The American College of Sports Medicine launched the American Fitness Index (Fitness Index) in 2008. The Fitness Index ranks the 100 largest cities in the United States according to variables that reflect and affect physical activity, physical fitness, health and quality of life of community members. Public health databases serve to develop the Fitness Index and include such components as: percent of adults exercising in the last 30 days, percent with obesity, percent who live within 10 minutes of a park and percent walking or biking to work. The Fitness Index provides information to civic and public health leaders regarding the “health” of their city and citizens and serves as a baseline or benchmark for cities to aspire and measure progress. When it comes to changing health behaviors and health outcomes, those efforts that influence policy and environment are the most important levers to pull (think Clean Indoor Air Act). Since implementation of tobacco legislation, we’ve seen the...