Experts say living near a park, bike path or green space is just as important as having the motivation to achieve your fitness goals.
Not all communities offer such amenities.
Those who meet all the criteria will participate in the annual American Fitness Index Released on Tuesday by the American College of Sports Medicine (ACSM) and the Elevance Health Foundation, the index ranks the nation’s 100 largest cities based on 33 indicators of individual and community health. The index measures whether a city’s people walk or bike to work and how much a city spends on public parks. It also evaluates a city’s food security, smoking rates, overall mental health and the quality of sleep its residents get.
This year, Arlington, Virginia, Washington, DC, and Seattle were ranked in the top three healthiest cities in the nation, according to the index.
Shantanu Agrawal, chief health officer at Elevance Health, said the community environment and the social support it provides have a huge impact on an individual’s overall health.
“If people don’t have the right environment around them, whether that’s the built environment, whether that’s access to mental health services, food services, whatever the case may be, it’s going to impact their health and their health outcomes,” Agrawal said.
In a study last month, the World Health Organization Since 2010, adults Lack of exercise. Lack of exercise increases the risk of heart attack, stroke, type 2 diabetes, dementia and certain cancers.
The American College of Sports Medicine recommends at least 150 minutes of moderate-intensity aerobic activity each week and two days of strength-building exercise each week. In the 2024 index, only 51% of adults met the aerobic activity recommendation, and only 24% met the goals for both aerobic and strength-building exercise.
According to ACSM President Stella Volpe, exercise experts would like to see 80% of adults meet the weekly aerobic activity threshold. She said the goal of the index is to remind community leaders of the importance of promoting the health of their entire communities. This could include investing in hiking and biking trails, public parks and pedestrian-friendly spaces. Thus, the fitness index places a bit more emphasis on a community’s built environment than on individual health habits.
“We want to focus on the community because we think that’s what’s going to impact public health and get people outside more,” Volpe said.
The city is back on top
Arlington, Virginia, was ranked the healthiest city in the nation for the seventh year in a row. The Northern Virginia county ranked first in the community and environment index and fourth in the personal health index. One of Arlington’s strengths is that about 88% of residents said they exercised in the previous month.
Volpe said Arlington’s abundance of outdoor activities reminded her of the lifestyle she observed on a recent trip to the Netherlands.
“When you think about a city like Arlington, there’s definitely a culture of that,” said Volpe, who said the city’s built environment, including parks, bike paths and walking trails, contributes to an overall culture of wellness.
Arlington also scored highly on other indicators: 76% of residents get at least seven hours of sleep a night, and just over 3% are smokers, one of the lowest rates in the nation, according to the report.
Washington DC and Seattle came in second and third.
Washington DC, located just across the Potomac River from Arlington, is the second most fit city on the index. The fit index ranks cities, towns and villages, so multiple jurisdictions within a metropolitan area compete against each other.
Residents of the nation’s capital scored highly when it came to fruit and vegetable consumption: About 38% of residents consume two or more servings of fruit per day, the highest percentage of the 100 cities, and more than 21% of Washington residents say they eat three or more servings of vegetables per day, the second-highest percentage.
Washington state residents also ranked in the top five for exercising, taking public transportation, and biking or walking to work.
Volpe said Washington and Arlington are walkable cities with great public transportation and safe bike lanes that allow people to get exercise on their way to work.
“We forget about active transportation,” Volpe says. “We walk to work, we bike to work, or we walk to public transportation that will take us to work,” and often we walk from the train or bus station to the office.
Seattle, the third healthiest city, has the third highest rate of physical activity among its residents. It also ranks third in public spending on parks. Other cities in the top 10 include San Francisco, Madison, Wisconsin, Minneapolis, Denver, Atlanta, Irvine, California, and St. Paul, Minnesota.
Oklahoma City ranked last on the list. Port St. Lucie, Florida; Memphis; Wichita; and North Las Vegas. ReportsIncludes 100 individual city rankings.
Mental health concerns continue
The index also points out the role of mental health in the overall health of communities: About 45% of people nationwide say they had poor mental health in the past month. While more people are suffering mentally, about 38% of respondents said they had poor physical health.
The index points to disparities among people who lack access to mental health services. Volpe said the percentage of people reporting poor mental health spiked after the COVID-19 pandemic and has remained stable over the past two years.
Exercise can help improve mental health, Volpe said, but added that people often don’t get access to care.
“We need to make sure people have access to the right care when it comes to their mental health,” Volpe said.
Agrawal of Elevance said the index looks at the links between mental health, diet and physical health. Lack of access to healthy, nutritious food could lead to anxiety, or people may eat sugary, processed foods that increase their risk of diabetes.
“You can’t just choose physical health, or just focus on mental health,” Agrawal says, because ultimately, that won’t make you healthier. “You have to focus on all aspects of your overall health.”
