Arlington, Virginia, has been named the nation's fittest city for the ninth year in a row, according to the 2026 American Fitness Index. The annual report, released on July 14 by the American College of Sports Medicine (ACSM) and the Elevance Health Foundation, evaluates the 100 most populous cities in the United States based on a combination of personal health metrics and community environmental indicators. Following Arlington, Washington, D.C. took the second spot, while Minneapolis, Seattle, and Denver rounded out the top five. At the other end of the ranking, Oklahoma City placed last, with Memphis, Port St. Lucie, Florida, Indianapolis, and Lubbock, Texas, completing the bottom five.
Stella Volpe, who chairs the ACSM fitness index advisory board, highlighted a growing divide between the healthiest and least healthy cities. Residents in top-performing cities benefit from lower rates of obesity and chronic disease, alongside higher levels of physical activity. These positive outcomes are strongly correlated with better access to public transportation, public parks, and dedicated walking and biking trails. Conversely, Volpe noted that cities scoring poorly often present significant barriers to these resources. She emphasized that while exercise is essentially medicine, the ability to access playgrounds, outdoor pull-up bars, or walkable urban environments is critical for community health. If a city does not provide these accessible spaces, the benefits of physical activity will not resonate with the population.
A significant portion of the 2026 report focuses on the rising concern of food insecurity. With the exception of Santa Ana, California, every major city analyzed reported worsening rates of food insecurity. On average, the national rate climbed 1.5 percentage points, rising from 12.9% in 2025 to 14.4% in 2026. This trend is occurring alongside legislative changes to the Supplemental Nutrition Assistance Program (SNAP), which provides essential food aid to millions of families. The 2025 bill reduced funding for the program and introduced stricter work requirements for recipients.
Stacy Dean, executive director of the Global Food Institute at George Washington University, expressed deep concern regarding the impact of these policy shifts. She noted that households qualifying for SNAP often have extremely limited income, which is already stretched thin to cover rent, childcare, and transportation costs. Dean, who previously served as deputy undersecretary at the U.S. Department of Agriculture during the Biden administration, pointed out that the changes under the Congressional Republican-backed "One Big Beautiful Bill" represent the largest adjustments to the program since 1996. While she acknowledged that families in the late 1990s were often able to leave the program due to a strong economy and higher-paying jobs, she expressed doubt that the same is true today. She stated that there is little confidence that families are leaving SNAP because they are better off financially.
The index also evaluated cities based on air quality and asthma rates. On average, approximately 1 in 10 adults in the 100 largest cities suffers from asthma, though rates vary significantly by location. Greensboro, North Carolina, recorded the highest asthma rate at 15.4%. Poor air quality can be a major deterrent to fitness, as pollutants can trigger respiratory symptoms and disrupt breathing during outdoor exercise. The report encourages individuals with asthma to monitor air quality indices to adjust their activity schedules, suggesting that some may find it safer to exercise during early morning or evening hours when pollution levels are lower, or to transition to indoor workouts. Staying active remains vital for those with asthma, as it can reduce the likelihood of hospitalizations, school absences, and the need for medical intervention.
Despite the challenges, some cities showed remarkable progress. Richmond, Virginia, achieved the largest gain in the 2026 ranking, moving up 20 spots to reach the 20th position. Other notable improvements included Charlotte, North Carolina, which rose 19 spots to No. 42; Virginia Beach, which climbed 18 spots to No. 61; and Durham, North Carolina, which jumped 17 spots to No. 49. Volpe concluded that the annual index is intended to celebrate high-performing cities while encouraging those at the bottom to implement small, actionable changes to improve community activity levels, reiterating that any movement is better than none.
Older adults with asthma often are less active than their peers, but the index report noted the importance of being active to improve overall health and quality of life. People with asthma who stay active are less likely to be hospitalized, miss school or need a medical visit to manage symptoms, the index said.
