Your City Can do More for Health
For health, our choices fall into three categories: daily habits (eating, exercise and stress), where we live, and how we vote.
All three directly affects our well-being—and, collectively, these choices shape the demand side of the market, influencing what governments and businesses supply.
Some good news first:
A report by the American College of Sports Medicine and Elevance Health Foundation found that 59.9% of Americans met the minimum aerobic activity (walking, biking, running, etc.) recommendation of 150 minutes of moderate intensity exercise per week—a nearly 10-point jump.
That’s encouraging, but we have a long way to go.
How else can we improve?
Let’s look at the role of where people live. There are numerous lists of the healthiest and unhealthiest cities in the U.S.—including this recent one from WalletHub, which looks at factors including:
Healthcare access and outcomes (obesity rates, premature death, hospital availability).
Healthy food (access, farmer’s markets, and healthy restaurants).
Fitness opportunities (exercise participation, gyms per capita, etc.).
Green space (parks and trails).
The results?
San Francisco came out on top as the healthiest city, while Huntington, West Virginia and Brownsville, Texas ranked at the bottom.
The “fattest” cities include McAllen, Texas, Little Rock, Arkansas, and Jackson, Mississippi. Denver, Colorado was the least fat city.
Not surprisingly, cities brag when they land near the top. “Bay Area city was once again named the ‘healthiest’ in America,” reported KRON4 in San Francisco; while The Coloradan noted, “Colorado has 3 of the fittest cities in the US. Did yours make the list?”
These rankings matter—but if cities are truly competing, there are other areas to improve that directly impact residents’ health:
Crime
Walking is effective and widely recommended for cardiovascular health, strength, and mental well-being. Cities can get better at addressing crime which keeps children and adults inside. Jackson, MS., is one of the fattest cities and also has one of the highest murder rates. Chicago, called “The City of Big Stomachs,” has been called the “homicide capital” for thirteen years. San Francisco, despite being named one of the healthiest cities, has one of the highest crime rates in America compared to other communities.
Supermarkets
Grocery stores may stock several hundred to 50,000 items, but food labels are far too complex to help people select the healthiest foods. Supermarkets could help by sorting items into healthy sections based on widely agreed upon criteria, have healthy food icons, or even open food stores that only sell healthy foods. For example, the “healthiest soups” could be grouped together in a single section.
Restaurants
Since the 1970s, the share of calories Americans consume away from home has risen by 74 percent and now accounts for nearly 1/3 (31.6%) of total calories.
Restaurants should expand healthy menu options and offer portion sizes matched to body type or goals (e.g. BMI-based small plates). Some restaurants already offer small portions, but more could follow. What we don’t need are versions of Las Vegas’ infamous Heart Attack Grill, piling plates with calories that most diners can’t—or won’t—leave behind.
Kids Menus
One in five children are now obese in the U.S., up from less than one in 10 in 1990. Kids menus are often handed to kids quickly, even before the family is seated, and feature the worst foods in the restaurants that are high calorie, sugary, fat bombs.
In a survey our consumer studies staff at FDA conducted back in the 1990s, we found that many parents thought that eventually, fat kids would outgrow their excessive weights. But in reality, more than half of obese children will become obese adults. Restaurants should support parents by asking before offering unhealthy kids’ menus—and by providing better alternatives.