The first thing I did when I moved to Long Beach was sign up for a race.
Running in your community is a great way to get to know a new city.
People living in America’s healthiest cities are more likely to walk briskly and go to the gym regularly. They also have lower rates of obesity and chronic diseases.
But cities that foster healthy communities play an equally important role. Consistently ranked among the best cities in the nation by the ACSM American Fitness Index, the city promotes physical activity with parks, trails, access to public transportation, and strong environmental markings.
The report says food insecurity is a growing concern even in the healthiest cities.
The annual Fitness Index, released July 14 by the American College of Sports Medicine and the Elevance Health Foundation, ranks the nation’s 100 most populous cities based on personal health and community/environmental health indicators.
Arlington, Virginia has been ranked the healthiest city in the nation for nine consecutive years. Washington, D.C., ranked second, followed by Minneapolis, Seattle and Denver. Oklahoma City ranked at the bottom of the list. Memphis; Port St. Lucie, Florida; Indianapolis and Lubbock, Texas, rounded out the bottom five of the rankings.
Stella Volpe, chair of the ACSM Fitness Index Advisory Committee, said the report revealed a widening gap between the healthiest and least healthy cities.
Residents of cities with higher scores had lower rates of obesity and chronic disease, higher levels of physical activity, and better access to walking and biking trails, public parks, and public transportation. The opposite is true for communities with low scores, Volpe said.
“If you have better access to parks and playgrounds, if you can do pull-ups outside, if you improve the walkability of your city, those things will resonate,” Volpe said. “But if your city is one where there are barriers to getting to those places, it’s not going to resonate.”
Food insecurity worsens in all but one city
All major cities in Orange County, California, except Santa Ana, reported worsening rates of food insecurity. Food insecurity is when people do not have access to, or do not believe they can access, nutritionally adequate and safe food due to financial or geographic constraints. Food insecurity rates increased by 1.5 points on average, rising from 12.9% in 2025 to 14.4% in 2026.
Rising food prices are making it difficult for most Americans to pay for healthy, nutritious food. And changes under President Donald Trump’s signature Tax Cuts and Spending Act of 2025 also changed eligibility for food assistance for low-income households.
The 2025 bill cut funding for the Supplemental Nutrition Assistance Program (SNAP), formerly known as food stamps, which provides food assistance to millions of families. The federally funded, state-administered program also has stricter work requirements for recipients.
“Families eligible for SNAP have very low incomes that are used to pay rent, child care, and gas for their cars,” said Stacey Dean, executive director of the George Washington University Global Food Institute. “SNAP was delivering groceries through the door. I am very concerned about what is happening to these families who are juggling yet another very difficult challenge in their lives.”
Dean said the changes to SNAP under “one big, beautiful bill” backed by congressional Republicans are the largest since 1996 under President Bill Clinton. But she said many families took advantage of the strong U.S. economy in the late 1990s and took higher-paying jobs, making them ineligible for SNAP.
For many families, that’s probably not happening right now, Dean said.
“No one is convinced that families are leaving (SNAP) because they are better off,” said Dean, who served as deputy assistant secretary for the U.S. Department of Agriculture’s Division of Food, Nutrition and Consumer Services in President Joe Biden’s administration.
Does air quality limit outdoor activities?
The index also ranked cities by percentage of days with good air quality and asthma incidence. Approximately 1 in 10 adults in the 100 largest cities had asthma, but the rate varied by a factor of three by community. According to the index, Greensboro, North Carolina, has the highest asthma rate at 15.4%.
People with asthma or other respiratory illnesses may have a hard time staying healthy in cities with poor air quality. When you try to exercise outdoors, air pollutants can interfere with your breathing and trigger asthma symptoms.
Although older adults with asthma are often less active than other older adults, the index report notes that being active is important to improve overall health and quality of life. The index shows that people with asthma who maintain an active lifestyle are less likely to be hospitalized, miss school, or need medical attention to manage their symptoms.
This index report suggests that everyone, including people with asthma, may consider checking the air quality index to adjust their exercise and other activity schedules. Some people may prefer to exercise early in the morning or in the evening when pollution levels are lower. Some people may feel safer walking or exercising indoors.
These cities made the biggest gains
Richmond, Virginia, improved the most, moving up 20 spots to become the 20th-best city in the nation. Other cities with big jumps include Charlotte, North Carolina, which jumped 19 spots to No. 42; Virginia Beach moved up 18 spots to No. 61. Durham, North Carolina, moved up 17 spots to No. 49.
Volpe said the annual rankings are intended to honor cities with high scores, but also to encourage lower-ranked cities to make small changes to improve their local activity levels.
“Exercise is medicine,” Volpe said. “Physical activity can really reduce your risk of chronic disease, and any exercise is better than no exercise.”
