Here are the 10 fittest and least fit big U.S. cities

Arlington, Va. and Washington, D.C. topped a ranking of America’s fittest cities newly released, with Wichita and Oklahoma City taking up the rear among the 100 largest U.S. cities.

The 16th annual American Fitness Index is a collaboration between the American College of Sports Medicine (ACSM) and the Elevance Health Foundation. The index uses census and city-provided data surrounding 34 fitness indicators to rank the 100 largest U.S. cities. 

Here’s the top 10 and bottom 10 on this year’s index.

1. Arlington, Va.
2. Washington, D.C.
3. Seattle, Wash.
4. Minneapolis, Minn.
5. Irvine, Calif.
6. Madison, Wis.
7. San Francisco, Calif.
8. St. Paul, Minn.
9. Denver, Colo.
10. Oakland, Calif.

90. San Antonio, Texas
91. Kansas City, Mo.
92. Lubbock, Texas
93. Indianapolis, Ind.
94. Tulsa, Okla.
95. Memphis, Tenn.
96. North Las Vegas, Nev.
97. Louisville, Ky.
98. Bakersfield, Calif.
99. Wichita, Kan.
100. Oklahoma City, Okla.

By providing data and expert analysis to increase awareness of each city’s health metrics, the groups behind the index hope to encourage meaningful discussion and action to address what the data reveals.

“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 ACSM president-elect Dr. Stella Volpe.

The index pulls together census data about health behaviors and outcomes, as well as the city’s built environment, recreational facilities and funding for certain policies. The health outcome indicators specifically refer to chronic diseases and their prevalence across the country.

The 2023 index found that over 30 percent of those residing in these cities — or 20 million people — report having high blood pressure. That same number reported obesity.

Cities that tend to have high rates of chronic disease often score low in personal health and community metrics. Typically, residents in these cities may not have access to recreational facilities, walkable or bikeable streets, or other community assets that promote physical activity. 

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

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

Though the ACSM and the Centers for Disease Control and Prevention recommend 150 minutes per week — or approximately 22 minutes per day — of moderate intensity aerobic and muscle-strengthening activities two times 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 disease, 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.”

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

While it will take years to fully understand the impacts of the pandemic, Volpe said that these numbers are likely due in part to a lack of social interaction that comes with working remotely. Again, she said, physical activity could reduce symptoms of mental illness, especially when done with others. 

Volpe hopes that the Index encourages cities to make the healthy choice the easy choice. 

This could be as simple as providing residents with city bikes, opening up fenced off areas to create more parks, or investing in safer sidewalks so people are more likely to walk to grab lunch, she said. 

However, physical activity also relies on individual choice as well.

“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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