Arlington, Virginia, is still the fittest city in America, taking the top spot in the ACSM American Fitness Index for the ninth year in a row. This annual ranking is built by the American College of Sports Medicine and the Elevance Health Foundation from 35 data points across the country’s 100 largest cities, covering everything from residents’ activity levels and chronic disease rates to parks, transit, air quality, and recreation access.
The index shows that Washington, D.C., came in second, followed by Minneapolis, Seattle, and Denver. San Francisco, Irvine, Atlanta, Madison, and Boston rounded out the top 10.
Ranking Criteria
The ACSM American Fitness Index looks at various factors, including personal health and community and environment.
Arlington finished first in the personal health category, while its neighbor Washington, D.C., took the top spot for community and environment. This category looks more at the city itself: parks, transit, walkability, bike access, and other factors that can shape how easily residents build movement into the day.
Stella Volpe, PhD, chair of the Fitness Index Advisory Board, said in the release, “The healthiest cities don’t just encourage exercise—they make movement part of daily life through infrastructure, transportation, and community design.”
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Top 10 Fittest Cities
The top 10 fittest cities are: Arlington, VA, Washington, D.C., Minneapolis, MN, Seattle, WA, Denver, CO, San Francisco, CA, Irvine, CA, Atlanta, GA, Madison, WI, and Boston, MA.
Arlington leads the nation.
At the bottom of the overall list were Oklahoma City, Memphis, Port Saint Lucie, Indianapolis, and Lubbock. Those cities generally faced a tougher mix of higher chronic disease rates, lower activity levels, and fewer local resources that make staying active easier.
Changes in the Rankings
There were some big moves in the middle of the list, too, with a few cities shifting in the overall rankings from 2025 to 2026. Richmond made the biggest jump, climbing 20 spots to No. 20. Charlotte rose 19 places to No. 42, Virginia Beach moved up 18 to No. 61, and Durham gained 17 to reach No. 49.
Orlando had the steepest drop, falling 19 spots to No. 65, while Laredo dropped 18 to No. 88 and Jacksonville fell 16 to No. 84.
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A few more interesting findings sit outside the top 10. Food insecurity, a measure of whether people have reliable access to enough food, rose for the second straight year, and nearly every city in the index moved in the wrong direction. Ninety-nine of the 100 cities reported higher rates than the year before, with the average rising from 12.9 percent to 14.4 percent.
Air quality was another uneven category. Across the 100 cities, good air quality was recorded on about 51 percent of days on average. Honolulu had the highest share at 98.4 percent, while several Arizona cities, including Scottsdale, Phoenix, Glendale, Chandler, Mesa, and Gilbert, came in at 9 percent.
It is likely that a city’s design plays a significant role in its ranking, as it can either help or hinder residents’ ability to stay active. As cities continue to grow and develop, they will need to prioritize infrastructure and transportation to promote healthy lifestyles.
For now, Arlington gets another year of bragging rights, but the new ranking just shows how much a city’s design can help—or hurt—the people in it trying to stay active.
