(HealthDay)—It's a three-peat. For the third year in a row, the Minneapolis-St. Paul metro area is the fittest in America, according to the American College of Sports Medicine's annual rankings released Wednesday.
"Minneapolis may be under snow for three months, but they capitalize on the resources that they have," said Walter Thompson, chair of the advisory board that compiles the report, called the American Fitness Index, or AFI.
"We're very pleased," said Minneapolis Mayor R.T. Rybak in an interview with HealthDay. "We get up off the couch, in every season."
To compile the annual rankings, the AFI takes into account city policies, community resources, health care access, the local prevalence of chronic diseases and preventive health behaviors in 50 metro areas across the United States.
Minneapolis topped the list with 78.2 points. It was closely followed by Washington, D.C. with 77.7 points. Portland, Ore., San Francisco and Denver rounded out the top five.
Near the bottom were Memphis, Tenn., Louisville, Ky., San Antonio and Detroit. Once again, Oklahoma City ranked last in the nation for measures of health. It's fallen to the bottom of the list each year since 2008, the first year of the AFI rankings.
Despite its dead-last position, Oklahoma City is making positive changes. Thompson pointed out that the city debuted on the list with a score of 24 points. This year, the metro area scored 31.2 on measures of health, wellness and fitness. The American College of Sports Medicine met with city leaders in 2011 to work on a plan to improve the city's fitness.
The biggest movers on the list were Portland and Denver. Portland jumped from number seven in 2012 to take the number-three slot this year. Denver leapt from number nine to number five.
Thompson said that most cities that make big moves on the list do so because of significant policy changes. They spend more money on parks, for example, or they enact citywide smoking bans.
What sets the top-tier cities apart? Thompson noted that they each have an infrastructure that supports physical activity. And they value their city parks. Minneapolis-St. Paul, for example, spends about $227 per person, per year on its city parks. Oklahoma City, by contrast, spends far less, about $60 per person, per year, according to a 2012 Trust for Public Land report.
More than half of the residents in the Twin Cities say they're at least moderately physically active. That may be because they have more playgrounds, swimming pools, tennis courts, golf courses, baseball diamonds and dog parks, per capita, than other cities. They're also more likely to take public transportation or to bike or walk to work, according to the report.
Mayor Rybak credits the city's founding fathers for its wealth of public spaces. "The founders made sure every inch of parkland was open to everyone. Unlike a lot of places where there's a beautiful lake and homes are built right onto the water, we have bike and walking trails in public realm dedicated along all of them," he said.
And they've got a mayor who is constantly looking for new ways to use all that public space. Rybak started a cross-country ski festival called the City of Lakes Loppet that takes over the city streets every winter.
Residents who observed the mayor's "Ski-to-Work Day"—they had to ski at least three miles to work—got a free entry to the city's new Tri-Loppet, a summertime event that will have residents canoeing, mountain biking and running around the city.
And they're planning a new two-block park called The Yard, which will connect the city's new football stadium to its downtown.
"And this is going to be a place we envision skate parks. And maybe taking all the snow we plow in the winter and creating huge hills to snowboard. The idea isn't just to have a passive park, but an active place," Rybak said.
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For the full list of fittest cities, head to the American Fitness Index 2013 Report.