

(Philadelphia-Camden-Wilmington, PA-NJ-DE-MD MSA)

Ranking: Total Score = 52.9; Rank = 20 Areas of Excellence (at or better than target goal): • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More recreation centers per capita • More swimming pools per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Lower park-related expenditures per capita Description of Philadelphia-Camden-Wilmington, PA-NJ-DE-MD MSA Population 6,018,800 Percent less than 18 years old 22.8% Percent 18 to 64 years old 63.4% Percent 65 years old and older 13.9% Percent male 48.3% Percent high school graduate or higher 89.1% Percent White 68.1% Percent Black or African American 20.9% Percent Asian 5.2% Percent Other Race 5.8% Percent Hispanic/Latino 8.3% Percent unemployed 10.4% Median household income $60,105 Percent of households below poverty level 9.3% Violent crime rate/100,000* N/A‡ Percent with disability 12.2% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

78

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 47.3 Rank = 26

Philadelphia Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

76.4%

Percent any physical activity or exercise in the last 30 days

27.0% 21.3%

82.6% 53.9%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

35.6%

9.7%

Percent with angina or coronary heart disease

2.8%

4.4%

10.2% 6.4%

19.6% 189.0

Percent currently smoking

29.2%

6.5%

Percent with diabetes

13.0%

35.6%

Percent with asthma 31.1%

Percent consuming 2+ fruits per day

35.9% 30.4%

Any days when mental health was not good during the past 30 days

18.9%

Percent meeting both CDC aerobic and strength activity guidelines

Percent consuming 3+ vegetables per day

61.0%

28.3%

Percent meeting CDC aerobic activity guidelines

19.6%

167.1

Death rate/100,000 for diabetes

13.1%

199.2

Death rate/100,000 for cardiovascular disease

167.1 18.7 17.0

Community/Environmental Indicators – Score = 58.3 Rank = 15 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000

Percent bicycling or walking to work

Recreational Facilities

12.9%

Dog parks/100,000

7.2 18.6

1.9 0.3 0.9 1.6

Park playgrounds/10,000

19.3 Golf courses/100,000

13.1 9.4%

2.3 0.4 0.9 2.0

Park units/10,000

4.1

4.3% Recreational centers/20,000

4.5% 2.8%

WalkScore®

2.1 1.0 4.8

Swimming pools/100,000 77.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

2.7

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Philadelphia Target Goal**

3.1 1.9 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$46.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

79

PHOENIX, AZ

(Phoenix-Mesa-Glendale, AZ MSA)

Ranking: Total Score = 44.0; Rank = 36 Areas of Excellence (at or better than target goal): • Higher percent eating 3+ vegetables per day • Lower death rate for cardiovascular disease • Higher percent of city land area as parkland • More acres of parkland per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good in the past 30 days • Higher percent of days when mental health was not good in the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer farmers’ markets per capita • Lower percent using public transportation to work • Lower Walk Score® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower level of state requirement for Physical Education classes Description of Phoenix-Mesa-Glendale, AZ MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

4,329,534 25.6% 61.1% 13.2% 49.7% 86.3% 80.4% 5.3% 3.5% 10.8% 29.9% 8.9% $51,359 12.7% 406.8 10.1%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas.

80

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 56.1 Rank = 20

Phoenix Target Goal*

Health Behaviors

Chronic Health Problems 76.8%

Percent any physical activity or exercise in the last 30 days

Percent obese

26.0% 21.3%

82.6% 51.4%

Percent in excellent or very good health

61.0%

25.9%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

22.8%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

29.2% 9.0% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

19.6%

Percent consuming 3+ vegetables per day

37.4%

Percent with asthma 31.0%

Percent consuming 2+ fruits per day

37.6% 30.4%

4.0%

10.4% 6.4%

19.6% 189.0 167.1

16.6%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

156.8

Death rate/100,000 for cardiovascular disease

167.1 19.2 17.0

Community/Environmental Indicators – Score = 32.0 Rank = 49 (note: most of these data were available only for the main city in the MSA) Built Environment

Ball diamonds/10,000

Dog parks/100,000

29.5 18.6

Golf courses/100,000

13.1 2.1% 4.3% 2.2% 2.8%

0.9 1.0 2.3 0.6 0.9 1.4 4.1 0.5 1.0 1.8

Swimming pools/100,000 38.0

WalkScore®

0.3

Park units/10,000 Recreational centers/20,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9

Park playgrounds/10,000

7.9

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

0.7

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

15.5%

Parkland as a percent of city land area

Phoenix Target Goal**

Tennis courts/10,000

3.1 0.8 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$100.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

81

PITTSBURGH, PA (Pittsburgh, PA MSA)

Ranking: Total Score = 54.8; Rank = 17 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days where physical health was not good in the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Fewer acres of parkland per capita • Fewer golf courses per capita Description of Pittsburgh, PA MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

82

2,360,733 19.6% 62.7% 17.7% 48.5% 92.2% 87.5% 8.3% 1.9% 2.3% 1.4% 7.2% $50,489 8.6% N/A‡ 13.8%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas ‡This measure was not available.

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 36.2 Rank = 40

Pittsburgh Target Goal*

Health Behaviors

Chronic Health Problems 75.4%

Percent any physical activity or exercise in the last 30 days

Percent obese

82.6%

27.1% 21.3% 52.2%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

17.7%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Percent with asthma 30.2%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

11.8%

36.6% 30.4% 34.5% 29.2% 9.2% 6.5% 5.5% 2.8% 11.0% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

28.5%

Percent meeting CDC aerobic activity guidelines

22.2%

167.1

Death rate/100,000 for diabetes

13.1%

200.8

Death rate/100,000 for cardiovascular disease

167.1 20.9 17.0

Community/Environmental Indicators – Score = 73.0 Rank = 4 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000

Percent bicycling or walking to work

Recreational Facilities

8.8%

Dog parks/100,000

10.1 18.6

1.9 1.3 0.9 4.2

Park playgrounds/10,000

19.9 Golf courses/100,000

13.1 5.5%

2.3 0.3 0.9 5.5

Park units/10,000

4.3% Recreational centers/20,000

3.7% 2.8%

WalkScore®

4.1 1.6 1.0 6.1

Swimming pools/100,000

3.1

60.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

4.1

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Pittsburgh Target Goal**

Tennis courts/10,000

2.8 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$106.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

83

PORTLAND, OR

(Portland-Vancouver-Hillsboro, OR-WA MSA)

Ranking: Total Score = 72.1; Rank = 3 Areas of Excellence (at or better than target goal): • Higher percent of any physical activity or exercise in the last 30 days • Higher percent eating 3+ vegetables per day • Lower death rate for cardiovascular disease • Higher percent of city land area as parkland • More acres of parkland per capita • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More golf courses per capita • More park units per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for diabetes • Fewer recreation centers per capita • Fewer swimming pools per capita Description of Portland-Vancouver-Hillsboro, OR-WA MSA Population 2,289,800 Percent less than 18 years old 23.1% Percent 18 to 64 years old 64.6% Percent 65 years old and older 12.3% Percent male 49.5% Percent high school graduate or higher 91.4% Percent White 82.1% Percent Black or African American 2.8% Percent Asian 5.9% Percent Other Race 9.2% Percent Hispanic/Latino 11.2% Percent unemployed 9.6% Median household income $56,978 Percent of households below poverty level 9.9% Violent crime rate/100,000* 266.5 Percent with disability 11.8%

84

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 69.5 Rank = 11

Portland Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

84.7%

Percent any physical activity or exercise in the last 30 days

26.0% 21.3%

82.6% 55.1%

Percent in excellent or very good health

32.2%

22.9%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

37.5%

39.2%

23.3% Percent with asthma 35.3%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

20.3%

Percent consuming 3+ vegetables per day

9.5% 6.5% 3.7% 2.8% 9.2% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

30.5%

Percent meeting CDC aerobic activity guidelines

167.1

15.9%

Death rate/100,000 for diabetes

13.1%

149.9

Death rate/100,000 for cardiovascular disease

167.1 22.0 17.0

Community/Environmental Indicators – Score = 74.6 Rank = 2 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

16.2%

Dog parks/100,000

18.6

1.9 5.7 0.9 2.2

Park playgrounds/10,000

2.3

29.3 Golf courses/100,000

13.1 6.0%

1.2 0.9 5.5

Park units/10,000

4.3% Recreational centers/20,000

6.1% 2.8%

WalkScore®

Swimming pools/100,000 63.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

3.4

Ball diamonds/10,000

24.6

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Portland Target Goal**

4.1 0.6 1.0 2.3 3.1 2.2 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$151.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

85

PROVIDENCE, RI

(Providence-New Bedford-Fall River, RI-MA MSA)

Ranking: Total Score = 51.6; Rank = 23 Areas of Excellence (at or better than target goal): • Lower death rate for diabetes • More farmers’ markets per capita • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More park units per capita • More recreation centers per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Fewer acres of parkland per capita • Lower percent using public transportation to work • Fewer golf courses per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Providence-New Bedford-Fall River, RI-MA MSA Population 1,601,374 Percent less than 18 years old 21.0% Percent 18 to 64 years old 63.9% Percent 65 years old and older 15.1% Percent male 48.3% Percent high school graduate or higher 85.0% Percent White 84.1% Percent Black or African American 5.5% Percent Asian 2.8% Percent Other Race 7.6% Percent Hispanic/Latino 10.9% Percent unemployed 9.8% Median household income $54,243 Percent of households below poverty level 9.5% Violent crime rate/100,000* 339.7 Percent with disability 13.0% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

86

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 45.9 Rank = 29

Providence Target Goal*

Health Behaviors

Chronic Health Problems 76.4%

Percent any physical activity or exercise in the last 30 days

Percent obese

26.2% 21.3%

82.6% 53.1%

Percent in excellent or very good health

61.0%

26.1%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

19.1%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

29.2% 11.3% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

14.1%

Percent consuming 3+ vegetables per day

35.7%

Percent with asthma 33.8%

Percent consuming 2+ fruits per day

37.5% 30.4%

4.7%

10.7% 6.4%

19.6% 189.0 18.5%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

181.2

Death rate/100,000 for cardiovascular disease

167.1 13.9 17.0

Community/Environmental Indicators – Score = 57.1 Rank = 16 (note: most of these data were available only for the main city in the MSA) Built Environment

Acres of parkland/1,000

Recreational Facilities

9.7%

Parkland as a percent of city land area

2.2 1.9

Ball diamonds/10,000

10.6% Dog parks/100,000

6.4 18.6

Golf courses/100,000

13.1

Percent using public transportation to work

2.9%

Percent bicycling or walking to work

3.5%

3.4 2.3 0.6 0.9 6.4

Park units/10,000

4.3% Recreational centers/20,000

2.8%

4.1 1.0 1.0 2.2

Swimming pools/100,000 76.0

WalkScore®

1.1 0.9

Park playgrounds/10,000 48.7

Farmers’ markets/ 1,000,000

Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Providence Target Goal**

3.1 0.9 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$71.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

87

RALEIGH, NC (Raleigh-Cary, NC MSA)

Ranking: Total Score = 61.5; Rank = 13 Areas of Excellence (at or better than target goal): • Lower death rate for cardiovascular disease • Lower death rate for diabetes • Higher percent of city land area as parkland • More acres of parkland per capita • More farmers’ markets per capita • More park units per capita • More recreation centers per capita • More tennis courts per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC aerobic and strength activity guidelines • Lower percent eating 2+ fruits per day • Lower percent eating 3+ vegetables per day • Higher percent with diabetes • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer dog parks per capita • Fewer golf courses per capita Description of Raleigh-Cary, NC MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

1,188,564 25.7% 64.5% 9.8% 48.7% 89.9% 70.0% 20.4% 4.6% 5.0% 10.3% 7.5% $60,319 9.3% 247.0 8.5%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

88

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 67.2 Rank = 13

Raleigh Target Goal*

Health Behaviors

Chronic Health Problems 80.8%

Percent any physical activity or exercise in the last 30 days

24.1%

Percent obese

21.3%

82.6%

59.7%

Percent in excellent or very good health

61.0%

25.8%

Percent meeting CDC aerobic activity guidelines

Any days when physical health was not good during the past 30 days

32.2%

23.3%

Percent with asthma 26.9%

Percent consuming 2+ fruits per day

35.6%

14.1%

Percent consuming 3+ vegetables per day

30.4%

Any days when mental health was not good during the past 30 days

18.5%

Percent meeting both CDC aerobic and strength activity guidelines

34.1%

29.7% 29.2% 7.1% 6.5% 3.0%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

6.4%

8.0%

19.6% 189.0 167.1

15.6%

Percent currently smoking

162.3

Death rate/100,000 for cardiovascular disease

167.1 16.4

Death rate/100,000 for diabetes

13.1%

17.0

Community/Environmental Indicators – Score = 55.9 Rank = 19 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

17.1%

Parkland as a percent of city land area

Raleigh Target Goal**

1.9

10.6%

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

1.0%

Percent bicycling or walking to work

1.5%

0.9 2.2

Park playgrounds/10,000

14.3

Farmers’ markets/ 1,000,000

0.7

Dog parks/100,000

31.0

Acres of parkland/1,000

2.3 0.0 0.9 5.1

Park units/10,000

4.1

4.3% Recreational centers/20,000 2.8%

WalkScore®

Swimming pools/100,000

1.7 1.0 2.5 3.1

29.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

1.5

Ball diamonds/10,000

Tennis courts/10,000

2.8 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$142.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

89

RICHMOND, VA (Richmond, VA MSA)

Ranking: Total Score = 52.3; Rank = 21 Areas of Excellence (at or better than target goal): • Lower percent of days when mental health was not good during the past 30 days • Lower death rate of diabetes • More farmers’ markets per capita • More dog parks per capita • More park playgrounds per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Higher percent eating 2+ fruits per day • Higher percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Fewer golf courses per capita • Lower level of state requirement for Physical Education classes Description of Richmond, VA MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

1,231,980 22.8% 64.2% 13.0% 48.4% 87.3% 62.5% 30.1% 3.0% 4.4% 5.3% 8.4% $56,769 8.2% 243.4 11.7%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

90

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 48.7 Rank = 24

Richmond Target Goal*

Health Behaviors

Chronic Health Problems 78.1%

Percent any physical activity or exercise in the last 30 days

28.4%

Percent obese

21.3%

82.6% 52.7%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

35.6%

9.0%

Percent with angina or coronary heart disease

2.8%

3.7%

10.6% 6.4%

19.6% 189.0

Percent currently smoking

29.2%

6.5%

Percent with diabetes

10.4%

28.9%

Percent with asthma 28.2%

Percent consuming 2+ fruits per day

33.0% 30.4%

Any days when mental health was not good during the past 30 days

20.5%

Percent meeting both CDC aerobic and strength activity guidelines

Percent consuming 3+ vegetables per day

61.0%

25.6%

Percent meeting CDC aerobic activity guidelines

167.1

19.0%

Death rate/100,000 for diabetes

13.1%

188.0

Death rate/100,000 for cardiovascular disease

167.1 10.7 17.0

Community/Environmental Indicators – Score = 55.8 Rank = 20 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

1.5

Dog parks/100,000

13.7 18.6

0.9 2.8

Park playgrounds/10,000 34.1 Golf courses/100,000

13.1 1.6%

2.3 0.0 0.9 3.3

Park units/10,000

4.3% Recreational centers/20,000

2.0% 2.8%

4.1 1.3 1.0 4.9

Swimming pools/100,000

3.1

49.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.6 1.9

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

7.3%

Acres of parkland/1,000

Percent using public transportation to work

Richmond Target Goal**

Tennis courts/10,000

6.6 2.0

Park-related Expenditures 1.0 2.5

Total park expenditure per resident

$85.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

91

RIVERSIDE, CA

(Riverside-San Bernardino-Ontario, CA MSA)

Ranking: Total Score = 47.5; Rank = 28 Areas of Excellence (at or better than target goal): • Higher percent meeting CDC aerobic activity guidelines • More dog parks per capita • More recreation centers per capita • More swimming pools per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Higher death rate for diabetes • Fewer farmers’ markets per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score® • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer tennis courts per capita Description of Riverside-San Bernardino-Ontario, CA MSA Population 4,350,096 Percent less than 18 years old 27.8% Percent 18 to 64 years old 61.2% Percent 65 years old and older 11.0% Percent male 49.8% Percent high school graduate or higher 78.6% Percent White 64.2% Percent Black or African American 7.5% Percent Asian 6.2% Percent Other Race 22.1% Percent Hispanic/Latino 48.4% Percent unemployed 14.2% Median household income $51,695 Percent of households below poverty level 15.3% Violent crime rate/100,000* 368.7 Percent with disability 10.8% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

92

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 49.1 Rank = 23

Riverside Target Goal*

Health Behaviors

Chronic Health Problems 73.6%

Percent any physical activity or exercise in the last 30 days

Percent obese

30.0% 21.3%

82.6% 50.9%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

21.8%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

38.8% 29.2% 8.4% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

18.0%

Percent consuming 3+ vegetables per day

37.6% 30.4%

Percent with asthma 35.0%

Percent consuming 2+ fruits per day

4.6%

10.8% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

32.3%

Percent meeting CDC aerobic activity guidelines

167.1

15.6%

Death rate/100,000 for diabetes

13.1%

217.5

Death rate/100,000 for cardiovascular disease

167.1 27.3 17.0

Community/Environmental Indicators – Score = 45.9 Rank = 33 (note: most of these data were available only for the main city in the MSA) Built Environment

18.6

Golf courses/100,000

13.1 1.5%

1.4 2.3 0.3 0.9 2.1

Park units/10,000

4.3% Recreational centers/20,000

2.0% 2.8%

4.1 1.1 1.0 3.4

Swimming pools/100,000 39.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

0.9

Park playgrounds/10,000

10.3

WalkScore®

1.3

Dog parks/100,000

15.7

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

1.7 1.9

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

9.3%

Parkland as a percent of city land area

Riverside Target Goal**

Tennis courts/10,000

3.1 0.8 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$125.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

93

SACRAMENTO, CA

(Sacramento-Arden-Arcade-Roseville, CA MSA)

Ranking: Total Score = 66.9; Rank = 10 Areas of Excellence (at or better than target goal): • Higher percent meeting CDC aerobic activity guidelines • Higher percent meeting both CDC aerobic and strength activity guidelines • Higher percent eating 2+ fruits per day • More farmers’ markets per capita • Higher percent bicycling or walking to work • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Fewer tennis courts per capita Description of Sacramento-Arden-Arcade-Roseville, CA MSA Population 2,196,482 Percent less than 18 years old 24.1% Percent 18 to 64 years old 62.9% Percent 65 years old and older 13.0% Percent male 49.1% Percent high school graduate or higher 88.0% Percent White 66.4% Percent Black or African American 7.1% Percent Asian 12.6% Percent Other Race 13.9% Percent Hispanic/Latino 20.6% Percent unemployed 13.1% Median household income $56,813 Percent of households below poverty level 12.2% Violent crime rate/100,000* 441.1 Percent with disability 12.0% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

94

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 69.9 Rank = 10

Sacramento Target Goal*

Health Behaviors

Chronic Health Problems 80.3%

Percent any physical activity or exercise in the last 30 days

Percent obese

82.6%

25.8% 21.3% 58.5%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

Any days when mental health was not good during the past 30 days

23.6%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

35.6%

37.2% 29.2% 9.6% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

18.1%

Percent consuming 3+ vegetables per day

40.9% 30.4%

Percent with asthma 35.9%

Percent consuming 2+ fruits per day

3.9%

10.1% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

33.0%

Percent meeting CDC aerobic activity guidelines

167.1

15.1%

Death rate/100,000 for diabetes

13.1%

177.2

Death rate/100,000 for cardiovascular disease

167.1 17.3 17.0

Community/Environmental Indicators – Score = 63.9 Rank = 9 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Dog parks/100,000

10.9 18.6

1.7 0.9 4.0

Park playgrounds/10,000 26.4 Golf courses/100,000

13.1 2.3%

2.3 1.3 0.9 4.8

Park units/10,000

4.3% Recreational centers/20,000

4.1% 2.8%

WalkScore®

4.1 1.0 1.0 2.6

Swimming pools/100,000 43.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

2.1 1.9

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

8.2%

Acres of parkland/1,000

Percent using public transportation to work

Sacramento Target Goal**

Tennis courts/10,000

3.1 1.0 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$133.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

95

SAINT LOUIS, MO (Saint Louis, MO-IL MSA)

Ranking: Total Score = 41.3; Rank = 41 Areas of Excellence (at or better than target goal): • More farmers’ markets per capita • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More golf courses per capita • More swimming pools per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC activity and strength guidelines • Lower percent eating 2+ fruits per day • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for cardiovascular disease • Fewer acres of parkland per capita • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Fewer recreation centers per capita • Lower park-related expenditures per capita • Lower level of state requirement for Physical Education classes Description of Saint Louis, MO-IL MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

2,795,794 23.2% 62.7% 14.1% 48.4% 89.8% 76.5% 18.1% 2.2% 3.2% 2.7% 9.0% $52,243 10.6% 463.6 12.5%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

96

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 34.4 Rank = 43

Saint Louis Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

74.8%

Percent any physical activity or exercise in the last 30 days

31.8% 21.3%

82.6% 53.6%

Percent in excellent or very good health

61.0%

27.8%

Percent meeting CDC aerobic activity guidelines

32.2%

15.8%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.5%

32.5%

23.3% 6.5%

Percent with angina or coronary heart disease

2.8%

27.0%

Percent consuming 2+ fruits per day

35.6%

Percent with diabetes

14.8%

Percent consuming 3+ vegetables per day

10.2%

Percent with asthma

5.9%

11.6% 6.4%

19.6% 189.0 20.0%

Percent currently smoking

167.1

Death rate/100,000 for diabetes

13.1%

216.2

Death rate/100,000 for cardiovascular disease

167.1 18.5 17.0

Community/Environmental Indicators – Score = 48.1 Rank = 30 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

9.2%

Acres of parkland/1,000

10.3

Percent bicycling or walking to work

Recreational Facilities 1.9 1.4

Dog parks/100,000 18.6

0.9 2.0 2.3

Park playgrounds/10,000

19.7

1.1

Golf courses/100,000

13.1 2.3%

0.9 4.0

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.0% 2.8%

0.4 1.0 3.1

Swimming pools/100,000

3.1

60.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

3.2

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Saint Louis Target Goal**

Tennis courts/10,000

3.1 2.0

Park-related Expenditures

0.0 2.5

Total park expenditure per resident

$55.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

97

SALT LAKE CITY, UT (Salt Lake City, UT MSA)

Ranking: Total Score = 65.7; Rank = 11 Areas of Excellence (at or better than target goal): • Higher percent of any physical activity or exercise in the last 30 days • Lower percent currently smoking • Lower percent with angina or coronary heart disease • Lower death rate for cardiovascular disease • Higher percent bicycling or walking to work • Higher Walk Score® • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More tennis courts per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher death rate for diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Lower park-related expenditures per capita Description of Salt Lake City, UT MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

1,123,712 29.1% 61.9% 9.0% 50.3% 89.2% 84.2% 1.7% 3.4% 10.7% 17.0% 7.4% $60,061 9.5% 327.5 8.9%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

98

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 74.4 Rank = 8

Salt Lake City Target Goal*

Health Behaviors

Chronic Health Problems 82.8%

Percent any physical activity or exercise in the last 30 days

Percent obese

82.6%

23.9% 21.3% 55.0%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

Percent with asthma 32.5%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

16.5%

37.3% 29.2% 9.4% 6.5% 2.4% 2.8% 7.0% 6.4%

19.6% 189.0

Percent currently smoking

35.1% 30.4%

Any days when mental health was not good during the past 30 days

20.4%

Percent meeting both CDC aerobic and strength activity guidelines

Percent consuming 3+ vegetables per day

61.0%

31.0%

Percent meeting CDC aerobic activity guidelines

167.1

12.3%

Death rate/100,000 for diabetes

13.1%

158.8

Death rate/100,000 for cardiovascular disease

167.1 20.7 17.0

Community/Environmental Indicators – Score = 57.1 Rank = 17 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Dog parks/100,000

10.8 18.6

3.7 0.9 3.1

Park playgrounds/10,000

2.3

10.7 Golf courses/100,000

13.1 3.9%

5.3 0.9 6.6

Park units/10,000

4.3% Recreational centers/20,000

2.9% 2.8%

WalkScore®

Swimming pools/100,000

4.1 0.5 1.0 1.1 3.1

55.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9 1.9

Ball diamonds/10,000 10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

2.9%

Acres of parkland/1,000

Percent using public transportation to work

Salt Lake City Target Goal**

Tennis courts/10,000

3.7 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$50.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

99

SAN ANTONIO, TX

(San Antonio-New Braunfels, TX MSA)

Ranking: Total Score = 35.6; Rank = 45 Areas of Excellence (at or better than target goal): • Lower percent with asthma Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting both CDC activity and strength guidelines • Lower percent eating 2+ fruits per day • Lower percent eating 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Lower percent in excellent or very good health • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for diabetes • Lower percent using public transportation to work • Lower percent bicycling or walking to work • Lower Walk Score ® • Fewer ball diamonds per capita • Fewer dog parks per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Fewer tennis courts per capita • Lower park-related expenditures per capita Description of San Antonio- New Braunfels, TX MSA Population 2,234,003 Percent less than 18 years old 26.1% Percent 18 to 64 years old 62.3% Percent 65 years old and older 11.6% Percent male 49.3% Percent high school graduate or higher 83.7% Percent White 77.4% Percent Black or African American 6.5% Percent Asian 2.2% Percent Other Race 13.9% Percent Hispanic/Latino 54.4% Percent unemployed 8.0% Median household income $51,486 Percent of households below poverty level 13.7% Violent crime rate/100,000* 390.7 Percent with disability 12.9% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

100

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 39.2 Rank = 36

San Antonio

Health Behaviors

Chronic Health Problems 73.9%

Percent any physical activity or exercise in the last 30 days

Percent obese

28.9% 21.3%

82.6% 45.9%

Percent in excellent or very good health

61.0%

26.1%

Percent meeting CDC aerobic activity guidelines

32.2%

17.3%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

34.5%

6.4% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

14.5%

Percent consuming 3+ vegetables per day

35.3%

Percent with asthma 27.7%

Percent consuming 2+ fruits per day

3.9%

11.3% 6.4%

19.6% 189.0

Percent currently smoking

Target Goal*

17.9%

167.1

Death rate/100,000 for diabetes

13.1%

184.6

Death rate/100,000 for cardiovascular disease

167.1 20.9 17.0

Community/Environmental Indicators – Score = 32.1 Rank = 48 (note: most of these data were available only for the main city in the MSA) Built Environment

Percent bicycling or walking to work

Dog parks/100,000

17.0 18.6

Golf courses/100,000

13.1 2.3%

0.3 0.9 1.3 2.3 0.5 0.9 1.8

Park units/10,000

4.3% Recreational centers/20,000

1.8% 2.8%

WalkScore®

4.1 0.6 1.0 1.9

Swimming pools/100,000 34.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9

Park playgrounds/10,000

10.7

Farmers’ markets/ 1,000,000 Percent using public transportation to work

1.0

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Target Goal**

Recreational Facilities

9.0%

Parkland as a percent of city land area

San Antonio

Tennis courts/10,000

3.1 1.0 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$52.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

101

SAN DIEGO, CA

(San Diego-Carlsbad-San Marcos, CA MSA)

Ranking: Total Score = 69.2 Rank = 8 Areas of Excellence (at or better than target goal): • Higher percent meeting CDC aerobic activity guidelines • Higher percent meeting both CDC aerobic and strength activity guidelines • Higher percent consuming 2+ fruits per day • Higher percent consuming 3+ vegetables per day • Lower percent currently smoking • Lower death rate for cardiovascular disease • Higher percent of city land area as parkland • More acres of parkland per capita • More farmers’ markets per capita • Higher percent bicycling or walking to work • More ball diamonds per capita • More dog parks per capita • More recreation centers per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent of days when mental health was not good during the past 30 days • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent using public transportation to work • Fewer golf courses per capita • Fewer swimming pools per capita • Fewer tennis courts per capita Description of San Diego-Carlsbad-San Marcos, CA MSA Population 3,177,063 Percent less than 18 years old 22.9% Percent 18 to 64 years old 65.2% Percent 65 years old and older 12.0% Percent male 50.3% Percent high school graduate or higher 86.1% Percent White 70.4% Percent Black or African American 5.1% Percent Asian 11.5% Percent Other Race 13.0% Percent Hispanic/Latino 32.7% Percent unemployed 9.6% Median household income $60,330 Percent of households below poverty level 11.5% Violent crime rate/100,000* 373.6 Percent with disability 9.6% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

102

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 79.5 Rank = 4

San Diego

Health Behaviors

Chronic Health Problems Percent obese

77.7%

Percent any physical activity or exercise in the last 30 days

22.7% 21.3%

82.6% 55.6%

Percent in excellent or very good health

61.0%

33.1%

Percent meeting CDC aerobic activity guidelines

32.2%

24.4%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

37.3%

7.0% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

20.0%

Percent consuming 3+ vegetables per day

32.1%

Percent with asthma 36.9%

Percent consuming 2+ fruits per day

3.7%

9.6% 6.4%

19.6% 189.0

Percent currently smoking

Target Goal*

167.1

9.5%

Death rate/100,000 for diabetes

13.1%

162.3

Death rate/100,000 for cardiovascular disease

167.1 19.1 17.0

Community/Environmental Indicators – Score = 59.1 Rank = 14 (note: most of these data were available only for the main city in the MSA) Built Environment

Dog parks/100,000

35.9 18.6

Golf courses/100,000

13.1

Percent using public transportation to work

2.8%

Percent bicycling or walking to work

3.4%

1.8 2.3 0.6 0.9 3.4

Park units/10,000

4.3% Recreational centers/20,000 2.8%

WalkScore®

1.2 0.9

Park playgrounds/10,000

15.7

Farmers’ markets/ 1,000,000

Swimming pools/100,000 49.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

2.2 1.9

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Target Goal**

Recreational Facilities 22.6%

Parkland as a percent of city land area

San Diego

Tennis courts/10,000

4.1 1.0 1.0 1.0 3.1 1.4 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$106.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

103

SAN FRANCISCO, CA

(San Francisco-Oakland-Fremont, CA MSA)

Ranking: Total Score = 71.0; Rank = 5 Areas of Excellence (at or better than target goal): • Higher percent meeting CDC aerobic activity guidelines • Higher percent meeting both CDC aerobic and strength activity guidelines • Higher percent eating 2+ fruits per day • Lower percent currently smoking • Lower percent obese • Lower percent with angina or coronary heart disease • Lower death rate for cardiovascular disease • Lower death rate for diabetes • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More dog parks per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer ball diamonds per capita • Fewer park playgrounds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer recreation centers per capita • Fewer swimming pools per capita Description of San Francisco-Oakland-Fremont, CA MSA Population 4,455,560 Percent less than 18 years old 20.8% Percent 18 to 64 years old 65.9% Percent 65 years old and older 13.3% Percent male 49.3% Percent high school graduate or higher 87.9% Percent White 54.4% Percent Black or African American 7.9% Percent Asian 23.7% Percent Other Race 14.0% Percent Hispanic/Latino 21.9% Percent unemployed 8.8% Median household income $74,922 Percent of households below poverty level 8.2% Violent crime rate/100,000* 550.8 Percent with disability 9.3%

104

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 80.6 Rank = 2

San Francisco

Health Behaviors

Chronic Health Problems Percent obese

79.2%

Percent any physical activity or exercise in the last 30 days

20.6% 21.3%

82.6% 58.4%

Percent in excellent or very good health

61.0%

34.8%

Percent meeting CDC aerobic activity guidelines

32.2%

24.5%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

Percent with asthma 36.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

19.5%

Percent consuming 3+ vegetables per day

36.7%

36.3%

11.6% 6.5% 2.3% 2.8% 9.3% 6.4%

19.6% 189.0

Percent currently smoking

Target Goal*

167.1

10.3%

Death rate/100,000 for diabetes

13.1%

146.7

Death rate/100,000 for cardiovascular disease

167.1 15.6 17.0

Community/Environmental Indicators – Score = 61.5 Rank = 12 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000 Farmers’ markets/ 1,000,000 Percent using public transportation to work Percent bicycling or walking to work

Target Goal**

Recreational Facilities

18.0%

Ball diamonds/10,000

0.8 1.9

10.6% Dog parks/100,000

6.6 18.6

3.3 0.9 1.6

Park playgrounds/10,000

28.5 Golf courses/100,000

13.1 15.6%

2.3 0.7 0.9 2.8

Park units/10,000

4.3% Recreational centers/20,000

6.1% 2.8%

WalkScore®

Swimming pools/100,000 84.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

San Francisco

4.1 0.6 1.0 1.1 3.1 1.9 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$263.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

105

SAN JOSE, CA

(San Jose-Sunnyvale-Santa Clara, CA MSA)

Ranking: Total Score = 69.4; Rank = 6 Areas of Excellence (at or better than target goal): • Higher percent meeting CDC aerobic activity guidelines • Higher percent consuming 3+ vegetables per day • Lower percent currently smoking • Lower percent obese • Higher percent in excellent or very good health • Lower percent of days when physical health was not good during the past 30 days • Lower death rate for cardiovascular disease • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent bicycling or walking to work • More dog parks per capita • More park playgrounds per capita • More recreation centers per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher death rate for diabetes • Fewer ball diamonds per capita • Fewer golf courses per capita • Fewer park units per capita • Fewer swimming pools per capita • Fewer tennis courts per capita Description of San Jose-Sunnyvale-Santa Clara, CA MSA Population 1,894,388 Percent less than 18 years old 23.8% Percent 18 to 64 years old 64.7% Percent 65 years old and older 11.6% Percent male 50.3% Percent high school graduate or higher 85.9% Percent White 51.3% Percent Black or African American 2.6% Percent Asian 32.2% Percent Other Race 13.9% Percent Hispanic/Latino 27.8% Percent unemployed 8.8% Median household income $90,737 Percent of households below poverty level 7.6% Violent crime rate/100,000* 274.0 Percent with disability 7.8% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

106

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 85.4 Rank = 1

San Jose Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

79.2%

Percent any physical activity or exercise in the last 30 days

16.4% 21.3%

82.6% 61.2%

Percent in excellent or very good health Any days when physical health was not good during the past 30 days

32.2%

23.3%

Percent with asthma 35.3%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

21.7%

Percent consuming 3+ vegetables per day

29.2% 30.4%

Any days when mental health was not good during the past 30 days

20.4%

Percent meeting both CDC aerobic and strength activity guidelines

35.1% 29.2% 9.2% 6.5% 2.9% 2.8% 7.2% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

36.2%

Percent meeting CDC aerobic activity guidelines

167.1

8.9%

Death rate/100,000 for diabetes

13.1%

138.1

Death rate/100,000 for cardiovascular disease

167.1 20.9 17.0

Community/Environmental Indicators – Score = 53.7 Rank = 24 (note: most of these data were available only for the main city in the MSA) Built Environment

Recreational Facilities

14.3%

Parkland as a percent of city land area

Ball diamonds/10,000

0.5 1.9

10.6%

18.6

Golf courses/100,000

13.1

Percent using public transportation to work

3.4%

Percent bicycling or walking to work

3.5%

0.9 2.7 2.3

Park playgrounds/10,000

20.6

Farmers’ markets/ 1,000,000

0.9

Dog parks/100,000

16.5

Acres of parkland/1,000

0.3 0.9 2.7

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.8%

WalkScore®

Swimming pools/100,000 48.0 51.1

Policy for School P.E. Level of state requirement for Physical Education

San Jose Target Goal**

Tennis courts/10,000

1.1 1.0 0.6 3.1 1.0 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$118.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

107

SEATTLE, WA

(Seattle-Tacoma-Bellevue, WA MSA)

Ranking: Total Score = 69.3; Rank = 7 Areas of Excellence (at or better than target goal): • Higher percent of any physical activity or exercise in the last 30 days • Lower death rate for cardiovascular disease • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More dog parks per capita • More park units per capita • More tennis courts per capita • Higher park-related expenditures per capita • Higher level of state requirement for Physical Education classes Improvement Priority Areas (worse than 20% of target goal): • Higher percent currently smoking • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer swimming pools per capita Description of Seattle-Tacoma-Bellevue, WA MSA Population Percent less than 18 years old Percent 18 to 64 years old Percent 65 years old and older Percent male Percent high school graduate or higher Percent White Percent Black or African American Percent Asian Percent Other Race Percent Hispanic/Latino Percent unemployed Median household income Percent of households below poverty level Violent crime rate/100,000* Percent with disability

3,552,157 22.3% 66.1% 11.6% 49.8% 91.8% 72.5% 5.6% 11.6% 10.3% 9.3% 7.6% $65,677 7.8% 336.8 10.4%

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

108

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 68.9 Rank = 12

Seattle Target Goal*

Health Behaviors

Chronic Health Problems 84.2%

Percent any physical activity or exercise in the last 30 days

Percent obese

24.6% 21.3%

82.6% 54.9%

Percent in excellent or very good health

32.2%

19.3%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

Percent with asthma 32.6%

Percent consuming 2+ fruits per day

Percent with angina or coronary heart disease

35.6%

Percent with diabetes

17.1%

Percent consuming 3+ vegetables per day

37.6%

39.9%

8.9% 6.5% 3.2% 2.8% 8.0% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

31.7%

Percent meeting CDC aerobic activity guidelines

16.1%

162.0

Death rate/100,000 for cardiovascular disease

167.1

Death rate/100,000 for diabetes

13.1%

167.1 19.5 17.0

Community/Environmental Indicators – Score = 69.8 Rank = 6 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000

Percent bicycling or walking to work

Recreational Facilities

10.3%

Dog parks/100,000

9.0 18.6

1.8 0.9 2.1 2.3

Park playgrounds/10,000

17.7 Golf courses/100,000

13.1 8.5%

0.8 0.9 7.0

Park units/10,000

4.3% Recreational centers/20,000

4.8% 2.8%

WalkScore®

Swimming pools/100,000

4.1 0.8 1.0 1.6 3.1

71.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.8 1.9

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000 Percent using public transportation to work

Seattle Target Goal**

2.7 2.0

Park-related Expenditures 3.0 2.5

Total park expenditure per resident

$255.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

109

TAMPA, FL

(Tampa-St. Petersburg-Clearwater, FL MSA)

Ranking: Total Score = 46.0; Rank = 31 Areas of Excellence (at or better than target goal): • More ball diamonds per capita • More dog parks per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent of days when physical health was not good during the past 30 days • Higher percent of days when mental health was not good during the past 30 days • Higher percent with asthma • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Higher death rate for diabetes • Lower percent of city land area as parkland • Fewer acres of parkland per capita • Lower percent using public transportation to work • Fewer tennis courts per capita • Lower level of state requirement for Physical Education classes Description of Tampa-St. Petersburg-Clearwater, FL MSA Population 2,842,878 Percent less than 18 years old 20.7% Percent 18 to 64 years old 61.3% Percent 65 years old and older 18.0% Percent male 48.5% Percent high school graduate or higher 88.3% Percent White 79.7% Percent Black or African American 11.9% Percent Asian 3.0% Percent Other Race 5.4% Percent Hispanic/Latino 17.0% Percent unemployed 10.9% Median household income $44,402 Percent of households below poverty level 12.0% Violent crime rate/100,000* 409.3 Percent with disability 14.2% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

110

ACSM American Fitness Index™ Components Personal Health Indicators – Score = 36.9 Rank = 39

Tampa Target Goal*

Health Behaviors

Chronic Health Problems Percent obese

74.7%

Percent any physical activity or exercise in the last 30 days

26.8% 21.3%

82.6% 49.6%

Percent in excellent or very good health

61.0%

27.6%

Percent meeting CDC aerobic activity guidelines

32.2%

18.9%

Percent meeting both CDC aerobic and strength activity guidelines

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

39.0%

35.9%

23.3% 6.5%

Percent with angina or coronary heart disease

2.8%

31.5%

Percent consuming 2+ fruits per day

35.6%

Percent with diabetes

13.8%

Percent consuming 3+ vegetables per day

8.9%

Percent with asthma

6.4%

12.6% 6.4%

19.6% 189.0 167.1

20.1%

Percent currently smoking

Death rate/100,000 for diabetes

13.1%

181.5

Death rate/100,000 for cardiovascular disease

167.1 24.6 17.0

Community/Environmental Indicators – Score = 54.9 Rank = 21.5 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area

Dog parks/100,000

10.0 18.6

1.9 2.6 0.9 2.4 2.3

Park playgrounds/10,000

11.3 Golf courses/100,000

13.1 1.2%

0.9 0.9 5.4

Park units/10,000

4.1

4.3% Recreational centers/20,000

2.5% 2.8%

1.5 1.0 3.8

Swimming pools/100,000 46.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

3.1

Ball diamonds/10,000

10.6%

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

Recreational Facilities

4.8%

Acres of parkland/1,000

Percent using public transportation to work

Tampa Target Goal**

Tennis courts/10,000

3.1 1.4 2.0

Park-related Expenditures

1.0 2.5

Total park expenditure per resident

$101.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

111

VIRGINIA BEACH, VA

(Virginia Beach-Norfolk-Newport News, VA-NC MSA)

Ranking: Total Score = 52.0; Rank = 22 Areas of Excellence (at or better than target goal): • Lower death rate for diabetes • Higher percent of city land area as parkland • More acres of parkland per capita • More farmers’ markets per capita • Higher percent bicycling or walking to work • More ball diamonds per capita • More park playgrounds per capita • More golf courses per capita • More park units per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Lower percent meeting CDC aerobic activity guidelines • Lower percent consuming 3+ vegetables per day • Higher percent currently smoking • Higher percent obese • Higher percent with angina or coronary heart disease • Higher percent with diabetes • Lower percent using public transportation to work • Lower Walk Score® • Fewer dog parks per capita • Fewer recreation centers per capita • Fewer swimming pools per capita • Lower level of state requirement for Physical Education classes Description of Virginia Beach-Norfolk-Newport News, VA-NC MSA Population 1,699,925 Percent less than 18 years old 22.9% Percent 18 to 64 years old 64.9% Percent 65 years old and older 12.2% Percent male 49.1% Percent high school graduate or higher 89.9% Percent White 60.2% Percent Black or African American 30.9% Percent Asian 3.7% Percent Other Race 5.2% Percent Hispanic/Latino 5.8% Percent unemployed 8.9% Median household income $55,997 Percent of households below poverty level 10.4% Violent crime rate/100,000* 300.8 Percent with disability 10.6% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

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ACSM American Fitness Index™ Components Personal Health Indicators – Score = 42.1 Rank = 32

Virginia Beach Target Goal*

Health Behaviors

Chronic Health Problems 30.2%

Percent obese

78.8%

Percent any physical activity or exercise in the last 30 days

21.3%

82.6%

51.0%

Percent in excellent or very good health

32.2%

20.1%

Percent meeting both CDC aerobic and strength activity guidelines

30.4%

Any days when mental health was not good during the past 30 days

29.2%

34.5%

32.6%

7.8%

Percent with asthma

6.5%

Percent with angina or coronary heart disease

2.8%

28.5% 35.6%

Percent with diabetes

13.1%

4.4%

11.6% 6.4%

19.6% 189.0

Percent currently smoking

Any days when physical health was not good during the past 30 days

23.3%

Percent consuming 2+ fruits per day

Percent consuming 3+ vegetables per day

61.0%

25.4%

Percent meeting CDC aerobic activity guidelines

167.1

20.6%

Death rate/100,000 for diabetes

13.1%

196.4

Death rate/100,000 for cardiovascular disease

167.1 16.9 17.0

Community/Environmental Indicators – Score = 61.8 Rank = 11 (note: most of these data were available only for the main city in the MSA) Built Environment

58.4 18.6

Dog parks/100,000

0.5 0.9 5.0

Park playgrounds/10,000 Golf courses/100,000

13.1 1.9%

2.3 1.2 0.9 6.5

Park units/10,000

4.1

4.3% Recreational centers/20,000

3.1% 2.8%

Swimming pools/100,000

0.3 1.0 1.4 3.1

31.0

WalkScore®

51.1

Policy for School P.E. Level of state requirement for Physical Education

1.9

14.7

Farmers’ markets/ 1,000,000

Percent bicycling or walking to work

3.2

Ball diamonds/10,000

10.6%

Acres of parkland/1,000

Percent using public transportation to work

Recreational Facilities

15.9%

Parkland as a percent of city land area

Virginia Beach Target Goal**

Tennis courts/10,000

3.7 2.0

Park-related Expenditures 1.0 2.5

Total park expenditure per resident

$146.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

113

WASHINGTON, DC

(Washington-Arlington-Alexandria, DC-VA-MD-WV MSA)

Ranking: Total Score = 77.3; Rank = 1 Areas of Excellence (at or better than target goal): • Lower death rate for cardiovascular disease • Lower death rate for diabetes • Higher percent of city land area as parkland • More farmers’ markets per capita • Higher percent using public transportation to work • Higher percent bicycling or walking to work • Higher Walk Score® • More dog parks per capita • More park units per capita • More recreation centers per capita • More swimming pools per capita • More tennis courts per capita • Higher park-related expenditures per capita Improvement Priority Areas (worse than 20% of target goal): • Higher percent with asthma • Higher percent with diabetes • Fewer acres of parkland per capita • Fewer park playgrounds per capita • Fewer golf courses per capita Description of Washington-Arlington-Alexandria, DC-VA-MD-WV MSA Population 5,860,342 Percent less than 18 years old 23.4% Percent 18 to 64 years old 66.0% Percent 65 years old and older 10.6% Percent male 48.7% Percent high school graduate or higher 90.1% Percent White 55.6% Percent Black or African American 25.3% Percent Asian 9.5% Percent Other Race 9.6% Percent Hispanic/Latino 14.5% Percent unemployed 6.6% Median household income $88,233 Percent of households below poverty level 5.7% Violent crime rate/100,000* 332.7 Percent with disability 7.8% *Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

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ACSM American Fitness Index™ Components Personal Health Indicators – Score = 79.9 Rank = 3

Washington, DC Target Goal*

Health Behaviors

Chronic Health Problems 81.0%

Percent any physical activity or exercise in the last 30 days

Percent obese

24.1% 21.3%

82.6% 58.7%

Percent in excellent or very good health

32.2%

22.3%

Percent meeting both CDC aerobic and strength activity guidelines

23.3%

Any days when physical health was not good during the past 30 days

30.4%

Any days when mental health was not good during the past 30 days

29.2%

35.6%

30.4%

8.6% 6.5%

Percent with angina or coronary heart disease

2.8%

Percent with diabetes

16.3%

Percent consuming 3+ vegetables per day

32.8%

Percent with asthma 34.1%

Percent consuming 2+ fruits per day

3.2%

8.5% 6.4%

19.6% 189.0

Percent currently smoking

61.0%

27.9%

Percent meeting CDC aerobic activity guidelines

167.1

13.2%

Death rate/100,000 for diabetes

13.1%

164.9

Death rate/100,000 for cardiovascular disease

167.1 16.9 17.0

Community/Environmental Indicators – Score = 74.9 Rank = 1 (note: most of these data were available only for the main city in the MSA) Built Environment Parkland as a percent of city land area Acres of parkland/1,000 Farmers’ markets/ 1,000,000 Percent using public transportation to work Percent bicycling or walking to work

Recreational Facilities

19.5%

1.7 1.9

Ball diamonds/10,000

10.6% Dog parks/100,000

12.8 18.6

1.2 0.9 1.7

Park playgrounds/10,000 28.5 Golf courses/100,000

13.1 14.1%

2.3 0.5 0.9 5.3

Park units/10,000

4.1

4.3% Recreational centers/20,000

4.0% 2.8%

WalkScore®

2.2 1.0 6.0

Swimming pools/100,000

3.1

74.0 Tennis courts/10,000

51.1

Policy for School P.E. Level of state requirement for Physical Education

Washington, DC Target Goal**

3.5 2.0

Park-related Expenditures 2.0 2.5

Total park expenditure per resident

$398.00 $101.80

*The target goal for the Personal Health Indicators that did not change was the 90th percentile for MSAs during 2008-2012. For the new personal health indicators the target goals were 90% of the 2014 values. **The target goal for the Community/Environmental Indicators that did not change was the MSA average for 2008 to 2012. New community indicators target goals were an average of the 2014 values.

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Appendix A – Data Sources Variable

Data Source

Web Site

Population Estimate

2012 U.S. Census http://www.census.gov/popest/data/metro/ totals/2012/index.html

Age Groups U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Percent male U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Percent high school U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ graduate or higher Community Survey – 1 Year pages/index.xhtml Estimates Percent in each race groups U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Percent Hispanic/Latino U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Percent unemployed U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Median household income U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Percent of households U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ below poverty level Community Survey – 1 Year pages/index.xhtml Estimates Violent crime rate/100,000 2012 – FBI Uniform Crime Reporting Program

http://www.fbi.gov/about-us/cjis/ucr/crime-inthe-u.s/2012/crime-in-the-u.s.-2012/violentcrime/violent-crime

Percent with disability U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ Community Survey – 1 Year pages/index.xhtml Estimates Percent any physical 2012 CDC BRFSS activity or exercising in the last 30 days

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http://www.cdc.gov/brfss/annual_data/ annual_2012.html

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Appendix A – Data Sources Variable

Data Source

Web Site

Percent meeting CDC 2011 CDC BRFSS aerobic activity guidelines

http://www.cdc.gov/brfss/annual_data/ annual_2011.htm

Percent meeting CDC 2011 CDC BRFSS aerobic and strength activity guidelines

http://www.cdc.gov/brfss/annual_data/ annual_2011.htm

Percent eating 2+ fruits 2011 CDC BRFSS per day

http://www.cdc.gov/brfss/annual_data /annual_2011.htm

Percent eating 3+ 2011 CDC BRFSS vegetables per day

http://www.cdc.gov/brfss/annual_data/ annual_2011.htm

Percent currently smoking

2012 CDC BRFSS http://www.cdc.gov/brfss/annual_data/ annual_2012.html

Percent obese

2012 CDC BRFSS http://www.cdc.gov/brfss/annual_data/ annual_2012.html

Percent in excellent 2012 CDC BRFSS or very good health

http://www.cdc.gov/brfss/annual_data/ annual_2012.html

Any days when physical 2012 CDC BRFSS health, was not good during the past 30 days

http://www.cdc.gov/brfss/annual_data/ annual_2012.html

Any days when mental 2012 CDC BRFSS http://www.cdc.gov/brfss/annual_data/ health, was not good annual_2012.html during the past 30 days Percent with asthma 2012 CDC BRFSS http://www.cdc.gov/brfss/annual_data/ annual_2012.html Percent with angina or 2012 CDC BRFSS coronary heart disease

http://www.cdc.gov/brfss/annual_data/ annual_2012.html

Percent with diabetes 2012 CDC BRFSS

http://www.cdc.gov/brfss/annual_data/ annual_2012.html

Death rate/100,000 for cardiovascular disease

2010 CDC Wonder

http://wonder.cdc.gov

Death rate/100,000 for diabetes

2010 CDC Wonder

http://wonder.cdc.gov

Parkland as a percent of city land area

2012 City Park Facts – The Trust for Public Land

http://www.tpl.org/

Health and Community Fitness Status of the 50 Largest Metropolitan Areas

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Appendix A – Data Sources Variable

Data Source

Web Site

Acres of parkland/1,000

2012 City Park Facts – The Trust for Public Land

http://www.tpl.org/

Farmers’ markets/1,000,000 2013 – USDA Farmers Markets http://www.ams.usda.gov/AMSv1.0/ farmersmarkets Percent using public U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ transportation to work Community Survey – 1 Year pages/index.xhtml Estimates Percent bicycling or U.S. Census – 2012 American http://factfinder2.census.gov/faces/nav/jsf/ walking to work Community Survey – 1 Year pages/index.xhtml Estimates Walk Score® 2014 – Walk Score®

http://www.walkscore.com/cities-andneighborhoods/

Ball diamonds/10,000

2012 –The Trust for Public Land

http://www.tpl.org/

Dog parks/100,000

2012–The Trust for Public Land

http://www.tpl.org/

Park playgrounds/10,000

2012–The Trust for Public Land

http://www.tpl.org/

Golf courses/100,000

2012–The Trust for Public Land

http://www.tpl.org/

Park units/10,000

2012–The Trust for Public Land

http://www.tpl.org/

Recreation centers/20,000 2012–The Trust for Public Land

http://www.tpl.org/

Swimming pools/100,000

2012–The Trust for Public Land

http://www.tpl.org/

Tennis courts/10,000

2012–The Trust for Public Land

http://www.tpl.org/

Park-related expenditures per capita

2012 –The Trust for Public Land

http://www.tpl.org/

Level of state requirement 2012 – School Health Policies http://www.cdc.gov/healthyyouth/shpps/2012/ for Physical Education and Programs Study data/physical_education/index.htm classes

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Appendix B – Members of the Expert Panel AFI Advisory Board Members Barbara E. Ainsworth, Ph.D., M.P.H., FACSM, FNAK Arizona State University Mesa, Arizona

Roseann M. Lyle, Ph.D., R.D., FACSM Purdue University West Lafayette, Indiana

Steven N. Blair, P.E.D, FACSM University of South Carolina Columbia, South Carolina

Melinda M. Manore, Ph.D., R.D., FACSM Oregon State University Corvallis, Oregon

Jacqueline Epping, M.Ed., FACSM U.S. Centers for Disease Control and Prevention (CDC) Atlanta, Georgia

Kenneth E. Powell, M.D., M.P.H., FACSM Epidemiologic and Public Health Consultant Atlanta, Georgia

John M. Jakicic, Ph.D., FACSM University of Pittsburgh Pittsburgh, Pennsylvania Liz Joy, M.D., M.P.H., FACSM Intermountain Healthcare/ University of Utah School of Medicine NiCole Keith, Ph.D., FACSM Indiana University/Regenstrief Institute, Inc. Indianapolis, Indiana

Angela Smith, M.D., FACSM Nemours/Alfred I. duPont Hospital for Children Walter R. Thompson, Ph.D., FACSM Georgia State University Atlanta, Georgia Stella Lucia Volpe, Ph.D., R.D., FACSM Drexel University Philadelphia, Pennsylvania

Health and Community Fitness Status of the 50 Largest Metropolitan Areas

119

Appendix B – Members of the Expert Panel Additional Members for AFI Expert Panel Ross Andersen, Ph.D., FACSM McGill University Montreal, Quebec, Canada

Caroline A. Macera, Ph.D., FACSM San Diego State University San Diego, California

Laura Brennan Ramirez, Ph.D., MPH Transtria LLC St. Louis, Missouri

Robert H. McNulty, J.D. Partners for Livable Communities Washington, DC

Natalie Colabianchi, Ph.D. University of South Carolina Columbia, South Carolina

Marcia G. Ory, Ph.D., M.P.H. Texas A & M Health Science Center College Station, Texas

Karen J. Coleman, Ph.D. Southern California Permanente Medical Group Pasadena, California

Nico Pronk, Ph.D., FACSM HealthPartners Minneapolis, Minnesota

Kelly Evenson, Ph.D., FACSM University of North Carolina-Chapel Hill Chapel Hill, North Carolina Sandra Ham, M.S. U.S. Centers for Disease Control and Prevention (CDC) Atlanta, Georgia Christine Hoehner, Ph.D., M.S.P.H. Saint Louis University St. Louis, Missouri Laura Kettel Khan, Ph.D. U.S. Centers for Disease Control and Prevention (CDC) Atlanta, Georgia

Robert Sallis, M.D., FACSM Kaiser Permanente Rancho Cucamonga, California Patricia Sharpe, Ph.D., M.P.H. University of South Carolina Columbia, South Carolina David Williams, Ph.D. Brown Medical School and the Miriam Hospital Providence, Rhode Island Wes Wong, M.D., M.M.M. Community Health Network Indianapolis, Indiana

Harold W. (Bill) Kohl, Ph.D., FACSM University of Texas Austin, Texas

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Appendix C – U.S. Values, MSA Averages and MSA Ranges for AFI Indicators

U.S. Value

MSA Average

MSA Range

313,914,040

3,423,902

1,123,712 – 19,831,858

Percent less than 18 years old

23.5%

23.8%

19.6% – 29.1%

Percent 18 to 64 years old

62.8%

63.6%

61.1% – 66.4%

Percent 65 years old and older

13.7%

12.6%

8.7% – 18.0%

Percent male

42.9%

49.0%

48.1% – 50.3%

Percent high school graduate or higher

86.4%

87.7%

78.6% – 93.2%

Percent White

73.9%

71.0%

48.2% – 87.5%

Percent Black or African American

12.6%

15.3%

1.7% – 46.0%

Percent Asian

5.0%

5.7%

1.4% – 32.2%

Percent Other Race

8.5%

8.0%

2.3% – 22.4%

Percent Hispanic/Latino

16.9%

16.1%

1.4% – 54.4%

Percent unemployed

9.4%

9.2%

5.6% – 14.2%

$51,371

$56,493

$44,379 – $90,737

Percent of households below poverty level

11.8%

11.0%

5.7% – 15.5%

Violent crime rate/100,000*

386.9

445.3

243.4 – 1056.8

Percent with disability

12.2%

11.2%

7.8% – 14.6%

Population

Median household income

*Due to differences in jurisdictional definitions and reporting, the FBI recommends that these rates not be compared across areas

ACSM American Fitness IndexTM Components Personal Health Indicators

U.S. Value

MSA Average

MSA Range

Health Behaviors  ercent any physical activity or P exercise in the last 30 days

77.1%

77.4%

71.7% – 84.7%

28.0%

27.8%

19.9% – 36.2%

 ercent meeting both CDC aerobic P and strength activity guidelines

20.1%

19.4%

11.6% – 25.2%

Percent consuming 2+ fruits per day

30.0%

30.0%

18.3% – 36.9%

Percent consuming 3+ vegetables per day

15.0%

14.8%

7.6% – 21.7%

Percent currently smoking

19.6%

17.8%

8.9% – 26.1%

Percent meeting CDC aerobic activity guidelines

Chronic Health Problems Percent obese

27.6%

27.3%

16.4% – 35.0%

Percent in excellent or very good health

52.2%

52.4%

42.6% – 61.2%

 ny days when physical health was A not good during the past 30 days

35.8%

35.6%

29.2% – 42.8%

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Appendix C – U.S. Values, MSA Averages and MSA Ranges for AFI Indicators

U.S. Value

MSA Average

MSA Range

Chronic Health Problems (cont.) Any days when mental health was  ot good during the past 30 days n

35.4%

35.1%

27.5% – 40.2%

Percent with asthma

8.9%

8.8%

4.9% – 12.1%

 ercent with angina or coronary P heart disease

4.3%

4.3%

2.3% – 7.5%

Percent with diabetes

9.7%

10.1%

6.5% – 14.0%

 eath rate/100,000 for D cardiovascular disease

194.2

187.5

118.8 – 247.1

Death rate/100,000 for diabetes

20.8

18.7

10.4 – 31.2

Community/Environmental Indicators (note: most of these data were available only for the main city in the MSA)



MSA Average+ Range of All Cities

Built Environment Parkland as percent of city land area

10.6%

2.5% – 25.8%

Acres of parkland/1,000

18.3%

2.8 – 84.1

Farmers’ markets/1,000,000

19.3%

2.8 – 48.7

Percent using public transportation to work

4.3%

0.4% – 31.0%

Percent bicycling or walking to work

2.9%

1.1% – 6.7%

Walk Score®

51.1%

24.4% – 87.6

Recreational Facilities Ball diamonds/10,000

1.9

0.3 – 5.1

Dog parks/10,000

1.0

0.0 – 5.7

Park playgrounds/10,000

2.3

1.0 – 5.0

Golf courses/100,000

0.9

0.0 – 5.3

Park units/10,000

4.2

1.3 – 10.9

Recreation centers/20,000

1.0

0.0 – 2.6

Swimming pools/100,000

3.0

0.5 – 9.7

Tennis courts/10,000

2.1

0.8 – 6.6

$99.5

$1.0 – $398.0

1.4

0–3

Park-related expenditures per capita Level of state requirement for Physical Education classes**

**3 = required at three levels: high school, middle school and elementary school; 2= required at two levels; 1= required at only one level +Averages were calculated from 2014 data and may differ from the community/environmental indicator target goal values.

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Appendix D – Counties in MSAs Atlanta-Sandy SpringsMarietta, GA Barrow County, GA Bartow County, GA Butts County, GA Carroll County, GA Cherokee County, GA Clayton County, GA Cobb County, GA Coweta County, GA Dawson County, GA DeKalb County, GA Douglas County, GA Fayette County, GA Forsyth County, GA Fulton County, GA Gwinnett County, GA Haralson County, GA Heard County, GA Henry County, GA Jasper County, GA Lamar County, GA Meriwether County, GA Newton County, GA Paulding County, GA Pickens County, GA Pike County, GA Rockdale County, GA Spalding County, GA Walton County, GA Austin-Round RockSan Marcos, TX Bastrop County, TX Caldwell County, TX Hays County, TX Travis County, TX Williamson County, TX Baltimore-Towson, MD Anne Arundel County, MD Baltimore County, MD Carroll County, MD Harford County, MD Howard County, MD Queen Anne’s County, MD Baltimore city, MD

Birmingham-Hoover, AL Bibb County, AL Blount County, AL Chilton County, AL Jefferson County, AL St. Clair County, AL Shelby County, AL Walker County, AL Boston-CambridgeQuincy, MA-NH Norfolk County, MA Plymouth County, MA Suffolk County, MA Middlesex County, MA Essex County, MA Rockingham County, NH Strafford County, NH Buffalo-Niagara Falls, NY Erie County, NY Niagara County, NY Charlotte-GastoniaRock Hill, NC-SC Anson County, NC Cabarrus County, NC Gaston County, NC Mecklenburg County, NC Union County, NC York County, SC Chicago-JoiletNaperville, IL-IN-WI Cook County, IL DeKalb County, IL DuPage County, IL Grundy County, IL Kane County, IL Kendall County, IL McHenry County, IL Will County, IL Jasper County, IN Lake County, IN Newton County, IN Porter County, IN Lake County, IL Kenosha County, WI

Cincinnati-Middletown, OH-KY-IN Dearborn County, IN Franklin County, IN Ohio County, IN Boone County, KY Bracken County, KY Campbell County, KY Gallatin County, KY Grant County, KY Kenton County, KY Pendleton County, KY Brown County, OH Butler County, OH Clermont County, OH Hamilton County, OH Warren County, OH Cleveland-Elyria-Mentor, OH Cuyahoga County, OH Geauga County, OH Lake County, OH Lorain County, OH Medina County, OH Columbus, OH Delaware County, OH Fairfield County, OH Franklin County, OH Licking County, OH Madison County, OH Morrow County, OH Pickaway County, OH Union County, OH Dallas-Fort Worth-Arlington, TX Collin County, TX Dallas County, TX Delta County, TX Denton County, TX Ellis County, TX Hunt County, TX Kaufman County, TX Rockwall County, TX Johnson County, TX Parker County, TX Tarrant County, TX Wise County, TX

Health and Community Fitness Status of the 50 Largest Metropolitan Areas

123

Appendix D – Counties in MSAs Denver-Aurora-Broomfield, CO Adams County, CO Arapahoe County, CO Broomfield County, CO Clear Creek County, CO Denver County, CO Douglas County, CO Elbert County, CO Gilpin County, CO Jefferson County, CO Park County, CO Detroit-Warren-Livonia, MI Wayne County, MI Lapeer County, MI Livingston County, MI Macomb County, MI Oakland County, MI St. Clair County, MI Hartford-West HartfordEast Hartford, CT Hartford County, CT Middlesex County, CT Tolland County, CT Houston-Sugar Land-Baytown, TX Austin County, TX Brazoria County, TX Chambers County, TX Fort Bend County, TX Galveston County, TX Harris County, TX Liberty County, TX Montgomery County, TX San Jacinto County, TX Waller County, TX Indianapolis-Carmel, IN Boone County, IN Brown County, IN Hamilton County, IN Hancock County, IN Hendricks County, IN Johnson County, IN Marion County, IN Morgan County, IN Putnam County, IN Shelby County, IN

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Jacksonville, FL Baker County, FL Clay County, FL Duval County, FL Nassau County, FL St. Johns County, FL Kansas City, MO-KS Franklin County, KS Johnson County, KS Leavenworth County, KS Linn County, KS Miami County, KS Wyandotte County, KS Bates County, MO Caldwell County, MO Cass County, MO Clay County, MO Clinton County, MO Jackson County, MO Lafayette County, MO Platte County, MO Ray County, MO Las Vegas-Paradise, NV Clark County, NV Los Angeles-Long BeachSanta Ana, CA Los Angeles County, CA Orange County, CA Louisville/Jefferson County, KY-IN Clark County, IN Floyd County, IN Harrison County, IN Washington County, IN Bullitt County, KY Henry County, KY Jefferson County, KY Meade County, KY Nelson County, KY Oldham County, KY Shelby County, KY Spencer County, KY Trimble County, KY

Memphis, TN-MS-AR Crittenden County, AR DeSoto County, MS Marshall County, MS Tate County, MS Tunica County, MS Fayette County, TN Shelby County, TN Tipton County, TN Miami-Fort LauderdalePompano Beach, FL Broward County, FL Miami-Dade County, FL Palm Beach County, FL Milwaukee-WaukeshaWest Allis, WI Milwaukee County, WI Ozaukee County, WI Washington County, WI Waukesha County, WI Minneapolis-St. PaulBloomington, MN-WI Anoka County, MN Carver County, MN Chisago County, MN Dakota County, MN Hennepin County, MN Isanti County, MN Ramsey County, MN Scott County, MN Sherburne County, MN Washington County, MN Wright County, MN Pierce County, WI St. Croix County, WI

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Appendix D – Counties in MSAs Nashville-DavidsonMurfreesboro-Franklin, TN Cannon County, TN Cheatham County, TN Davidson County, TN Dickson County, TN Hickman County, TN Macon County, TN Robertson County, TN Rutherford County, TN Smith County, TN Sumner County, TN Trousdale County, TN Williamson County, TN Wilson County, TN

Oklahoma City, OK Canadian County, OK Cleveland County, OK Grady County, OK Lincoln County, OK Logan County, OK McClain County, OK Oklahoma County, OK

New Orleans-Metairie-Kenner, LA Jefferson Parish, LA Orleans Parish, LA Plaquemines Parish, LA St. Bernard Parish, LA St. Charles Parish, LA St. John the Baptist Parish, LA St. Tammany Parish, LA

Philadelphia-CamdenWilmington, PA-NJ-DE-MD Burlington County, NJ Camden County, NJ Gloucester County, NJ Bucks County, PA Chester County, PA Delaware County, PA Montgomery County, PA Philadelphia County, PA New Castle County, DE Cecil County, MD Salem County, NJ

New York-Northern New JerseyLong Island, NY-NJ-PA Middlesex County, NJ Monmouth County, NJ Ocean County, NJ Somerset County, NJ Nassau County, NY Suffolk County, NY Essex County, NJ Hunterdon County, NJ Morris County, NJ Sussex County, NJ Union County, NJ Pike County, PA Bergen County, NJ Hudson County, NJ Passaic County, NJ Bronx County, NY Kings County, NY New York County, NY Putnam County, NY Queens County, NY Richmond County, NY Rockland County, NY Westchester County, NY

Orlando-Kissimmee-Sanford, FL Lake County, FL Orange County, FL Osceola County, FL Seminole County, FL

Phoenix-Mesa-Glendale, AZ Maricopa County, AZ Pinal County, AZ Pittsburgh, PA Allegheny County, PA Armstrong County, PA Beaver County, PA Butler County, PA Fayette County, PA Washington County, PA Westmoreland County, PA

Portland-VancouverHillsboro, OR-WA Clackamas County, OR Columbia County, OR Multnomah County, OR Washington County, OR Yamhill County, OR Clark County, WA Skamania County, WA Providence-New BedfordFall River, RI-MA Bristol County, MA Bristol County, RI Kent County, RI Newport County, RI Providence County, RI Washington County, RI Raleigh-Cary, NC Franklin County, NC Johnston County, NC Wake County, NC Richmond, VA Amelia County, VA Caroline County, VA Charles City County, VA Chesterfield County, VA Cumberland County, VA Dinwiddie County, VA Goochland County, VA Hanover County, VA Henrico County, VA King and Queen County, VA King William County, VA Louisa County, VA New Kent County, VA Powhatan County, VA Prince George County, VA Sussex County, VA Colonial Heights city, VA Hopewell city, VA Petersburg city, VA Richmond city, VA

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Appendix D – Counties in MSAs Riverside-San Bernardino-Ontario, CA Riverside County, CA San Bernardino County, CA Sacramento-ArdenArcade-Roseville, CA El Dorado County, CA Placer County, CA Sacramento County, CA Yolo County, CA Saint Louis, MO-IL Bond County, IL Calhoun County, IL Clinton County, IL Jersey County, IL Macoupin County, IL Madison County, IL Monroe County, IL St. Clair County, IL Crawford County, MO (pt.)* Franklin County, MO Jefferson County, MO Lincoln County, MO St. Charles County, MO St. Louis County, MO Warren County, MO Washington County, MO St. Louis city, MO Salt Lake City, UT Salt Lake County, UT Summit County, UT Tooele County, UT

San Antonio-New Braunfels, TX Atascosa County, TX Bandera County, TX Bexar County, TX Comal County, TX Guadalupe County, TX Kendall County, TX Medina County, TX Wilson County, TX San Diego-CarlsbadSan Marcos, CA San Diego County, CA San Francisco-OaklandFremont, CA Alameda County, CA Contra Costa County, CA Marin County, CA San Francisco County, CA San Mateo County, CA San Jose-SunnyvaleSanta Clara, CA San Benito County, CA Santa Clara County, CA Seattle-Tacoma-Bellevue, WA King County, WA Snohomish County, WA Pierce County, WA Tampa-St. PetersburgClearwater, FL Hernando County, FL Hillsborough County, FL Pasco County, FL Pinellas County, FL

Virginia Beach-NorfolkNewport News, VA-NC Currituck County, NC Gloucester County, VA Isle of Wight County, VA James City County, VA Mathews County, VA Surry County, VA York County, VA Chesapeake city, VA Hampton city, VA Newport News city, VA Norfolk city, VA Poquoson city, VA Portsmouth city, VA Suffolk city, VA Virginia Beach city, VA Williamsburg city, VA Washington-ArlingtonAlexandria, DC-VA-MD-WV Frederick County, MD Montgomery County, MD District of Columbia, DC Calvert County, MD Charles County, MD Prince George’s County, MD Arlington County, VA Clarke County, VA Fairfax County, VA Fauquier County, VA Loudoun County, VA Prince William County, VA Spotsylvania County, VA Stafford County, VA Warren County, VA Alexandria city, VA Fairfax city, VA Falls Church city, VA Fredericksburg city, VA Manassas city, VA Manassas Park city, VA Jefferson County, WV

* The portion of Sullivan city in Crawford County, Missouri, is legally part of the St. Louis, MO-IL MSA.

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