News — Indianapolis, IN (July 18, 2023) — Arlington, Virginia, and Washington, D.C., are the top cities in the 16th 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. Arlington was named “America’s Fittest City” for the sixth consecutive year, with top scores in both the personal health and community/environment sub-scores.
The ACSM/Elevance Health Fitness Index evaluated America’s 100 largest cities using 34 evidence-based indicators. Rounding out the top 10 fittest cities are Seattle, Washington; Minneapolis, Minnesota; Irvine, California; Madison, Wisconsin; San Francisco, California; St. Paul, Minnesota; Denver, Colorado; and Oakland, California (the East Bay city’s first time in the top 10). Full rankings and scores, a summary report, a city comparison tool and other insights are accessible on the .
“No city is immune to chronic disease, but fortunately, every city and every person can take positive steps toward creating healthier lifestyles,” said Shantanu Agrawal, M.D., chief health officer of Elevance Health. “Physical activity has proven to be an effective tool in reducing the prevalence of many chronic diseases.鈥疓etting sufficient physical activity could prevent one in 12 cases of diabetes, one in 15 cases of heart disease and one in 10 premature deaths. We also know that food is medicine, and consistent access to nutritious food is an essential part of maintaining health. When we provide our bodies with nutritious foods, we are less affected by diet-sensitive chronic conditions. Proper nutrition, fitness, and health are deeply connected, and when we prioritize all three, we can improve our quality of life.”
The science-based Fitness Index offers city leaders valuable data annually to make potentially life-changing decisions in policy, systems and environmental-change strategies that drive fitness and health improvements in their communities. The Fitness Index research findings indicated the impacts of the COVID-19 pandemic are still being felt across the country, and the full impact may not be known for decades.
“The importance of the Fitness Index has taken on new meaning for individuals and communities seeking to improve their health and well-being,” said Stella Volpe, Ph.D., RDN, FACSM, ACSM-CEP, chair of the American Fitness Index Advisory Board, and ACSM president-elect. “Research suggests that to improve physical and mental health, prevent disease and disability, and enhance quality of life for all Americans, we must create a culture that integrates physical activity into our daily lives.”
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 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.
“Unfortunately, Americans are still not moving enough,” said Volpe. “This underscores the need for local community leaders to step up and make bold spending choices, policy decisions and infrastructure changes to increase opportunities for residents to be physically active and healthy. Collective actions and resources at the community level greatly influence the health choices available to us, and the Fitness Index is a road map for where communities can improve.”
Arlington, Virginia, ranked among the top 10 cities for 16 of 34 indicators, giving it a balance of healthy behaviors and community assets. Arlington had the highest percentage of residents exercising in the last 30 days, the lowest percentage of residents with diabetes, no pedestrian fatalities and tied for cities with the highest percentage of residents who live within a 10-minute walk to a park. All cities can be compared to Arlington or others ranked in the Fitness Index by accessing the online .
Additional findings from the 2023 Fitness Index rankings include:
Cities in the top 25 generally scored well in health outcomes. However, cities outside of the top 25 took honors for lowest rates of asthma and heart disease, with El Paso, Texas, and Bakersfield, California, leading the way, respectively.
Riverside, California, improved the most, rising 18 spots (from No. 90 to No. 72) in the rankings, the largest shift being an improvement in personal health indicators — specifically, more people consuming fruits and vegetables and fewer days with poor mental health.
Santa Clarita, California, replaced Hialeah, Florida, in the top 100 cities based on the U.S. Census population data. Santa Clarita was No. 66 in the overall rankings.
Cities with the highest rates of one chronic disease tend to also have high rates of other chronic diseases and generally rank in the bottom 25 overall: diabetes and obesity (Laredo, Texas); high blood pressure (St. Petersburg, Florida); heart disease (Louisville, Kentucky); asthma (Fort Wayne, Indiana); and stroke (Winston-Salem, North Carolina).
The 2023 ACSM/Elevance Health Fitness Index rankings are listed below.
Overall Rank
1. Arlington, VA
2. Washington, D.C.
3. Seattle, WA
4. Minneapolis, MN
5. Irvine, CA
6. Madison, WI
7. San Francisco, CA
8. St. Paul, MN
9. Denver, CO
10. Oakland, CA
11. Portland, OR
12. Atlanta, GA
13. Chicago, IL
14. San Diego, CA
15. Boston, MA
16. San Jose, CA
17. Honolulu, HI
18. New York, NY
19. Spokane, WA
20. Santa Ana, CA
21. Austin, TX
22. Buffalo, NY
23. Boise, ID
24. Tampa, FL
25. Lincoln, NE
26. Plano, TX
27. Anaheim, CA
28. Fremont, CA
29. Pittsburgh, PA
30. Aurora, CO
31. Chula Vista, CA
32. Jersey City, NJ
33. St. Petersburg, FL
34. Albuquerque, NM
35. Colorado Springs, CO
36. Richmond, VA
37. Newark, NJ
38. Sacramento, CA
39. Miami, FL
40. Norfolk, VA
41. Virginia Beach, VA
42. Raleigh, NC
43. Milwaukee, WI
44. Orlando, FL
45. Charlotte, NC
46. Omaha, NE
47. Long Beach, CA
48. Durham, NC
49. Los Angeles, CA
50. Anchorage, AK
51. Houston, TX
52. Tucson, AZ
53. Cleveland, OH
54. New Orleans, LA
55. Baltimore, MD
56. Dallas, TX
57. Cincinnati, OH
58. Philadelphia, PA
59. Scottsdale, AZ
60. Chandler, AZ
61. Glendale, AZ
62. Greensboro, NC
63. Phoenix, AZ
64. El Paso, TX
65. Mesa, AZ
66. Santa Clarita, CA
67. Jacksonville, FL
68. Reno, NV
69. Columbus, OH
70. Garland, TX
71. Stockton, CA
72. Riverside, CA
73. Arlington, TX
74. Fresno, CA
75. Winston-Salem, NC
76. Laredo, TX
77. Gilbert, AZ
78. St. Louis, MO
79. Fort Worth, TX
80. Lexington, KY
81. Corpus Christi, TX
82. Irving, TX
83. Henderson, NV
84. Toledo, OH
85. Nashville, TN
86. Chesapeake, VA
87. Detroit, MI
88. Fort Wayne, IN
89. Las Vegas, NV
90. San Antonio, TX
91.` Kansas City, MO
92. Lubbock, TX
93. Indianapolis, IN
94. Tulsa, OK
95. Memphis, TN
96. North Las Vegas, NV
97. Louisville, KY
98. Bakersfield, CA
99. Wichita, KS
100. Oklahoma City, OK
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. For more than a decade and a half, the ACSM American Fitness Index® has provided an annual snapshot of community fitness for some of the largest cities and metros in the U.S. The 2023 Fitness Index evaluated America’s 100 largest cities using 34 indicators representing health behaviors, health outcomes, built environment, recreational facilities and policy/funding. Cities with the highest scores are considered to have strong community fitness, a concept analogous to individuals having strong personal fitness. Find more details at or follow us @ACSMFitIndex on Twitter/ #100FitCities.
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. Additionally, the Foundation also responds to disasters when our communities need us the most. Through its key areas of focus, the Foundation 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. The Foundation coordinates with the company’s year-round Dollars for Dollars program which provides 100 percent match of associates’ donations, as well as its Volunteer Time Off and Dollars for Doers community service programs. To learn more about Elevance Health Foundation, please visit or follow us @ElevanceFND on Twitter and Elevance Health Foundation on Facebook.
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