The 18th annual ACSM American Fitness Index ranked the 100 largest cities based on 35 indicators to reveal the fittest US cities for 2025. The Index is published by the American College of Sports Medicine (ACSM) and the Elevance Health Foundation, the philanthropic arm of Elevance Health, after tracking how well the 100 largest US cities support healthy and active lifestyles.
The top five cities in this year’s rankings are: Arlington, Virginia; Washington, D.C.; Seattle, Washington; San Francisco, California; and Denver, Colorado. Rounding out the top 10 fittest cities are Minneapolis, Minnesota; Madison, Wisconsin; Atlanta, Georgia; Sacramento, California; and San Diego, California.
The recent report showed a negative trend in three indicators – air quality, food insecurity and reports of excellent or very good health – each getting slightly worse. Ninety-nine of the 100 cities in the Fitness Index had an increase in their food insecurity percentage.
On a positive note, data show a commitment among the largest 100 cities, from both cities and their residents, to promote and maintain active lifestyles through increased aerobic and strength activities. Other improvements were seen in decreased rates of smoking, with 73 cities recording a 2.6 percent decrease on average.
Additional insights are accessible on the Fitness Index website.
