The newly released 2026 American Fitness Index ranks the 100 largest U.S. cities based on the health of their residents and the ways their communities support active living. Commonly called “America’s Fittest Cities,” the annual report from the American College of Sports Medicine looks beyond exercise habits to consider factors such as chronic disease, park access, walkability, recreation facilities, and local policies that make physical activity easier. Beyond the rankings, the report provides guidance for all cities that want to enhance the health and wellbeing of their residents.
The new rankings and what they mean for Aiken is the topic of my Health & Fitness column in the Aiken Standard this week.
The index ranks cities in two broad categories. Personal Health measures residents’ behaviors and health outcomes, including physical activity, diet, sleep, smoking, obesity, diabetes, cardiovascular disease and mental health. Community and Environment evaluates the conditions that support—or discourage—healthy living. These include walkability and bikeability, public transportation, air quality, park access, trails, recreation facilities, and policies such as Complete Streets and school physical education requirements.
Cities receive points for favorable results and lose points for less favorable ones. The combined score is intended to show how successfully a community supports an active, healthy lifestyle.
Arlington, Virginia, ranked first for the ninth consecutive year, followed by Washington, D.C., Minneapolis, Seattle, and Denver. San Francisco, Irvine, Atlanta, Madison and Boston completed the top 10. Arlington led the Personal Health category, while Washington ranked first for Community and Environment.
The report also suggests of a divide in the health of our communities. Higher-ranked cities generally have lower obesity and chronic disease rates, more residents meeting activity guidelines, and stronger walking and biking systems. Still, rankings can change: Richmond, Charlotte, and Virginia Beach made some of this year’s largest gains.
The important lesson is that the healthiest cities make activity part of ordinary life. Residents are more likely to walk, bike, or use public transportation, not necessarily as a workout, but to reach work, school, stores and other destinations. They also have access to parks, trails, and recreation facilities where activity is safe, affordable and appealing.
In other words, being active requires personal responsibility, but our surroundings influence how easy that responsibility is to fulfill. Telling people to exercise is less effective when neighborhoods lack sidewalks, roads feel unsafe for bicycles, parks are difficult to reach, or recreation programs are unaffordable.
Aiken, like many small cities, is not ranked, but the findings still offer a useful guide to make our city “fitter.” We can continue connecting neighborhoods, schools, parks, businesses, and downtown with safe sidewalks, crossings, and bicycle routes. Complete Streets policies can ensure that road projects consider pedestrians, cyclists, older adults, and people with disabilities—not only automobiles. Parks and trails should be well maintained, shaded where possible, and accessible to residents throughout the community.
We can also expand low-cost recreation, support physical education and after-school activity, improve access to healthy food, and provide indoor options during extreme heat or poor weather. Because access alone does not guarantee use, programs and facilities should reflect what residents actually want and need.
Individuals have a role, too. We can use local parks and trails, participate in recreation programs, walk short trips when practical, and speak up when community plans affect opportunities for activity.
The Fitness Index reminds us that a fit city is not simply a place filled with fit people. It is a place intentionally designed to help more people become active and healthy. Aiken may never appear in this particular ranking, but it can still become a community where movement is a normal, safe, and enjoyable part of everyday life.
Dr Parr Says... 