How U.S. Cities Are Ranked for Fitness
The American College of Sports Medicine (ACSM) publishes an annual American Fitness Index (AFI) to rank the health and fitness of the 100 largest U.S. cities. The index evaluates how communities support active lifestyles through individual behavior, public health data, and community infrastructure.
What the Fitness Index Measures
The AFI is based on two major categories:
- Personal Health Factors
Physical activity, obesity rates, smoking prevalence, sleep habits, and self-reported health. - Community and Environmental Support
Access to parks, bike paths, recreational facilities, public transportation, and local policies that promote movement.
The index relies on verified data sources and uses consistent, science-based methodology.
2023 Rankings – Strong Performers and National Trends
In 2023, many U.S. metro areas saw improvements in health-related scores. This suggests progress in physical activity, nutrition, and access to wellness resources.
Top Cities in 2023
1. Washington, D.C. (Score: 77.9)
- 80% of residents reported recent physical activity
- Only 12.6% of residents smoke
- High park access and strong cardiovascular health data
- Ranked 2nd in Personal Health, 3rd in Community Health
2. Minneapolis, MN (Score: 76.2)
- 59% reported excellent or very good health
- Low obesity and smoking rates
- Ranked 4th in Personal Health, 2nd in Community Health
3. Denver, CO (Score: 72.6)
- Lowest obesity rate: 20.8%
- Ranked 1st in Personal Health
- Lower community support ranking (8th)
Other top-10 cities in 2023 included:
Portland, San Francisco, Seattle, Boston, Salt Lake City, Hartford, and San Diego
2024 Rankings – Updated Leaders in Urban Fitness
In 2024, the AFI reflected new data and emerging trends. While some cities maintained their strong positions, others rose in the rankings due to improved health metrics and better infrastructure.
Top Cities in 2024
1. Arlington, VA (Score: 85.6)
- 87.8% engaged in recent exercise
- Only 3.4% smoke
- Nearly all residents live within a 10-minute walk of a park
- Ranked #1 for the seventh year in a row
2. Washington, D.C. (Score: 77.4)
- Leads in fruit and vegetable intake
- Highly active commuting and public transit use
- Continues to perform well in both health and infrastructure categories
3. Seattle, WA (Score: 74.7)
- Invests $321 per person in parks annually
- High physical activity and walkability levels
Other cities in the 2024 top 10 included:
San Francisco, Madison, Minneapolis, Denver, Atlanta, Irvine, and St. Paul
Key Takeaways: What Sets These Cities Apart
- Consistency in Health: Cities like Arlington, D.C., and Minneapolis show a long-term commitment to public health.
- Infrastructure Matters: Parks, bike lanes, and walkable streets boost a city’s overall fitness score.
- Health Behaviors Still Need Work: Mental health and sleep quality remain areas for improvement.
Summary
The American Fitness Index highlights how health outcomes are influenced not just by individual habits but by community structure. Cities that prioritize green spaces, mobility, and healthy food access foster healthier populations.