HEALTH
2 Missouri cities ranked among least fit cities in US
Ahmed JawadiUSA TODAY NETWORK
July 17, 2026, 5:11 a.m. CT
Two Missouri cities have once again ranked in the bottom half of this year’s list of the nation’s fittest cities
The annual fitness index, published July 14 by the American College of Sports Medicine and Elevance Health Foundation, ranks the nation’s 100 most populous cities on personal health and community/environmental health indicators
The gap between the healthiest and least healthy cities is growing wider, according to the report. It said that the fittest cities consistently combine lower obesity and chronic disease rates with higher physical activity, stronger active transportation and broad access to parks and recreation infrastructure. Conversely, low-ranked cities continue to struggle with higher obesity, lower activity levels, food insecurity and fewer opportunities to integrate movement into daily life
Here’s where the Missouri cities landed on ACSM’s 2026 fitness index:
St. Louis, Kansas City make 2026 list
- St. Louis: Overall rank No. 60
- Kansas City: Overall rank No. 82
While Kansas City maintains its No. 82 spot from 2025, St. Louis improved considerably — moving up 12 spots from its previous ranking
How healthy is St. Louis?
Overall, 46% of St. Louis residents were in excellent or very good health
Here’s how the city fared in health behaviors:
- 75% reported exercising in the previous month
- 53% are meeting aerobic activity guidelines
- 25% are meeting aerobic and strength activity guidelines
- 5% bicycle or walk to work
- 8% use public transportation to work
- 26% consume two or more fruits per day
- 13% consume three or more vegetables per day
- 62% sleep seven or more hours per day
- 17% report smoking
How did Kansas City fare in health behaviors?
Overall, 44% of Kansas City residents were in excellent or very good health
Here’s how the city fared in health behaviors:
- 77% reported exercising in the previous month
- 55% are meeting aerobic activity guidelines
- 24% are meeting aerobic and strength activity guidelines
- 3% bicycle or walk to work
- 2% use public transportation to work
- 22% consume two or more fruits per day
- 9% consume three or more vegetables per day
- 66% sleep seven or more hours per day
- 13% report smoking
What are the top 10 fittest cities in America?
The 10 fittest cities in the country share traits like strong active transportation systems, high physical activity rates, broad access to parks and recreation and policies that support active lifestyles
- Arlington, Virginia
- Washington, D.C.
- Minneapolis
- Seattle
- Denver
- San Francisco
- Irvine, California
- Atlanta
- Madison, Wisconsin
- Boston
What are the 10 least fit cities in America?
- Oklahoma City
- Memphis
- Port St. Lucie, Florida
- Indianapolis
- Lubbock, Texas
- Bakersfield, California
- Louisville
- Wichita, Kansas
- Detroit
- Tulsa, Oklahoma
