Is your city the fittest in America? Find out in this 2026 ranking.
The American College of Sports Medicine and the Elevance Health Foundation released their 2026 fitness index today. This annual report evaluates the 100 most populous cities in the United States based on personal health metrics alongside community and environmental standards. Key indicators include access to parks and public transit, alongside local obesity and chronic disease rates.
Arlington, Virginia, holds the top position for the ninth consecutive year. Other top performers include Washington, DC, Minneapolis, Seattle, and Denver. At the other end of the list, Oklahoma City appears at the bottom. Memphis, Port St. Lucie, Indianapolis, and Lubbock also rank in the bottom five.
The 2026 data shows a significant correlation between city design and public health. Areas with more walking trails, parks, and functional public transportation show lower rates of chronic illness. Stella Volpe, chair of the fitness index advisory board, notes that urban layout acts as a barrier or a catalyst for activity. If a city limits access to outdoor spaces, residents find it harder to maintain daily movement.
Despite physical health gains in top cities, the report highlights a sharp increase in food insecurity. Rates climbed to 14.4 percent across most major cities, a rise of 1.5 percentage points from 2025. Experts attribute this trend to higher grocery costs and policy changes regarding the Supplemental Nutrition Assistance Program. These changes include tighter eligibility and work requirements established in federal legislation last year.
Air quality remains a secondary challenge for urban fitness. Asthma rates vary significantly across the country, with Greensboro, North Carolina, reporting the highest figures at over 15 percent. Poor air quality limits outdoor exercise, particularly for vulnerable populations. Experts recommend checking air quality levels before planning outdoor workouts, or opting for indoor facilities when pollution levels spike.