Sacramento's health and wellness has been put to the test: its high number of farmers markets, its low numbers of mass-transportation users, its too-few tennis courts and its residents who bike all of it.
When scores were tallied, the greater Sacramento area emerged seventh among the 50 largest metropolitan areas in the nation on this year's American Fitness Index.
"For years Sacramento has had a wonderful quality of life from a leisure aspect, with the tree canopy coverage, its two rivers and the American River bikeway trail," said Judy Robinson, principal planner with the county Department of Community Development. "We are rich in resources, and these are things that contribute significantly to Sacramento's quality of life and it's why we're all living here."
Apparently, the American College of Sports Medicine has noticed.
Its American Fitness Index measures metropolitan areas annually on levels of community fitness. The index assigns scores out of 100 based on behavior, disease rates, health care, resources and community policy related to healthy living.
In the 2013 report, Minneapolis-St. Paul emerged in first place for the third consecutive year. The area that includes Sacramento, Arden Arcade and Roseville scored 66.8, moving down one place from last year, when the city earned 68.4 and sixth place.
Robinson said she was glad to see that the index reached outside the Sacramento County limits to include the surrounding areas, and she was thrilled with Sacramento's high ranking.
For each metro area, health indicators were divided into "areas of excellence" and "improvement priority areas."
Among areas of excellence, Sacramento has a high numbers of farmers markets, parks and recreational areas, and a high number of residents who bike or walk to work and eat produce. The community spends more than the target amount on parks and has high state requirements for physical education classes.
However, in areas for improvement, Sacramento has a higher-than-target number of residents with asthma, diabetes, angina or coronary heart disease, and people who reported feeling poor mental health. Fewer people use public transportation to get to work than recommended by the target goal, and the report also states that Sacramento has fewer tennis courts per capita than other areas.
Also, the metro area devotes fewer acres to parkland, and a lower percentage of city land is used for parks than the index recommends.
Laura Podolsky, project manager for the nonprofit Local Government Commission, said the Sacramento Area Bicycle Advocates and the Sacramento Metropolitan Air Quality Management District are experimenting with "parklets" in which city roads would be transformed for other uses.
"We are looking to convert city land, taking some of that space and converting it to public space where other things can occur and it can be used for landscaping, dining or benches," Podolsky said.
All of the indicators that needed improvement in 2012 still need improvement, according to this year's index.
The metro area is doing worse than last year, according to the report, in the number of people who smoke and the levels of regular physical activity.
The indicators are divided into two categories: personal health and community/environmental. Sacramento ranked ninth in both categories. Personal health was given a 68.3 and community/environmental health was scored at 65.4.
Ryan Puckett, a spokesman for the American Fitness Index, is familiar with the ranking formulas. He explained how the Sacramento area can be ranked ninth in both personal health indicators and community/environmental indicators, yet rank seventh overall: If a city scores well in one category and poorly in another, it can bump competitors with steady scores to a higher ranking.
"One of the reasons they selected the data they selected is it's not really something you can refute," Puckett said. "There are some health rankings out there that are not very scientific, but the methodology for this has to meet certain criteria."
The indicators are related to the health and activity of a community, are publicly available, can be changed by community efforts, were measured recently and reported reputably and are measured on a regular basis, Puckett said.
The report "should help people focus a little bit," he said. "There are so many things you can do to improve your city's overall health and fitness status. You can identify with this report where you're falling short and where you're doing pretty good."
Teri Duarte, executive director of the nonprofit WALKSacramento, said she is delighted to see such a high ranking for the area, but she is not surprised at the high number of people with asthma because Sacramento's air quality is poor.
"We have high rates of walking and biking, which is great," she added. "But we still have really high rates of physical inactivity."
Duarte, whose organization promotes walkable communities, said Sacramento's tree canopy contributes to healthy lifestyles, leading people to walk in cooler, shaded areas and contributing to positive social interactions. She added that building more compactly and filling vacant lots would solve many of the area's health and fitness issues.
"Public transportation is not financially feasible in spread-out areas of development," she said. "People are forced to drive, which causes social isolation leading to depression and road rage."
Podolsky said incorporating activity into daily life reflects directly on physical health, and Sacramento's high ranking is "great news" for the community. She said the study reveals areas in which Sacramento can improve, be more ambitious and focus as a city on community health.
Index ranks health in largest metro areas
The American Fitness Index ranks the health and community fitness status of America's 50 largest metropolitan areas. It was created by the American College of Sport Medicine with the help of the Indiana University School of Medicine and a panel of health and physical activity experts.
See the complete report at www.americanfitnessindex.org.
The AFI's top 10 metro areas:
1. Minneapolis-St. Paul-Bloomington, Minn.
2. Washington, D.C.-Arlington-Alexandria, Va.
3. Portland-Hillsboro, Ore.-Vancouver, Wash.
4. San Francisco-Oakland-Fremont
5. Denver-Aurora-Broomfield, Colo.
6. Boston-Cambridge-Quincy, Mass.-N.H.
7. Sacramento-Arden Arcade-Roseville
8. Seattle-Tacoma-Bellevue, Wash.
9. Hartford-West Hartford-East Hartford, Conn.
10. San Jose-Sunnyvale-Santa Clara
Call The Bee's Morgan Searles, (916) 321-1102. Follow her in Twitter @morgansearles.