Here Are the 10 Most and Least Fit U.S. Cities

Wondering if you live in the fittest, or least fit, city in the United States?

The 16th Annual American Fitness Index in collaboration with the American College of Sports Medicine (ACSM) and the Elevance Health Foundation used census and city-provided data to compile and rank the most fit cities in the U.S.

The rankings aren't meant to shame residents but they aim to encourage a discussion about where each city lies in respect to activities and exercise.


"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?,'" says ACSM president-elect Stella Volpe.

The most fit cities include:

  • Arlington, Virgina
  • Washington, D.C.
  • Seattle, Washington
  • Minneapolis, Minnesota
  • Irvine, California
  • Madison, Wisconsin
  • San Francisco, California
  • St. Paul, Minnesota
  • Denver, Colorado
  • Oakland, California

Census data, health behaviors, the city's environment, recreational facilities, and funding were all taken into consideration when creating the index. The index also looks at chronic diseases and where they arise the most in the U.S.

In the least fit cities, 30% — or 20 million people — reported high blood pressure and obesity.

The least fit cities include:

  • San Antonio, Texas
  • Kansas City, Missouri
  • Lubbock, Texas
  • Indianpolis, Indiana
  • Tulsa, Oklahoma
  • Memphis, Tennessee
  • North Las Vegas, Nevada
  • Louisville, Kentucky
  • Bakersfield, California
  • Wichita, Kansas
  • Oklahoma City, Oklahoma

The cities on the low-scoring list tend to have less recreational facilities and less walkable or bike-able streets. The ACSM and CDC recommend 150 minutes of aerobic or muscle-strengthening activities per week. This is only 22 minutes per day, but only 23.7% of adults in the survey claimed they met this guideline.


"We have years of data that have well established the fact that physical activity and exercise can hep prevent chronic disease," says Volpe.

Diseases like obesity, cancer, diabetes, hypertension, and stroke could be prevented with some sort of activity that would also boost mental health as well.

Overall, the index hopes that these least fit cities will take into account the results and find more ways to create more parks, city bikes, or sidewalks for folks to walk along.

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


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