Advancing health through science, education and medicine

The 2016 AFI Data Report: An Overview

By: Walter R. Thompson, Ph.D., FACSM
AFI Advisory Board Chair


San Francisco and Miami, Dallas and Washington, D.C., Portland and Boston. These cities are separated by great distances across the country. In many ways, they are vastly different cities. However, despite their differences and distance, these cities and others are all connected by the ACSM American Fitness Index® (AFI).

At first glance, the AFI Data Report clearly has a great amount of information for the reader. Since its first publication in 2008, AFI's purpose has been to help cities assess and evaluate health and fitness. To do so, each year the 50 most populated metropolitan statistical areas (MSAs; referred to as cities, including the suburbs, for most of us) in the United States are ranked and scored based on scientific evidence of health and fitness. The report measures health behaviors, levels of chronic disease conditions and community resources that support physical activity. Readers must first distinguish the difference between the cities' rankings and their scores to capture the real state of health and fitness in their city. A city's ranking is relative to the other cities in the list. There are 50 cities with 50 scores and, in order to organize them, the cities are ranked, one to 50 based on their scores. Focusing on the trends in the city's score over the years will give an indication of whether the health status is changing (rising, declining or staying the same).

The 2016 AFI Data Report saw exciting changes in the rankings and data. Some highlights include:

  • Total scores increased for 30 cities (60 percent)
  • 11.8 percent increase in the percentage of individuals who indicated they exercised in the last 30 days
  • 4.7 percent drop in the percentage who smoked
  • 7.4 percent drop in the diabetes death rates overall
  • 5.2 percent increase in total park expenditure per resident


  • However, in addition to these positive shifts, other findings were more negative. Nineteen cities had scores that slipped from 2015 to 2016. There was also a 7.7 percent increase in the percentage of populations reporting a diagnosis of angina (chest pain often associated with heart disease) and a 7 percent increase in the reporting of a diagnosis of diabetes (even though the death rate due to diabetes has decreased). That being said, it is important to realize that data can be slow moving. Progress toward a healthier and fitter city can take a while to be reflected in the report itself. In the meantime, you can advocate for change within your own city by contacting your mayor, city council and park officials to start making those small, but significant changes in our cities.

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