Arlington, Virginia, has once again been recognized as the fittest city in the United States, according to the 2026 American College of Sports Medicine (ACSM) Fitness Index. This marks the ninth consecutive year the city has topped the annual report.

The Fitness Index evaluated the 100 largest U.S. cities based on 35 indicators across personal health, community infrastructure, and environmental conditions. Cities that performed well, like Arlington, demonstrated high rates of physical activity, low chronic disease rates, robust public transportation, and ample access to parks and recreation facilities.

Arlington's success is attributed to factors such as 92.2% of its residents exercising in the previous month, 76.4% sleeping at least seven hours a day, and 67.3% reporting excellent or very good health. The city also recorded the lowest percentages for smokers (1.2%) and residents with diabetes (5.7%). Extensive trail networks, bike lanes, and well-funded park and recreation facilities contribute to the city's active environment.

Following Arlington, Washington, D.C., secured the second position, with Minneapolis, Seattle, and Denver rounding out the top five. New York City ranked 26th, with only 74.4% of its residents exercising in the previous month and 43.6% reporting excellent or very good health. A significant 40.2% of New Yorkers also reported poor mental health.

The report also identified cities showing the most improvement, including Richmond, Virginia; Charlotte, North Carolina; and Virginia Beach, Virginia. At the lower end of the rankings, Oklahoma City, Oklahoma, placed 100th, preceded by Memphis, Tennessee, in 99th, and Port St. Lucie, Florida, in 98th.

The ACSM report underscored a growing disparity in health outcomes across American cities. Top-ranked cities exhibit obesity rates more than 10 percentage points lower than those in the lowest-ranked cities, and their residents are significantly more likely to meet recommended physical activity guidelines. Conversely, lower-ranked cities struggle with higher rates of chronic diseases such as obesity, diabetes, and cardiovascular disease.

Nationwide, food insecurity has increased for the second consecutive year, with 99 out of 100 cities experiencing higher rates. The national average now exceeds 14% of residents living with food insecurity. Air quality also varied significantly, impacting millions with respiratory conditions like asthma. On average, cities experienced good air quality on approximately 51% of days annually, with eight cities reporting fewer than 10% of days with good air quality.

The ACSM uses evidence-based indicators, reviewed annually by content experts. The report notes potential data limitations, including year-to-year sample variability, reliance on self-reported data, and occasional data availability issues.