Today, May, 19, the American College of Sports Medicine (ACSM) and the Anthem Foundation released the eighth annual American Fitness Index, and for the Philadelphia metro region, it brings with it a sense of what we are doing well and what we still need to work on.

The ACSM studies Metropolitan Statistical Areas and our area comprised of Philadelphia, Camden, Wilmington and surrounding cities ranked 22 out of 50.  The American Fitness Index (AFI) is broken down into community/environmental indicators (parks, recreational facilities, use of public transit) and personal health indicators (physical activity and heart disease prevalence), and like in previous years, we did well with community/environmental indicators, but still have work to do on reaching personal health goals.

Our score also included some other interesting insights into our region's infrastructures and behaviors. We have a higher percent of people who bike or walk to work and we have more farmers' markets, ball diamonds and recreation centers per capita. We also have a higher level of state requirement for Physical Education classes.

On the flip side, we have fewer golf courses and parkland per capita and spend less money on our parks. We also have a higher percent of residents who smoke, are obese and who have been diagnosed with coronary heart disease or diabetes. Not enough of us are getting the recommended amount of exercise or eating enough vegetables every day either.

Stella Volpe, PhD, RD, FACSM, Chair of the Department of Nutrition Sciences at Drexel, who is a Fellow of ACSM and member of the advisory board that put together the indicators, talked to Philly.com about the ranking.

"It is important to note that even though the Philadelphia metro area is 22 out of 50, our ranking has been improving since 2009. We are going in the right direction."

The one score that particularly concerned Dr. Volpe was the decline in physical activity. "We want that to change," she said. "Taking even little steps in exercising more and eating better is important. Simple things like taking the stairs instead of the elevator and eating a piece of fruit means a lot."

How other cities fared

The nation's fittest city is Washington DC with Minneapolis-St. Paul and San Diego taking second and third place. Oklahoma City, Memphis and Indianapolis rank last among the 50 metro areas studied. View the rankings and individual metro data here.

The nation's overall fitness

Overall, the AFI reveals a troubling 11.3 percent drop in the percentage of individuals who exercised in the last 30 days, and a 7.8 percent increase in the diabetes death rates from 2014 to 2015. The AFI ranking also notes a 5.5 percent drop in those who eat enough fruit each day.

How the data was collected

With funding from The Anthem Foundation, ACSM studies Metropolitan Statistical Areas (MSA) using a composite score to measure the health of each MSA. Access to public parks was added as a new measure in 2015. ACSM, the Indiana University School of Family Medicine and a panel of 26 health and physical activity experts developed the methodology to analyze U.S. Census data, data from the U.S. Centers for Disease Control and Prevention's Behavioral Risk Factor Surveillance System (BRFSS), The Trust for the Public Land City Park Facts and other existing research data in order to give a scientific, accurate snapshot of the health and fitness status at a metropolitan level.

"The AFI is two things: a measure of how healthy a metro area is today, and a call-to-action for urban and suburban leaders to design infrastructures that promote active lifestyles and lead to positive health outcomes," said Walter R. Thompson, Ph.D., FACSM, chair of the AFI Advisory Board in a press release. "Our goal is to provide communities and residents with resources that help them assess, respond and achieve a better, healthier life."

Because physical inactivity has become an epidemic in the U.S., ACSM encourages Americans to exercise for at least 30 minutes and participate in 10 minutes of stretching and light muscle training five days a week.

Read more Sports Doc for Sports Medicine and Fitness.