The Most and Least Fit Cities in the U.S. – AskMen

Where you live can impact your dating success, overall lifestyle, and even your happiness. But have you ever considered that there may also be a connection between your location and your health?
For the past 16 years, The American College of Sports Medicine (ACSM) has published the American Fitness Index — an annual ranking of the 100 largest cities in the U.S. And you may be surprised by the 2023 results.
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The ACSM’s ranking is based on more than 30 different fitness-related metrics, which include:
Curious about how your city stacks up? Read on to find out the fittest — and the least fit — cities in the country.
According to the ACSM report, cities with the highest Fitness Index scores have more resources that support healthy living — a strong sense of community fitness. If you live in a super walkable city that offers lots of affordable gyms and fitness studios, it probably goes without saying that it’s a bit easier to stay in shape.
With that in mind, here are the cities that came out on top for fitness metrics:
Arlington earned the title of the fittest city in America for the sixth time — and also ranked first in both the personal health and community/environment sub-scores. Also worth noting? Arlington had the highest percentage of residents exercising in the last 30 days and the lowest percentage of residents with diabetes.
Runners-up Washington and Seattle both ranked among the top 10 cities for 13 different indicators. The ACSM found that residents of Washington are the best at getting those fruits and veggies in, and they also ranked in the top 10 for biking or walking to work. Residents of Seattle, meanwhile, have the fourth highest percentage of residents biking or walking to work — and the ACSM attributes this to the fact that the city has made obvious efforts to support bikers.
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Although San Francisco dropped down the rankings in 2021 and 2022, it finally returned to the top 10 fittest cities this year. Meanwhile, its neighboring city of Oakland just cracked the top cities for the first time in the ranking’s history.
On the other end of the spectrum, cities that rank low on the Fitness Index tend to have fewer resources to support healthy living — and/or more challenges that hinder it:
The cities that ranked in the bottom 25 overall tended to also have the highest rates of chronic diseases. For example, San Antonio, Lubbock, Wichita, and Louisville all ranked highest for obesity.
That said, the ACSM acknowledges that these cities often have low community/environment sub-scores, which indicates that residents probably don’t have enough community assets and support to help them lead a healthy lifestyle. The ACSM also notes that physical inactivity is often rooted in poor social and economic factors. This helps to explain the health disparities that affect marginalized communities.
These residents instead face inadequate or missing sidewalks and street infrastructure and fewer places that can be reached by walking or biking from home,” the ACSM writes. “Strategies to increase physical activity must include people who have historically been excluded from planning and implementation processes. In addition to parks and recreation and public health departments, transportation, city planning, waste management, and maintenance departments also play important roles in supporting infrastructure that promotes walking, biking, and other types of physical activity in daily life.”
Something to keep in mind with this ranking: just because one city ranks first doesn’t necessarily mean that it has excellent values across all indicators, and similarly, the lowest-ranked city doesn’t necessarily have the lowest values across all indicators.
“The ranking merely indicates that, relative to each other, some cities scored better than others,” the ACSM explains.
And apparently, the U.S. has some serious work to do across the board in terms of staying active.
“Despite the overwhelming evidence of the benefits of aerobic activity and strength training to prevent and manage chronic diseases, most adults are still not moving enough,” reads the ACSM report. “On average, 78.1% of adults in the Fitness Index cities reported exercising in the previous month, but only 50.9% met the aerobic activity guidelines and just 23.7% met the guidelines for both aerobic and strength activities.”
Not only that, but the ACSM reports that one-third of residents in the 100 largest U.S. cities are obese or have high blood pressure — and these numbers are rising compared to before the pandemic.
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