Oklahoma City is ranked dead last for healthiest big city in America. Health experts in the state said they're not surprised.
In reference to things like health care access, obesity rates, and recreation opportunities, Oklahoma City fell short.
Dr. Dale Bratzler said that's not new, and they're issues the entire state has had, but Oklahoma has made a big step in the right direction.
"Expanding Medicaid may be one of the biggest things that we've done recently in recent memory to actually make a difference," said Bratzler, chair of OU Health's Department of Administration and Policy.
Oklahoma City and Tulsa are on the wrong end of the American Fitness Index, with Oklahoma City ranked at number 100 and Tulsa ranked at 99.
Bratzler said lack of health insurance and access to doctors play a major role in the state's shortcomings.
"Particularly in many rural communities it still remains difficult and I would argue that it remains difficult even in our urban centers like Oklahoma City," he said. "When people don't have health insurance, they delay care. They often don't receive preventative services with results in poor health.
The American College of Sports Medicine's list showed how Oklahoma City measured up to the other criteria used to make the list. Over a quarter of the Oklahoma City population smokes, almost half have high blood pressure, about 20% of people have diabetes, and almost 70% of people have not exercised in the last month.
"Diabetes, particularly type 2 diabetes, is tightly linked with obesity rates and then, of course, stroke, high blood pressure, heart disease are all tied to obesity," Bratzler said.
Acting Director of OKC Parks and Recreation Melinda McMillan-Miller said parks are a great place to get exercise on a budget.
"You can go and get a full body workout in only seven minutes and it's absolutely free. Or they can go to another park and just play around a basketball, or tennis, just take a walk, throw a Frisbee with your kid, take the dog out," she said.
But the geography of the sprawled city makes it difficult for everyone to have access.
Oklahoma City's Parks and Recreation recently bought three plots of land to develop into parks.
The American Fitness Index is published by the American College of Sports Medicine and the Anthem Foundation. The index ranks the nation's 100 most populous cities by 34 variables of personal health behaviors, outcomes and community indicators such as air quality and walkability.