Methodology

To create the American Fitness Index, a national panel of 26 content experts evaluated 100 of the most populated U.S. cities on 35 evidence-based indicators across five areas:

• Health behaviors, which include the percentage of people who are at least moderately physically active, the percentage of people smoking, and the percentage of people sleeping at least seven hours a day
• Health outcomes, which include the percentage of people in excellent or very good health, the percentage of people with obesity, and the percentage of people with health insurance
• Built environment, which includes the air quality index, a biking score, a walking score, and the number of primary healthcare providers per 100,000 residents
• Recreational facilities, which include dog parks per 10,000 residents, recreational centers per 20,000 residents, and tennis courts per 10,000 residents
• Policy and funding, which includes park expenditure per resident and physical education requirements

This year, two new indicators (trail miles and splashpads) were added to the Fitness Index. The tennis courts indicator was also updated to include pickleball and dual-use courts. According to ACSM, these changes "reflect the importance of community assets that meet the evolving needs and demands of residents."

The health behaviors and health outcomes categories were used to create a personal health sub-group, and the built environment, recreational facilities, and policy and funding categories were used to create a community/environment sub-group.

The expert panel ranked each indicator, with unhealthy indicators being reverse ranked, and then the weighted ranks were used to create sub-scores. The individual weighted scores were also averaged for both sub-groups to create a total score. Both total scores and sub-scores for the 100 cities were then ranked. 

The fittest US cities

This year, the top 10 fittest U.S. cities were:

1. Arlington, VA
2. Washington, D.C.
3. Seattle, WA
4. San Francisco, CA
5. Denver, CO
6. Minneapolis, MN
7. Madison, WI
8. Atlanta, GA
9. Sacramento, CA
10. San Diego, CA

According to ACSM, there were some major changes in the rankings this year, with some cities moving up multiple ranks:

• Sacramento, California, moved from No. 32 in 2024 to No. 9 this year.
• All four Ohio cities (Cincinnati, Cleveland, Columbus, and Toledo) moved up in ranks this year, with Cincinnati making the highest jump from No. 62 to No. 35.
• Both Nebraska cities (Lincoln and Omaha) increased their ranks this year, with Lincoln moving from No. 23 to No. 16 and Omaha moving from No. 51 to No. 32.
• Similarly, both New Jersey cities rose in the ranks, with Jersey City moving from No. 42 to No. 28 and Newark from No. 47 to No. 29.

Improvements to fitness and ongoing challenges

According to ACSM, there was a significant increase in Americans' aerobic and strength activity across the different cities between 2024 and 2025.

In 2025, an average of 59.9% of city residents met aerobic activity guidelines, up from 50.9% in 2024. Of the 100 cities, 94 reported increased aerobic activity levels, with Plano, Texas, and Fort Wayne, Indiana, showing the largest increase. 

In ACSM's 2024 report, cities reported good air quality in almost two out of three days. However, in the 2025 report, cities reported good air quality on fewer than half of clear days over the last year. According to the report, wildfire smokes from Canada likely contributed to this decline in air quality, particularly for people in the Northeast and Great Lakes region.

More people also reported food insecurity in 2025 compared to 2024. In 2024, 10.4% of people reported food insecurity, which increased to 12.9% in 2025. The only city that didn't see any increase in food insecurity was Anchorage, Alaska.

According to ACSM, the increase in food insecurity may be due to the end of pandemic-era programs, including an expanded child tax credit. More people could also face food insecurity under the One Big Beautiful Bill Act, with an analysis from the Urban Institute showing that up to 22.2 million Americans could lose some or all their Supplemental Nutrition Assistance Program benefits.

Overall, Stella Volpe, ACSM's past president and chair of the Fitness Index Advisory Board, encouraged government leaders and citizens to review the report's findings and find ways to improve their health.

"More of us are finding meaningful ways to live healthier and embrace fitness opportunities," Volpe said. "All of us must maintain this momentum and encourage our leaders to make bold spending choices, policy decisions and infrastructure changes to increase opportunities for residents to be physically active and healthy – one city at a time."