And This Year’s Fittest City in the United States Is… (2024)

Every year, the American College of Sports Medicine ranks America’s 100 most populous cities based on health indicators to determine which cities are the fittest. Spoiler alert: The reigning champ wins again in the 2023 edition of the list.

For the sixth year in a row, the ACSM has ranked Arlington, Virginia, as the fittest city in the United States, taking top scores in the personal health and the community and environment sub-scores of the study. Washington, D.C., and Seattle rounded out the top three.

The study, done in partnership with the Elevance Health Foundation, assigns a score to the top 100 most populated cities based on 34 indicators and ranks them in what it calls the Fitness Index.

“Physical activity has proven to be an effective tool in reducing the prevalence of many chronic diseases,” said Dr. Shantanu Agrawal, Elevance Health’s chief health officer. “Getting sufficient physical activity could prevent one in 12 cases of diabetes, one in 15 cases of heart disease, and one in 10 premature deaths.”

The ACSM hopes that the Fitness Index can provide city leaders with valuable scientific data to make decisions that can improve their citizens’ health and better equip their residents with amenities like green spaces to enhance their quality of life.

“The importance of the Fitness Index has taken on new meaning for individuals and communities seeking to improve their health and well-being,” said ACSM president-elect Stella Volpe. “Research suggests that to improve physical and mental health, prevent disease and disability, and enhance quality of life for all Americans, we must create a culture that integrates physical activity into our daily lives.”

The ACSM recommends at least 150 minutes per week of moderate-intensity aerobic activity—about 22 minutes daily—and muscle-strengthening activity twice weekly. Volpe said that while 78 percent of adults in the Fitness Index cities reported exercising in the previous month, only 51 percent met the aerobic activity guidelines, and just 24 percent met both aerobic and strength activity guidelines.

“Unfortunately, Americans are still not moving enough,” Volpe said. “This underscores the need for local community leaders to step up and make bold spending choices, policy decisions, and infrastructure changes to increase opportunities for residents to be physically active and healthy. Collective actions and resources at the community level greatly influence the health choices available to us, and the Fitness Index is a road map for where communities can improve.”

Arlington ranked in the top 10 cities for 16 of the 34 indicators in the study, getting high marks for both the healthy behaviors of the population and the proliferation of community assets that help promote active lifestyles.

The city had the highest percentage of residents that had exercised in the last 30 days, along with the lowest rate of residents with diabetes, zero pedestrian fatalities, and was tied for cities with the highest percentage of residents who live within a 10-minute walk to a park or green space.

Oklahoma City, Oklahoma—which has had the dubious distinction of a last-place finish the past several years—once again brings up the rear in the rankings.

To see how your city fared, click here to check out the ACSM’s full rankings.