Top 10 Highly Fit and Least Fit Major US Cities

Arlington, Virginia and Washington, D.C. have emerged as the top fittest cities in America, according to a recent ranking. Conversely, Wichita and Oklahoma City ranked lowest among the 100 largest cities in the U.S.

The American Fitness Index, now in its 16th year, is a collaboration between the American College of Sports Medicine (ACSM) and the Elevance Health Foundation. It uses census and city-provided data on 34 fitness indicators to assess the fitness levels of the largest U.S. cities.

Here are the top 10 and bottom 10 cities on the index:

1. Arlington, Virginia
2. Washington, D.C.
3. Seattle, Washington
4. Minneapolis, Minnesota
5. Irvine, California
6. Madison, Wisconsin
7. San Francisco, California
8. St. Paul, Minnesota
9. Denver, Colorado
10. Oakland, California

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90. San Antonio, Texas
91. Kansas City, Missouri
92. Lubbock, Texas
93. Indianapolis, Indiana
94. Tulsa, Oklahoma
95. Memphis, Tennessee
96. North Las Vegas, Nevada
97. Louisville, Kentucky
98. Bakersfield, California
99. Wichita, Kansas
100. Oklahoma City, Oklahoma

By providing data and expert analysis, the groups behind the index aim to increase awareness of each city’s health metrics and stimulate actions to address the findings.

“We want City Council folks to hopefully look at this and think, ‘Okay, if we’re at the bottom, we have places to grow. What could we do even small that will help the people in our city move more and be healthier?” said Dr. Stella Volpe, president-elect of ACSM.

The index considers census data on health behaviors and outcomes, as well as the city’s built environment, recreational facilities, and funding for relevant policies. Health outcome indicators specifically measure the prevalence of chronic diseases across the country.

The 2023 index revealed that over 30 percent of residents in these cities, or 20 million people, report having high blood pressure. The same percentage reported obesity.

Cities with high rates of chronic disease often score poorly in personal health and community metrics. These cities may lack access to recreational facilities, walkable or bikeable streets, and other community assets that encourage physical activity.

Sufficient physical activity, according to the U.S. Department of Health and Human Services, has the potential to prevent one in 12 cases of diabetes, one in 15 cases of heart disease, and one in 10 premature deaths.

Despite recommendations from ACSM and the Centers for Disease Control and Prevention for 150 minutes of moderate intensity aerobic and muscle-strengthening activities per week, only 23.7 percent of adults surveyed met both guidelines.

“We have years of data that have well established the fact that physical activity and exercise… can help prevent chronic diseases, things like obesity, cancer, diabetes, hypertension, and stroke,” Volpe said.

“Being active every day, even if it’s not as high as some people think it ‘should be,’ helps people physiologically to prevent chronic disease, and that also includes mental health.”

Although Washington, D.C. is ranked the second fittest city in America, almost 50 percent of its residents reported poor mental health in the previous month.

While the impacts of the pandemic are still being understood, Volpe believes these numbers are partially due to a lack of social interaction resulting from remote work. Once again, she emphasizes that physical activity can alleviate symptoms of mental illness, especially when done with others.

Volpe hopes that the Index will motivate cities to prioritize health and make it easier for residents to make healthy choices. This could involve initiatives like providing city bikes, opening fenced-off areas for parks, or investing in safer sidewalks to encourage walking for everyday activities.

However, individual choice also plays a significant role in promoting physical activity.

“You don’t have to go out and run a marathon every day,” Volpe added. “I always try to tell people that 10-minute bouts throughout the day, even if you’re just walking, add up.”

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