A CITY CAN’T get “fit” without two kinds of citizens. It needs loads of people like you filling up local parks and speeding along freshly paved bike lanes and generally having a blast outside or in rec centers. But it also needs elected officials actively responding to the needs of these constituents by setting health policy and creating new public spaces and making sure that pothole in the bike lane gets fixed pronto.

The 20 winners that follow have all figured out the right balance between their active citizens and their active leaders. But how exactly did we arrive at this list?

We analyzed 100 of America’s most populous cities and gave each an activity rating based on fitness guidelines, as defined by the Centers for Disease Control and Prevention, and, on the flip side, the percentage of the population reporting inactivity. This rating contributed 50 percent of the weighted score.

Then we looked at general health, with our team determining the percent- age of the population reporting “good, very good, or excellent overall health,” according to the CDC and various state and county health records. We also pulled self-reported data about heart health and obesity. These three categories made up the other 50 percent of the weighted score, with obesity level carrying 25 percent, general health 15 percent, and cardiac health the remaining 10 percent.

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After calculating all that, we found a clear correlation between raw data and fitness culture (how much a city creates opportunities for fitness and encourages connection). A city’s culture of activity can play a large role in persuading people to exercise with others, says Dan Giordano, D.P.T., C.S.C.S., cofounder of Bespoke Treatments, a physical-therapy clinic.

“These top cities engage people to be active—whether it’s biking, hiking, or walking,” says Michael Fredericson, M.D., of Stanford Medicine’s Department of Orthopaedic Surgery. “Researchers now know that being in shape can involve more than working out in a gym.”

It can involve simply stepping outside and joining the community of active people in your city, even if—especially if—it didn’t make this list.

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1. San Francisco

California / Fitness Score: 98.2

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Although San Fran doesn’t have the highest good-health score (Madison took that one) or the lowest obesity percentage (Denver beat it out), it has the top activity score. It’s the epicenter of fitness tech, with Apple, Fitbit, and Strava nearby. So maybe members of the tech community are stoking one another’s activity goals to crush it in the 3,413 acres of open space and more than 220 parks where residents can run, swim, bike, throw a Frisbee, or do any other kind of high-energy thing in a hilly city built between the ocean and the bay.

2. Madison

Wisconsin / Fitness Score: 92.7

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Madison’s five lakes provide residents with year-round fitness: ice skating and fishing in the winter; swimming, kayaking, and stand-up paddleboarding (and even SUP polo) in the summer. The city also has the second-highest activity score and the second-highest heart-health score.

3. Seattle

Washington / Fitness Score: 92.5

2019 Rock'n'Roll Seattle Marathon and 1/2 Marathon

A scene from the 2019 Rock’n’Roll Seattle Marathon and 1/2 Marathon.

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