ACSM American Fitness Index

The ACSM American Fitness Index Program (AFI) is an initiative of the American College of Sports Medicine that aims to quantitatively measure the overall health and fitness level of American metropolitan areas. The measure is a composite of indicators for personal health, availability of health care providers, and community resources for physical activity. The first study, completed in May 2008, ranked the 15 most populous metropolitan areas in the nation, along with Greater Indianapolis (where the ACSM is based). Today, the 50 most populous metropolitan areas are ranked. As of 2013, the Minneapolis-St. Paul-Bloomington metro area holds the top ranking. Oklahoma City, Oklahoma is in last place.

Besides a simple ranking, the ACSM provides individual reports for ranked metro areas, detailing how each score was assigned. This is in keeping with the ACSM's stated goal of arming local policy-makers with the information necessary to improve the health, fitness and quality of life of community residents by promoting healthier lifestyles and physical activity.

Methodology
Scores are assigned by comparing various indicators to the national average and rewarding or penalizing the metro area as appropriate. These indicators are classified into two broad categories: Personal Health, which measures the health habits of metro area residents, including their fitness, diet, chronic health problems, and access to health care, and Community and Environment, which includes scores to measure the availability and convenience of alternative transportation, ease of access to community health facilities like pools, tennis courts, and baseball diamonds, and the percentage of the metro area designated as parkland.

These indicators are combined with population statistics that are known or believed to be related to overall community health, such as employment levels, rates of violent crime, median household income, average level of education, and population demographics.