Arlington is again the fittest city in the U.S., according to researchers at the American College of Sports Medicine (ACSM) and Elevance Health Foundation. It’s a title the county has held for nine years in a row.
Washington, D.C., held fast to No. 2 ranking, while Minneapolis unseated Seattle for third, according to the 19th annual American Fitness Index, released July 14. The index evaluates the nation’s 100 largest cities using 35 indicators across two overarching categories: personal health and community/environment.
From this year’s findings, a tale of (two types) of cities emerges as the gap between America’s healthiest and least healthy cities grows. High-ranking cities are those “where healthy choices are built into everyday life, whereas low performers have “structural barriers [that] continue to limit long-term health,” according to a press release.
“Where you live increasingly determines how healthy you are,” says Stella Volpe, past president of ACSM and chair of the Fitness Index Advisory Board. “The healthiest cities don’t just encourage exercise—they make movement part of daily life through infrastructure, transportation and community design.”
Two other Virginia cities made some of the largest gains on the index since last year. Richmond shot up 20 spots, rising from No. 40 to No. 20, and Virginia Beach rose 17 places from 66 to 49.
Why Arlington Leads
Cities in the top 10 share several common traits, according to the report, including strong active transportation systems, high physical activity rates, broad access to parks and recreation, and policies that support active lifestyles.
“The cities that consistently rank at the top aren’t succeeding because of one program or one investment,” Volpe says. “They’ve built systems that support healthier living over time. They are the ones creating environments where physical activity can easily become a part of everyday routines.”
Arlington earned the top spot after residents reported that they exercised during the previous month, sleep more than seven hours a night and are in excellent or very good health. Additionally, the county has the lowest rates of smoking and diabetes.
In this year’s rankings, Arlington’s community/environment score did fall from No. 1 (which it held in 2025) to No. 3. That’s likely because of a 12.1% increase in food insecurity over last year, compared with other cities’ relative improvements, according to the findings.
Nationwide Health Hurdles
Rising food insecurity is a nationwide problem that Volpe noted last year. Ninety-nine of the 100 largest cities in the 2026 study reported higher rates than the previous year. Overall, food insecurity rose from 12.9% in 2025 to 14.4% in 2026.
“Multiple factors likely contributed to this trend, including economic pressures, increases in food costs and changes in programs that support food access,” the report summarizes. “The food insecurity data included in the 2026 Fitness Index reflect 2023 data, meaning that the most recent economic changes may not yet be fully captured. Because food prices continued to rise through 2024 and 2025, food insecurity may remain an important indicator to monitor in future editions of the Fitness Index.”
The report also noted a dramatic variation in air quality and its affects on asthma, which can limit physical activity for the 28 million Americans who have it. Cities nationwide have good air quality about 51% of the year, on average, although eight cities reported 10% or fewer days with good air quality. The index ranked Arlington No. 6 for air quality, with 84.4% of days having good air quality. (Last year, the American Lung Association’s 2025 State of the Air study gave the county an F.)
The county ranks much lower—72—for asthma. About 11.5% of residents suffer from it.
One way to improve air quality and opportunities for healthy activity, according to the report, is through investment in the local transportation infrastructure: “By improving air quality and expanding opportunities for safe movement, cities can help ensure that more residents, including those with asthma, are able to stay active and support their overall health,.”
