The American College of Sports Medicine (ACSM) has released its annual ranking of America’s 100 most populous cities based on how well they support healthy, active lifestyles. The winner, Arlington, Virginia, and the rest of the top 4-ranked cities—Washington, D.C.; Seattle, WA; and San Francisco, CA—are repeat champions, while Oklahoma City, Oklahoma, continues its several-year losing streak, with an inauspicious last-place ranking again. Despite the recurrence of first and last place, this year’s report includes a few new insights.
Other Hearst Subscriptions Download Your Training Plan, assigns a score to the top 100 most populated cities based on 34 indicators and ranks them in what it calls the Fitness Index.
“More of us are finding meaningful ways to live healthier and embrace fitness opportunities,” said Stella Volpe, the former ACSM President and Chair of the Fitness Index Advisory Committee. “All of us must maintain this momentum and encourage our leaders to make bold spending choices, policy decisions and infrastructure changes to increase opportunities for residents to be physically active and healthy—one city at a time.”
The ACSM hopes that city and county officials will use the Fitness Index as a data-driven baseline to measure progress and make informed decisions to further improve residents’ health. It’s also intended to give context to physical, behavioral, and social drivers of community health.
While there’s much room for improvement, the overall data shows that generally speaking, more people are getting their steps in and doing cardio—whether that means running, walking, swimming, dancing, stair climbing, jump roping, or something else. The overall data show a 9 percent average increase in people meeting aerobic activity guidelines: 59.9 percent in 2025, up from 50.9 percent previously reported by the Centers for Disease Control and Prevention. Out of the 100 largest U.S. cities, 94 reported improved activity levels, with the largest increases seen in Plano, Texas, and Fort Wayne, Indiana.
The 2025 rankings included two new indicators—trail miles and splashpads—reflecting the importance of community resources that meet the evolving needs and demands of residents. Trail miles are defined in this context not just as recreational activity opportunities but also a community’s ability to engage in active transportation like walking or biking Elevance Health Foundation.
The Fitness Index aims to be comprehensive in its approach and includes indicators that address systemic inequality. Unfortunately, this year’s rankings found that three indicators moved meaningfully in an unhealthy direction: air quality, food insecurity, and reports of excellent or very good health.
Wildfires and droughts across the U.S. contributed to declines in air quality, and all but one city in the Fitness Index saw an increase in its food insecurity percentage. Food insecurity has many causes, but the study points to the expiration of the expanded Child Tax Credit and the end of other COVID-era programs supporting food access as a potential precipitating factor.
“We celebrate the best efforts of individuals and municipalities to improve overall health and fitness levels,” said Volpe.
“These efforts are always going to be affected—good or bad—by a broad variety of other factors,” she continued. “This year, pollution from wildfires and legislation addressing food insecurity that limited further progress. Regardless, such challenges should never deter us from supporting and expanding healthy lifestyles for all.”
Health & Injuries ACSM’s full rankings What Are the Fittest Cities in America? The Top 10 Will Surprise You.
Abby Carney is a writer and journalist in New York. A former D1 college runner and current amateur track athlete, she's written about culture and characters in running and outdoor sports for Runner's World, Like the Wind Magazine, How to Run Injury-Free, and other outlets. She also writes about things that have nothing to do with running, and was previously the editor of a food magazine.
