The latest ACSM American Fitness Index reveals the top U.S. cities for health and fitness, with one East Coast city extending its long-running streak at No. 1
The American College of Sports Medicine (ACSM), in partnership with the Elevance Health Foundation, has released the 2026 American Fitness Index, ranking the 100 largest U.S. cities using 35 indicators across personal health, community infrastructure and environmental conditions.
This year’s report shows a widening gap between cities that prioritize movement and those where residents have fewer opportunities to walk, bike and exercise and increasingly face higher rates of obesity, chronic disease and food insecurity.
Top 5 Fittest Cities in America, 2026:
1. Arlington, Virginia
Arlington remains the country’s fittest city for the ninth consecutive year. It ranked first for personal health and continued to perform strongly across physical activity, park access and transportation infrastructure. The Virginia city also reported good air quality on 84.4% of days, one of the highest rates among the cities studied.
2. Washington, D.C.
Washington, D.C., ranked first in the Index’s community and environment category, reflecting its parks, trails, public transportation and infrastructure supporting walking and biking. The city also dedicates 21.5% of its land area to parks, placing it among the national leaders on the Index’s updated park measure.
3. Minneapolis, Minnesota
Minneapolis moved into the top three this year after ranking sixth in 2025. The city placed second for community and environment, supported by active transportation, recreation infrastructure and access to outdoor athletic fields. It also recorded a 19% improvement in the share of days with good air quality.
4. Seattle, Washington
Seattle continues to rank among the healthiest major U.S. cities, placing second in personal health. Its residents benefit from high physical activity levels and an environment that supports walking, biking, recreation and outdoor living.
5. Denver, Colorado
Denver rounds out the top five, ranking highly across both personal health and community conditions. The city continues to benefit from strong exercise participation, access to recreation and infrastructure that helps residents incorporate movement into their daily routines.
Best of the Rest
San Francisco ranked sixth, followed by Irvine, Atlanta, Madison and Boston. Irvine returned to the top 10 after moving from No. 12 to No. 7, while Boston climbed from No. 13 to No. 10…