The ACSM / Elevance Health Foundation Fitness Index evaluated America’s 100 largest cities using 34 evidence-based indicators. Rounding out the top 10 fittest cities are Madison, Wisconsin; Minneapolis, Minnesota; Washington, D.C.; Seattle, Washington; Irvine, California; Portland, Oregon; St. Paul, Minnesota; Denver, Colorado; and Chicago, Illinois (first time in the top 10). Full rankings and scores, a summary report, city comparison tool and other insights are accessible on the Fitness Index website.
“Congratulations to those city leaders and planners who led efforts to develop parks and playgrounds, build bike paths and safe streets, and offer a built environment that encourages physical activity,” said Shantanu Agrawal, M.D., chief health officer of Elevance Health. “As we entered another year of the pandemic, health disparities in our communities continued to be an issue, which only encourages us to tackle health equity head on. We were also faced with another year of loss, sickness and isolation, resulting in the need for improved mental health. As we start to return to our previous routines, we need to underscore the significant mental and physical health benefits that exercise has in our lives.”
Now in its 15th year, the Fitness Index offers city leaders valuable research to make potentially life-changing decisions in policy, systems and environmental change strategies that drive fitness and health improvements in their communities.
As mental health concerns grow rapidly across the nation, this year’s Fitness Index provides statistical evidence regarding the problem’s scope. On average, 39.6% of residents in the Fitness Index cities reported poor mental health. Nearly 58% of adults in the U.S. perceive a pandemic-related negative effect on emotional or mental health. Cities reporting the highest rates of poor mental health (listed from highest to lowest) include New Orleans, Louisiana; Laredo, Texas; San Francisco, California; Washington, D.C.; San Jose, California; Madison, Wisconsin; Lubbock, Texas; Stockton, California; Riverside, California; and Cincinnati, Ohio.
There is good news. Research has shown physical activity – both aerobic and strength training – to be effective in preventing and reducing symptoms of anxiety and depression, improving mood and self-esteem, and improving quality of sleep.
ACSM issued a statement in August 2021 and is offering resources on the benefits of physical activity for those with mental health issues
“The Fitness Index Advisory Board hypothesized that poor mental health issues might be a significant factor because the pandemic disrupted every phase of our lives, some more than others,” said Stella Volpe, Ph.D., R.D.N., ACSM-CEP, FACSM, chair of the American Fitness Index Advisory Board. “Our decision to hone in on this important factor was accurate. We found that cities ranked in the top 25 tended to score well in personal health indicators; however, there was one exception – mental health. Four cities in the top 25 also ranked among the cities with the poorest mental health.”
ACSM and the Centers for Disease Control and Prevention (CDC) recommend at least 150 minutes per week of moderate-intensity aerobic activity, about 22 minutes per day. They also recommend muscle strengthening activity twice a week. Volpe said 22.4% of adults in the Fitness Index cities reported no exercise in the previous month, and only 50.9% met the aerobic activity guidelines, while an even smaller percentage (23.8) met the guidelines for both aerobic and strength activities.
“Increases in physical activity are likely to help reduce the mental health burden,” said Volpe. “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. Local community actions that change personal behaviors also reduce obesity rates, incidence of chronic disease and stress. ACSM and the Elevance Health Foundation now implement year-round education and outreach activities around the Fitness Index results to help identify needs in each city and contribute to potential solutions.”
Arlington, Virginia, earned its No. 1 designation for the fifth time, a Fitness Index record, by ranking first in six indicators and scoring among the top 10 cities in 19 of the 34 categories. Arlington was ranked No. 1 in both the personal health and community/environment sub-scores. All cities can be compared to Arlington or others ranked in the Fitness Index by accessing the online City Comparison Tool.
Additional findings from the 2022 Fitness Index rankings include:
- Cities ranking No. 1 for meeting exercise indicators included Arlington, Virginia, for exercising in the previous month; St. Petersburg, Florida, for meeting aerobic activity guidelines; and Anaheim, Irvine, and Santa Ana, California, tied for meeting aerobic and strength activity guidelines.
- There was an increase in the percentage of Americans exercising in the previous month (77.6%); sleeping 7+ hours/day (68%); and reporting excellent /very good health (55.9%), since last year’s Fitness Index.
- Tampa, Florida, jumped from No. 57 to No. 25 in the rankings, the largest shift being an improvement in personal health indicators. Tampa saw increases in exercise, sleep, and those in excellent/very good health. It saw decreases in reporting of poor physical health, angina/coronary heart disease, stroke and diabetes.
- Spokane, Washington, replaced Baton Rouge, Louisiana, in the Top 100 cities based on the U.S. Census population data. Spokane ranked No. 30 in the overall rankings.
The 2022 ACSM / Elevance Health Foundation Fitness Index rankings are listed below.
Overall Rank
1. Arlington, VA
2. Madison, WI
3. Minneapolis, MN
4. Washington, D.C.
5. Seattle, WA
6. Irvine, CA
7. Portland, OR
8. St. Paul, MN
9. Denver, CO
10. Chicago, IL
11. Oakland, CA
12. Boise, ID
13. Boston, MA
14. San Francisco, CA
15. Aurora, CO
16. Lincoln, NE
17. New York, NY
18. Atlanta, GA
19. Jersey City, NJ
20. San Jose, CA
21. Buffalo, NY
22. Honolulu, HI
23. San Diego, CA
24. Santa Ana, CA
25. Tampa, FL
26. Fremont, CA
27. Austin, TX
28. Sacramento, CA
29. Plano, TX
30. Spokane, WA
31. Anaheim, CA
32. Milwaukee, WI
33. Albuquerque, NM
34. Raleigh, NC
35. Tucson, AZ
36. Richmond, VA
37. Durham, NC
38. Pittsburgh, PA
39. St. Petersburg, FL
40. Miami, FL
41. Long Beach, CA
42. Glendale, AZ
43. Virginia Beach, VA
44. Omaha, NE
45. Newark, NJ
46. New Orleans, LA
47. Norfolk, VA
48. Chula Vista, CA
49. Colorado Springs, CO
50. Reno, NV
51. Orlando, FL
52. Los Angeles, CA
53. Winston-Salem, NC
54. Charlotte, NC
55. Cleveland, OH
56. Anchorage, AK
57. Dallas, TX
58. Chandler, AZ
59. Hialeah, FL
60. Scottsdale, AZ
61. Houston, TX
62. Philadelphia, PA
63. Nashville, TN
64. Stockton, CA
65. Mesa, AZ
66. Phoenix, AZ
67. Baltimore, MD
68. Cincinnati, OH
69. San Antonio, TX
70. St. Louis, MO
71. Jacksonville, FL
72. Greensboro, NC
73. Gilbert, AZ
74. Garland, TX
75. Fort Wayne, IN
76. Columbus, OH
77. El Paso, TX
78. Fresno, CA
79. Laredo, TX
80. Irving, TX
81. Corpus Christi, TX
82. Fort Worth, TX
83.5. Arlington, TX
83.5. Toledo, OH
85. Bakersfield, CA
86. Lubbock, TX
87. Chesapeake, VA
88. Kansas City, MO
89. Wichita, KS
90. Riverside, CA
91. Detroit, MI
92. Lexington, KY
93. Henderson, NV
94. Memphis, TN
95. Las Vegas, NV
96. Louisville, KY
97. Indianapolis, IN
98. Tulsa, OK
99. North Las Vegas, NV
100. Oklahoma City, OK
About the American College of Sports Medicine
The American College of Sports Medicine (ACSM) serves as the largest sports medicine and exercise science organization in the world with more than 50,000 international, national and regional members and certified fitness professionals. All are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine. ACSM advocates for legislation that supports continued funding of parks, trails and safe routes to school; the need for all Americans to meet the physical activity recommendations included in the National Physical Activity Guidelines; as well as the need for the guidelines to be regularly updated every 10 years. For more than a decade the ACSM American Fitness Index has provided an annual snapshot of community fitness for some of the largest cities and metros in the U.S. The 2022 ACSM American Fitness Index evaluated America’s 100 largest cities using 34 indicators representing health behaviors, health outcomes, built environment, recreational facilities and policy/funding. Cities with the highest scores are considered to have strong community fitness, a concept analogous to individuals having strong personal fitness. Find more details at http://www.acsm.org or follow us @ACSMFitIndex on Twitter/ #100FitCities.
About Elevance Health Foundation
Elevance Health Foundation is the philanthropic arm of Elevance Health, Inc. The Foundation works to advance health equity by focusing on improving the health of the socially vulnerable through partnerships and programs in our communities with an emphasis on maternal child health; substance use disorder; and food as medicine. Through its key areas of focus, the Foundation also strategically aligns with Elevance Health’s focus on community health and becoming a lifetime, trusted health partner that is fueled by its purpose to improve the health of humanity. To learn more about Elevance Health Foundation, please visit www.elevancehealth.foundation or follow us @ElevanceFND on Twitter and Elevance Health Foundation on Facebook.