2023 Innovation Issue: NiCole Keith on how Indianapolis can improve its health ranking

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Of the 100 fittest cities in the nation, Indianapolis remains near the bottom.

In 2022 (the last time rankings were released), the American College of Sports Medicine/Anthem Foundation American Fitness Index (AFI) ranked Indianapolis 97th, while Fort Wayne ranked 75th. The rankings are established by a series of public surveys that evaluate personal health behaviors and outcomes, the built environment (air quality, bike and walk scores, food insecurity, and parks per 10,000 residents), recreational facilities, policies and funding, and resident demographics.

What makes Indianapolis fall 22 ranks below our neighbors to the north? The explanation will follow the order of the AFI report, but not necessarily the order of importance.

The personal health scores of Indianapolis residents fell far below those of Fort Wayne residents. While the health behaviors of Indianapolis residents—such as being physically active, eating fruits and vegetables, and refraining from smoking—were similar to those of Fort Wayne residents, Indianapolis ranked lower in mental health and physical health outcomes, mostly related to chronic disease. In Indianapolis, air quality was poorer and food insecurity was higher. There were fewer parks and playgrounds, and park expenditures per resident was lower.

This might sound depressing; however, AFI presents opportunities for Indianapolis to be better both personally and through policy. Indianapolis residents can improve individually, and the city rankings have a chance to increase through community adjustments.

People should care about their own health improvements because positive health behaviors such as more physical activity, a healthy diet and better sleep improve health outcomes. Improved health outcomes lead to being better able to care for ourselves and our loved ones, being more productive at work or at school, longer independent living, and generally having longer, healthier lives.

Employers benefit from offering a physically active environment in the workplace. These offerings can result in improved work productivity, fewer sick days and reduced health care costs. Physically active employee environments have also been shown to attract better and more energetic talent to the workplace. Providing opportunities to bike and walk to work (active transportation) offers an excellent return on investment in the long term.

Opportunities for active transportation also make a tremendous impact on communities. For example, creating and promoting public spaces to support physical activity participation improves the community in several ways. Active transportation reduces air pollution produced by fossil fuels that come from gasoline-powered vehicles such as cars and buses.

Economic development and spending are influenced by active transportation. When compared to driving, walking or biking past a retailer increases the likelihood that the pedestrian or cyclist will stop in to browse or buy. The enticement of aromatic foods to stimulate the appetite is hard to appreciate when driving past a restaurant at 35 miles per hour. At this same speed, it’s difficult to see that quirky T-shirt that’s just perfect for you. In fact, research indicates that public spaces that promote physical activity are associated with higher consumer spending and better economic growth.

It is important to realize that not all communities are the same and that, in many ways, low-income communities are most in need of intentional building of community assets. For example, the risk of vehicle-related pedestrian fatalities is higher in inner-city communities throughout the nation. Indianapolis is no different. While improving communities, being attentive to such disparities is imperative.

Walkable and bikeable neighborhoods throughout the United States have higher property values, more property-tax-revenue generation and lower crime rates. Community assets related to active transportation also include more social capital within that community, meaning the environment promotes stronger social ties to the neighborhood and among neighborhood residents. This promotes not only a healthy community environment but also the health of its members.

Each day, most people actively transport themselves from one location to another. Extending the distance is in part a personal responsibility, but city planners, policymakers and other community leaders must also be held accountable to make the healthy choice the easy choice.

Indianapolis has several coalitions working on this problem, including Top10, a coalition of over 150 organizations addressing the built environment, nutrition, tobacco and e-cigarettes, as well as policy. JumpIN for Healthy Kids focuses on promoting healthy and active living environments for children and their families.

Improving health outcomes is everyone’s responsibility. Indianapolis is primed to move up in the AFI rankings and promote a healthier future for all.•

__________

Keith is a physical activity researcher at Regenstrief Institute specializing in community-based participatory research with a focus on health equity.

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