On the negative side, people in the Puget Sound region report having a higher number of days than average in a month where their mental health was “not good;” more people here report having asthma than in other cities; and there are fewer basketball hoops per capita.

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Dear Seattle, you’re fourth in the nation in fitness — fitter than average and slightly behind Minneapolis, Washington, D.C., and San Francisco, which score higher on the 10th Annual American Fitness Index as ranked by the American College of Sports Medicine.

The report takes the country’s 50 most populous metropolitan areas and scores them based on performance in preventive health behaviors, levels of chronic disease, health-care access, and community resources and policies that support physical activities, such as the prevalence of parks.

Here are the cities who ranked in the top 10 this year:
1. Minneapolis-St. Paul-Bloomington
2. Washington-Arlington-Alexandria
3. San Francisco-Oakland-Hayward
4. Seattle-Tacoma-Bellevue
5 . San Jose-Sunnyvale-Santa Clara
6. Boston-Cambridge-Newton
7. Denver-Aurora-Lakewood
8. Portland-Vancouver-Hillsboro
9. Salt Lake City
10. San Diego-Carlsbad

The goal of the report is to serve as a tool to evaluate health indicators that can be modified to improve the residents’ well being. The goals are based on criteria established by health-oriented agencies, such as the Centers for Disease Control and Prevention (CDC), or were derived by generating the 90th percentile from the 2008-12 fitness data.

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The top improvements in the Seattle metropolitan area:

  • The number of farmers’ markets per 1,000,000 increased from 11.5 to 17.1.
  • The death rate per 100,000 for cardiovascular disease decreased from 192.4 to 162.0.
  • The death rate per 100,000 for diabetes decreased from 22.5 to 19.5.
  • The percent bicycling or walking to work increased from 4.1% to 4.6%.

According to the report, Seattle’s ranking was also affected by positive scores in the following areas: the number of people who reported that they had gotten regular exercise in the last 30 days; the number of people who reported meeting the CDC’s recommendations for aerobic and strength activity; the number of people who reported using public transportation to get to work; and the number of dog parks per capita.

On the negative side, people in the Puget Sound region reported having a higher number of days than average in a month where their mental health was “not good;” more people here reported having asthma than in other cities; and there are fewer basketball hoops per capita, according to the report.

The report also listed a number of encouraging trends including: smoking rates have declined nationwide; death rates from diabetes and cardiovascular disease dropped; the number of farmers’ markets increased; and more people overall are taking public transportation to work.