Indianapolis, IN — July 23, 2024 — Arlington, Virginia; Washington, D.C.; and Seattle, Washington, are the top cities in the 17th annual ACSM American Fitness Index® (Fitness Index) rankings published by the American College of Sports Medicine® (ACSM) and the Elevance Health Foundation, the philanthropic arm of Elevance Health. This year’s rankings and findings for America’s 100 largest cities also revealed significant changes and trends.
The Fitness Index results — based on 33 evidence-based indicators — showed more Americans are walking and biking to work, park expenditures are up, and food security improved slightly. Conversely, residents in the 100 largest cities are not exercising enough to meet minimum ACSM standards, the number of people getting seven hours or more of sleep each night is down and there was a decrease in reports of excellent/very good health as well as an increase in residents reporting poor physical health and mental health.
“As an organization that is committed to, connected to, and invested in our communities, the Elevance Health Foundation has pledged to strengthen our communities and address health inequities in our country. Similarly, ACSM works to extend and enrich lives through the power of movement,” said Shantanu Agrawal, M.D., chief health officer of Elevance Health. “The Fitness Index is the intersection between our aspirational paths, bringing our unified visions to life as we provide practical resources to communities.”
Dr. Agrawal added that “the Fitness Index is a powerful tool that can help us address the physical, behavioral, and social drivers of health in communities while providing the data and expertise that empower advocates and city officials alike. That means our partnership with ACSM extends to advocates across the nation who can leverage these insights and tailor their efforts to promote policies that address specific community needs.”
Rounding out the top ten fittest cities are San Francisco, California; Madison, Wisconsin; Minneapolis, Minnesota; Denver, Colorado; Atlanta, Georgia; Irvine, California; and St. Paul, Minnesota. Full rankings and scores, a call-to-action report, a city comparison tool, infographic and other insights are accessible on the Fitness Index website: acsm.org/fitnessindex.
“The Fitness Index offers four ways city leaders and residents can make a substantial difference: fuel knowledge, celebrate success, inspire action and join the movement,” said ACSM President Stella Volpe, Ph.D., FACSM, ACSM-CEP. “The significance and value of the index goes well beyond the rankings. City officials can use the Fitness Index as a baseline to measure progress and make data-driven decisions that improve residents’ health. This data can also serve as a yardstick for future evaluation, enabling cities to track their progress and celebrate their achievements in creating healthier and more vibrant communities.”
The top three cities in the Fitness Index enjoyed strong performances in distinctly different areas. Arlington ranked first in community/environmental indicators. And, although it ranked fourth in personal health indicators, Arlington had the highest rate of residents exercising in the previous month (87.8%), had the most getting seven or more hours of sleep a night (76.4%) and the lowest percentage smoking (3.4%).
Residents of Washington, D.C., ranked the best at eating their fruits and vegetables. They had the highest rate of consuming two or more fruits a day (37.9%) and the second best in consuming three or more vegetables (21.4%). The nation’s capital also ranked in the top five cities that exercised in the previous month, used public transportation, and biked or walked to work.
Residents of Seattle, Washington, have the third-highest rate of exercising in the previous month. They also value their parks, investing the third-highest amount for park expenditures at $321 per capita.
Two cities had significant rises in the rankings and two others saw substantial drops:
Lexington, Kentucky, ranked 49th, an improvement of 31 places. The people of Lexington increased the percentage who exercised in the previous month and reported excellent or very good health, fewer days with poor physical health and lower rates of obesity. The city also supported these healthy habits by investing in their parks with an increase in expenditures from $65 in 2023 to $88 in 2024 per capita.
Miami, Florida, improved 26 places to the 13th position overall. The personal health of Miamians ranked 16th, up 27 positions from last year. Among the personal health indicators there was an 11% increase in residents who exercised in the previous month and a decrease in those who smoke, down to 6.6% from 13.7% in 2023. Within the community health/environment indicators, there were improvements in the air quality index and an increase in park expenditures.
Conversely, two other cities experienced double-digit drops in the rankings.
Tampa, Florida, dropped 21 spots to the 45th position. The community/environmental indicators mostly stayed the same, but there were a number of small digressions in the personal health indicators: a decrease in residents who get at least seven hours of sleep and a decrease in feeling excellent/very good. In addition, there was an increase in reports of poor physical health and increases in obesity, asthma, strokes, diabetes and the pedestrian fatality rate.
Greensboro, North Carolina, ranked 80th, dropping 18 places from last year. The personal health indicators had a notable decrease in residents getting seven or more hours of sleep, a decrease in feeling excellent/very good and an increase in reports of poor mental health.
Volpe said there could be several reasons for a drop in ranking, but most cities are not significantly declining from year to year. “The biggest reason for a drop is that other cities are scoring slightly higher and bumping other cities down in the ranking,” she said.
ACSM recommends at least 150 minutes per week of moderate-intensity aerobic activity — about 22 minutes per day — and muscle-strengthening activity twice a week. Volpe said on average 78% of adults in the Fitness Index cities reported exercising in the previous month, but only 51% met the aerobic activity guidelines, while an even smaller percentage (24%) met both aerobic and strength activity guidelines.
“Post pandemic, Americans are not as active as we would like,” said Volpe. “To help facilitate this, local community leaders must step up and make bold spending choices, policy decisions and infrastructure changes to increase opportunities for residents to be physically active and healthy. The Fitness Index is a trusted road map showing sound strategies for communities to improve. By embracing collaborative advocacy and leveraging data-driven insights, we can collectively move toward a healthier future for America, one city at a time.”
The 2024 ACSM/Elevance Health Foundation Fitness Index rankings are listed below:
Overall Rank
1. Arlington, VA
2. Washington, D.C.
3. Seattle, WA
4. San Francisco, CA
5. Madison, WI
6. Minneapolis, MN
7. Denver, CO
8. Atlanta, GA
9. Irvine, CA
10. St. Paul, MN
11. San Diego, CA
12. Portland, OR
13. Miami, FL
14. Boston, MA
15. Honolulu, HI
16. St. Petersburg, FL
17. Pittsburgh, PA
18. Chicago, IL
19. Oakland, CA
20. Spokane, WA
21. San Jose, CA
22. Plano, TX
23. Lincoln, NE
24. Raleigh, NC
25. Albuquerque, NM
26. New York, NY
27. Boise, ID
28. Richmond, VA
29. Santa Ana, CA
30. Chula Vista, CA
31. Durham, NC
32. Sacramento, CA
33. Austin, TX
34. Colorado Springs, CO
35. Aurora, CO
36. Milwaukee, WI
37. Anaheim, CA
38. Buffalo, NY
39. Anchorage, AK
40. Fremont, CA
41. Norfolk, VA
42. Jersey City, NJ
43. Long Beach, CA
44. Virginia Beach, VA
45. Tampa, FL
46. Orlando, FL
47. Newark, NJ
48. Cleveland, OH
49. Lexington, KY
50. Charlotte, NC
51. Omaha, NE
52. New Orleans, LA
53. Dallas, TX
54. Los Angeles, CA
55. Philadelphia, PA
56. Tucson, AZ
57. Reno, NV
58. Baltimore, MD
59. Stockton, CA
60. Riverside, CA
61. Houston, TX
62. Cincinnati, OH
63. Scottsdale, AZ
64. St. Louis, MO
65. Glendale, AZ
66. Columbus, OH
67. Nashville, TN
68. Jacksonville, FL
69. Laredo, TX
70. Mesa, AZ
71. Chandler, AZ
72. Garland, TX
73. El Paso, TX
74. Phoenix, AZ
75. Fort Worth, TX
76. Winston-Salem, NC
77. Irving, TX
78. Fresno, CA
79. Detroit, MI
80. Greensboro, NC
81. Chesapeake, VA
82. Kansas City, MO
83. Fort Wayne, IN
84. Arlington, TX
85. Henderson, NV
86. Gilbert, AZ
87. Toledo, OH
88. Corpus Christi, TX
89. San Antonio, TX
90. Las Vegas, NV
91. Louisville, KY
92. Bakersfield, CA
93. Lubbock, TX
94. Indianapolis, IN
95. Tulsa, OK
96. North Las Vegas, NV
97. Wichita, KS
98. Memphis, TN
99. Port St. Lucie, FL
100. Oklahoma City, OK
Find more details at acsm.org/fitnessindex or follow us @ACSMNews on X, formally known as Twitter, #100FitCities.
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; and the need for the guidelines to be regularly updated every 10 years.
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 X and Elevance Health Foundation on Facebook.
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