Fittest US Cities: Democrat-Led Metros Top Health Rankings

A shirtless Robert F. Kennedy Jr., often photographed in jeans and held up by supporters as a symbol of rugged wellness, has become one of the most visible faces of health policy in America since taking the health secretary post under President Donald Trump. But as he pushes his Make America Healthy Again agenda, the cities most aligned with his movement are lagging behind Democratic-led urban centers in the race to be the nation’s fittest.

In June, Kennedy, 72, brought back the presidential fitness test in schools — a move that drew predictable groans from generations of students familiar with its punishing mix of strength, endurance, speed and agility challenges.

Kennedy said the revival was driven by concerns over childhood obesity, the rise of chronic disease and declining overall health among young Americans. The test was first introduced in 1956 under former President Dwight Eisenhower and was eventually phased out during the 2012-13 school year.

‘More than 60 years ago, my uncle, President John F. Kennedy, challenged America to make physical fitness a national priority, because he understood that the strength of our nation begins with the health of our people,’ Kennedy said in a statement at the time.

‘We are giving parents, schools, and communities the tools to help children build healthy habits, strengthen their bodies, and discover what they’re capable of achieving.’

Kennedy’s broader health campaign has taken aim at everything from artificial food dyes to the food pyramid, forming a central part of his MAHA platform. The movement has also attracted followers who promote clean eating, reject seed oils and oppose vaccines.

Yet despite that intense focus on health and wellness, Republican-led cities are trailing Democratic-run metropolitan areas when it comes to physical fitness, according to an American College of Sports Medicine (ACSM) Fitness Index report.

No conservative city appeared in the top 10. The first Republican-led city to make the ranking was Dallas, Texas, which landed at No. 43. The city has a population of about 1.3 million, with the average resident falling between the ages of 20 and 39.

There are a few cities run by nonpartisan mayors that ranked above Dallas, such as Plano and Frisco, Texas. 

However, liberal cities far outranked the lands of MAHA, with Arlington, Virginia, coming in the top slot for the ninth year in a row. 

Arlington is followed by Washington, DC, Minneapolis, Minnesota; Seattle, Washington; Denver, Colorado; San Francisco and Irvine, California; Atlanta, Georgia; Madison, Wisconsin; and Boston, Massachusetts.

‘Public policy plays a major role in residents’ health,’ Bradley Schurman, CEO of Human Change and author of The Super Age, told the Daily Mail. 

‘Sidewalks, for example, not only create a physically healthier population, but also a mentally healthier one by fostering connections among residents.’ 

While traveling the US in the past year to research his upcoming book The Geography of Prosperity, Schurman found that mayors – regardless of political affiliation – who focus on making public health investments are seeing positive changes in their communities. 

He highlighted how Oklahoma City, which is run by a Republican mayor and is the third largest conservative city in the nation, has implemented a temporary penny tax to help fund 200 miles of sidewalks. 

He also pointed to Democratic-led Tulsa, which was gifted $465 million to create 66.5-acre Gathering Place Park, which was largely paid for by philanthropist George Kaiser. 

‘People are using these spaces, but it takes time to change overall health behavior,’ the author said. 

While visiting Sioux Falls, South Dakota, he took a 15-minute walk to a meeting, where his host was ‘horrified’ that he would do such a thing. 

‘For her, at least, that was a car journey,’ he said, explaining how despite public efforts, it can take time for people to readjust expectations and habits. 

But for Shurman, who lives in Washington, DC, and hasn’t owned a car in more than 10 years, the walk was not out of his norm, as he has ‘exercise built into my daily life.’ 

‘Whether that’s running to the grocery store or the coffee shop,’ he said. ‘I often take Metro to the airport, too, which adds at least 15 minutes of walking. Those little things add up over time, and contribute to DC and Arlington’s incredible score.’ 

Shurman said Irvine jumping up five spots and Boston reentering the top 10 are all due to the local governments making ‘sustained, multi-year capital investments in parks, transit, and walkable infrastructure, and kept funding them across administrations.’ 

Jose Guevara, a fitness instructor in Georgia, told the Daily Mail that healthier cities are designed to encourage exercise by ‘making moving easier to include in everyday life.’ 

‘People are more likely to be active when exercise is easy and convenient,’ he told the Daily Mail. 

‘Cities near the top of the rankings often have strong public transport, accessible parks and recreation centers, walking routes, and cycle lanes. These features allow residents to walk or cycle to nearby places, take their children to a park or use local fitness facilities more easily.’ 

Other ways the top cities help promote healthy living are by having a variety of options, as not everyone enjoys running or lifting weights. By adding bike lanes, a city can encourage riders to pedal through the streets. And by adding sidewalks, it can help residents access parks and gyms. 

‘The main lesson is simple: the highest-ranked cities make healthy choices easier,’ Guevara said. ‘When communities provide safe, affordable, and convenient ways to move, residents are more likely to stay active and support their long-term health.’ 

However, even cities like New York City, which is arguably the most walkable city in the US and the largest, don’t rank nearly as high as one would expect. 

It’s currently ranked 26th, despite Democratic Socialist Mayor Zohran Mamdani recently announcing a temporary closure of streets to allow students to play soccer during the World Cup, and Governor Kathy Hochul providing state residents with 20 hours of prenatal leave for expecting mothers. 

Both of those policies – alongside walkability and access to public transit and green spaces – will improve overall public health in New York. However, the Big Apple’s rank is lower due to higher levels of chronic disease, ACSM President Stella Volpe told the Daily Mail. 

The US’ second biggest city, Los Angeles, also ranks fairly low at 55th out of 100 cities. Despite having nearly four million residents and stereotypically being the land of Pilates and green juice fanatics, it ranks lower due to its dependency on cars and its lack of robust public transit, Volpe said. 

‘The public image of a fit city may reflect affluent neighborhoods rather than the average experience of the entire population,’ Dr Pablo Prichard, a longevity expert and host of NBC’s Forever Young, told the Daily Mail. 

‘New York contains enormous differences between neighborhoods. Some residents have extraordinary access to parks, healthy food, and medical care, while the opposite is true in other neighborhoods,’ he said. 

‘Los Angeles has favorable weather and a visible fitness culture, but much of the city is highly car-dependent. Long commutes, fragmented sidewalks, and widely separated destinations make routine walking difficult for many residents.’ 

Washington, DC, which also has a robust public transit system and is more walkable like NYC, ranks number two. 

‘We profess that exercise is medicine,’ Volpe said. ‘For us, it’s a way for cities to learn more about where they are. It’s not meant to shame any city if they didn’t rank high, it’s meant to have cities evaluate,’ she said of the annual fitness report. 

‘Truly where people live increasingly shapes how healthy they are.’ 

The index report, which started in 2017, looks at various public data sets, including from the CDC, to evaluate human health, like smoking and chronic illness levels, and infrastructure, like accessibility and proximity to green spaces. 

‘The top performing cities consistently have lower obesity and chronic disease rates. They tend to have higher physical activity levels. They have better walking, biking, and public transportation infrastructure. And they have greater access to parks and recreation sites,’ Volpe said. 

‘Sadly, the gap between those healthiest cities and those that are the least healthy has continued to widen.’ 

The gap largely comes down to resources, Volpe said. 

Where New York City might have the funds to offer universal childcare, other places, like Texas, may not. The city’s budget has to be divided differently and go to different resources, meaning investing in public health isn’t always possible. 

But even the cities that do have the budget to invest doesn’t mean people start using the resources. 

Cities can add more lighting to streets or open a new park, but if residents don’t know about it or don’t perceive it as safe, it might go unused, and therefore, the city’s ranking would still be lower.

It takes time to see the new or improved spaces truly impact one’s community. 

‘If you build it, people don’t necessarily come,’ Volpe said.   

‘Simply having a park or sidewalk on a map is not enough,’ Prichard echoed.

‘Those spaces also have to be safe, well maintained, connected to neighborhoods and usable when people are actually free, early in the morning, after work, or at night. A city can have substantial green space and still have poor health outcomes if residents do not feel safe using it or cannot reach it conveniently.’

Prichard also said that many public initiatives – such as zoning and parks – might not seem like healthcare policies, but they are. 

‘They eventually show up in healthcare outcomes,’ he said. 

The doctor said that although Democratic leaders typically support things, like public transportation and bike infrastructure, it doesn’t necessarily mean liberal policies are better. 

‘The bottom-ranked cities are politically mixed and include several cities with Democratic mayors, that alone shows that party affiliation does not determine fitness,’ Prichard told the Daily Mail.

As for RFK Jr’s MAHA movement, Prichard said it’s too early to tell if the federal initiative will have a positive impact on society.  

‘The value of Make America Healthy Again will ultimately be judged by measurable results: whether people eat better, move more, develop less chronic disease, and gain access to healthier choices, regardless of income or ZIP code,’ he said. 

‘The healthiest city is not necessarily the city with the most gyms or parks. It is the city where ordinary people can safely and realistically live an active, well-nourished, socially connected life.’ 

The ACSM is not a political institution, and Volpe declined to answer questions regarding the implications of political parties in relation to health. 

‘We’re not evaluating politics,’ she told the Daily Mail. ‘We’re evaluating what is going on in each city, and our goal is to try to make people more active, and highlight where their cities land.’ 

The Daily Mail has reached out to the Department of Health for comment.