Run specialty retailers should check out the American College of Sports Medicine’s (ACSM) recently released list of the top U.S. cities for health and fitness. Conducted in partnership with the Elevance Health Foundation, ACSM’s comprehensive report ranks the 100 largest U.S. cities using 35 evidence-based health and environmental indicators.
The good news is that aerobic activity is up nearly nine percent across the country, with 94 cities showing improvement and more residents meeting strength activity benchmarks as well. The bad news: These gains are offset by rising food insecurity, reported in 99 of 100 cities and worsening air quality due to wildfires across the U.S. and Canada.
With that in mind, here are the 2025 Top 5 Fittest Cities in America, as listed by ACSM and reported by athletechnews.com:
1. Arlington, VA. Arlington remains the gold standard for urban fitness, holding the top spot in both personal health and community environment. It boasts high rates of physical activity, low smoking prevalence, strong access to parks and recreation and a health-forward infrastructure that supports year-round movement.
2. Washington, DC. Ranking first in trail mileage and top five overall, D.C. leverages its extensive network of walking and biking paths to encourage activity among residents. The city prioritizes access to public green spaces and fitness amenities while reducing barriers to active commuting.
3. Seattle, Washington. Seattle’s high personal health rank and strong community support have given it the number three spot. The city’s residents report high levels of aerobic and strength activity, supported by widespread access to recreation, walkable neighborhoods and a culture that embraces outdoor living despite weather variability.
4. San Francisco, California. San Francisco continues to perform strongly with low rates of chronic disease, high rates of active transportation like walking and cycling and robust community health resources. It has a high personal health score, bolstered by high fruit and vegetable consumption and lower-than-average rates of obesity and cardiovascular conditions.
5. Denver, Colorado. In part due to its mountainous surroundings, Denver ranks highly in both physical activity and environmental assets. It offers abundant park acreage per resident and excels in resident engagement with aerobic exercise, consistently in the top ten of these rankings.
Following closely behind are Minneapolis (6), Madison (7), Atlanta (8), Sacramento (9) and San Diego (10). Sacramento’s 23-place jump from last year signals major local investment in recreation and access, while San Diego re-entered the top tier with improved strength activity scores and a growing network of shared-use facilities.
While the overall trend points to more Americans getting active, 94 out of 100 cities improved in aerobic activity, nearly all reported increased food insecurity, driven by shifting federal policy. Air quality also worsened, with wildfire smoke affecting millions in the Northeast and Midwest.
This year’s Fitness Index introduced new indicators: trail mileage, splashpads and expanded tracking of tennis courts to include pickleball and dual-use courts, showing evolving recreational preferences. Washington, D.C. ranked No. 1 in trail miles, Boston in splashpads and Richmond, VA in courts. The Index also noted a promising 2.6 percent decrease in smoking rates across 73 cities and an increase in per capita park spending in 64 cities, seven of which reported increases of more than $100.
However, public health experts warn that environmental and socioeconomic threats remain. Food insecurity surged as pandemic-era assistance programs expired and wildfire-related air pollution affected millions, particularly in the Northeast and Midwest.
