Is your city the fittest in America? Find out in this 2026 ranking.
People in the nation's fittest cities are more likely to take brisk walks or routinely hit the gym. They are also have lower rates of obesity and chronic disease.
But cities that cultivate a healthy community play an equally important role. Cities that consistently rank among the nation's fittest on the ACSM American Fitness Index promote physical activity with parks, trails, access to public transportation and strong environmental marks.
Even among the healthiest cities, food insecurity is a growing concern, according to the report.
The annual fitness index, published July 14 by American College of Sports Medicine and Elevance Health Foundation, ranks the nation's 100 most populous cities on personal health and community/environmental health indicators.
Arlington, Virginia, ranked as the nation's fittest city for the ninth year in a row. Washington, DC, checked in at No. 2, followed by Minneapolis, Seattle and Denver. Oklahoma City ranked at the bottom of the list. Memphis; Port St. Lucie, Florida; Indianapolis and Lubbock, Texas rounded out the bottom five on the ranking.
Stella Volpe, who chairs the ACSM fitness index advisory board, said the report revealed a growing gap between the healthiest and least healthy cities.
Residents of high-scoring cities had lower obesity and chronic disease rates, higher physical activity and better access to walking and biking trails, public parks and public transportation. The opposite is true in communities that score poorly, Volpe said.
"If we have greater access to parks and playgrounds, where we can maybe do pull-ups outside, or greater walkability in our cities, those things will resonate," Volpe said. "But if your city is one where there are barriers to get to those places, it's not going to resonate."
Food insecurity worsens in all but one city
Every major city except Santa Ana, located in Orange County, California, reported worsening rates of food insecurity. Food insecurity is when people can't get or don't think they can get nutritionally adequate and safe foods due to money or geography constraints. On average, food insecurity rates climbed 1.5 percentage points, increasing from 12.9% in 2025 to 14.4% in 2026.
Rising grocery prices make it difficult for a larger share of Americans to pay for healthy and nutritious food. And changes under President Donald Trump's signature 2025 tax cut and spending bill also changed food assistance eligibility for low-income families.
The 2025 bill reduced funding for the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, which provides food aid for millions of families. The federally-funded, state-administered program also has imposed stricter work requirements for recipients.
"Households who qualify for SNAP have very little income that is stretched to pay rent and childcare and to put gas in the car," said Stacy Dean, executive director of the Global Food Institute at George Washington University. "SNAP was bringing groceries through the door. I'm deeply concerned about what's happening to families as they juggle one more very difficult challenge in their lives."
Dean said SNAP changes under Congressional Republican-backed "One Big Beautiful Bill" are the largest since 1996 during President Bill Clinton's administration. But she said many families benefitted from a strong U.S. economy in the late 1990s to get higher-paying jobs so they were no longer SNAP eligible.
For many families, that's likely not happening now, Dean said.
"Nobody is confident that families are leaving (SNAP) because they're better off," said Dean, who was the deputy undersecretary at the U.S. Department of Agriculture's food, nutrition and consumer services division during President Joe Biden's administration.
Air quality limits outdoor activity?
The index also ranked cities by percentage of good air quality days and asthma rates. While about 1 in 10 adults in the 100 largest cities had asthma, rates varied threefold in communities. Greensboro, North Carolina, has the highest asthma rate at 15.4%, according to the index.
People with asthma and other respiratory conditions might struggle to stay fit in cities with poorer air quality. Air pollutants can disrupt breathing and trigger asthma symptoms when people try to exercise outdoors.
Older adults with asthma often are less active than their peers, but the index report noted the importance of being active to improve overall health and quality of life. People with asthma who stay active are less likely to be hospitalized, miss school or need a medical visit to manage symptoms, the index said.
The index report suggested everyone, including those with asthma, might consider checking air quality index to adjust exercise or other activity schedules. Some people might want to exercise early mornings or in the evening when pollution levels are lower. Others might find it safer to walk or work out indoors.
These cities made the biggest gains
Richmond, Virginia, made the biggest gain in the ranking, moving up 20 spots to rank as the nation's 20th fittest city. Other cities that made large gains included Charlotte, North Carolina, up 19 spots to No. 42; Virginia Beach moved up 18 spots to No. 61; Durham, North Carolina jumped 17 spots to No. 49.
Volpe said the annual ranking is meant to celebrate cities that score well - but also encourage lower-ranking cities to make small changes to improve community activity levels.
"Exercise is medicine," Volpe said. "Physical activity really can decrease our risk of chronic disease, and any movement is better than none."
This article originally appeared on USA TODAY: Is your city the fittest in America? Find out in this 2026 ranking.
Reporting by Ken Alltucker, USA TODAY / USA TODAY
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This story was originally published July 14, 2026 at 12:01 AM.