Introduction Walkable access to parks, sufficient park acreage, and investments in park and recreation resources are 3 indicators of quality city park systems. Few studies, however, have examined the collective effects of these indicators on public health outcomes. Methods Combining 3 nationwide public data sets, this study modeled the relationships between a composite score of urban park system quality effects on physical activity and self-reported health while controlling for demographic and lifestyle variables. Data were obtained from the Centers for Disease Control and Prevention's 500 Cities Project, the Trust for Public Land's City Park Facts Report, and the US Census Bureau. Results Regression analyses indicated that the composite park quality score was significantly related to both physical activity levels and physical health across a sample of 59 cities. Higher scores were associated with fewer physically inactive residents but were not significantly associated with better physical health. Conclusion Assessing the collective contribution of park access, park acreage, and investment suggests that improvements to a city's composite score may correspond with greater physical activity, but more research is needed to establish the long-term relationships between park system quality and physical health.
