100-city average
50.8
From 26.6 in Oklahoma City
to Arlington's 85.1
ACSM American Fitness Index · 2018–2026
Arlington, Virginia has been America's fittest city for nine straight years. Washington, D.C. — the city it is a suburb of — is second. Look under the ranking and the two have swapped roles: D.C. does the exercising, Arlington gets the health.
the title measures the wrong halfWhat the ranking is actually comparing
Every July the American College of Sports Medicine ranks the 100 largest U.S. cities on 35 indicators of health and fitness, and every July since 2018 the answer has been Arlington, Virginia.
Arlington is not really a city. It is a 26-square-mile county of 240,000 people directly across the Potomac from Washington, and in this ranking it competes against Houston and New York. That framing matters, but it is not the interesting part. The interesting part is that its neighbor is right behind it, and the two win on opposite things.
Every indicator, both cities, 2026
Position on each track is the city's rank among all 100, best on the left. Grouped into ACSM's own three categories.
On the measures that ask whether people actually move, Washington wins almost everything. 68.1% of D.C. residents meet federal aerobic guidelines against Arlington's 65.7%. On the harder standard — aerobic and strength — it is 38.3% to 33.4%, third in the country versus twenty-second. Nearly 15% of Washingtonians bike or walk to work; in Arlington it is 5.4%. D.C. eats more fruit and more vegetables too.
Arlington takes three of the nine behaviors, and they are a revealing three: the loosest activity question on the survey — any exercise at all in the past month, where Arlington is first in America at 92.2% — plus sleeping seven hours and not smoking. Arlington's smoking rate of 1.2% is the lowest of any large city in the country, and eight times lower than Washington's.
Then the outcomes invert completely. Of the ten chronic-disease and health-status measures, Arlington beats Washington on nine. The exception is asthma, and it is a tie to a tenth of a point. Arlington has the lowest diabetes rate in the country and the best self-reported health; D.C. ranks 93rd of 100 on poor mental health days.
Washington is the city that exercises. Arlington is the city that is healthy. The index awards its title to the second thing.
2018 → 2026
Arlington's overall rank has been 1 in every edition since the index started ranking cities in 2018. The movement in this story is all Washington's: third in the first year, then a slump to sixth, then a steady climb back that has held it at #2 since 2023.
Arlington has never finished anywhere but first.
D.C. climbed from 16th to 3rd. This is where Arlington keeps the title.
In 2026 D.C. took first for the first time — and Arlington fell to third.
How D.C. won the infrastructure half
Washington taking the community and environment sub-score in 2026 looks like a story about investment. Some of it is: D.C. has 237.6 trail miles per 100,000 residents, the most of any large city in America and more than six times Arlington's 37.6. It has more recreation centers, more pools, more splashpads, a higher Walk Score, and spends $363 per resident on parks against Arlington's $282.
But a large part of the 2026 flip is a definition change. ACSM replaced parks per 10,000 residents with parks as a percentage of city area, reasoning that city officials control how much land they zone for parks but not how many people move in. The two measures rank these two places almost exactly opposite.
The 2025 measure. Arlington is small and park-dense per capita.
The 2026 replacement. Washington's federal parkland is a fifth of the District.
Arlington went from 15th to 37th on that single indicator and Washington from 52nd to 7th — a 45-place swing driven entirely by the denominator, in the same year Washington took the sub-score. Neither city built or lost a park to make it happen.
Three things to know before trusting a trend line
Most of these numbers don't update every year. The Fitness Index is published annually, but its sources are not. Between the 2025 and 2026 editions, the share of residents meeting aerobic guidelines was identical in 97 of 97 comparable cities. So was aerobic-plus-strength. So were fruit, vegetable and blood-pressure figures. In six editions, the headline physical-activity number has changed exactly once.
| Indicator | 2021→22 | 2022→24 | 2024→25 | 2025→26 |
|---|---|---|---|---|
| Meets aerobic guidelines | 99/99 | 99/99 | 4/100 | 97/97 |
| Meets aerobic + strength | 99/99 | 99/99 | 4/100 | 97/97 |
| Eats 2+ fruits a day | 99/99 | 5/99 | 99/100 | 97/97 |
| Eats 3+ vegetables a day | 99/99 | 5/99 | 99/100 | 97/97 |
| High blood pressure | 99/99 | 6/99 | 5/100 | 97/97 |
| Sleeps 7+ hours | — | 0/99 | 100/100 | 97/97 |
| Bikes or walks to work | 99/99 | 8/99 | 4/100 | 4/97 |
| Food insecurity | 2/99 | 1/99 | 0/100 | 0/97 |
| Obesity | 0/99 | 1/99 | 4/100 | 2/97 |
Air quality is measured by county, not by city. Arlington records good air on 84.4% of days; Washington, on the other side of the same river, on 63.7%. Both are real EPA readings from different county monitors — the same artifact that gives Phoenix, Mesa, Chandler, Gilbert, Scottsdale and Glendale one identical 9.0% between them, filling six of the ten worst-air slots with a single county counted six times.
And the comparison set changes underneath the ranking. Spokane, Norfolk and Fremont all placed in the 2025 top ten and are simply absent from the 2026 edition — they fell out of the 100 largest cities. Frisco, Cape Coral and Hialeah took their places. Some of every city's year-over-year movement is other cities arriving and leaving.
None of which makes Arlington's nine years fake. It has the lowest smoking rate, the lowest diabetes rate, the best self-reported health and near-universal park access in a country where the average city manages none of those. It just means the title is measuring a healthy population more than an active one — and on the active half, the city across the river is winning.