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California flexes fitness: Three cities land in top 10 of national health index

California's Fittest Cities in 2025: Insights from the ACSM Fitness Index

In the ever-evolving landscape of public health and wellness, the American College of Sports Medicine (ACSM) has once again released its annual Fitness Index, providing a comprehensive snapshot of how America's largest cities are faring in terms of physical activity, nutrition, and overall community health. For 2025, the spotlight turns to California, a state renowned for its diverse geography, from sun-drenched beaches to rugged mountains, which naturally lends itself to active lifestyles. This year's rankings highlight several Golden State cities that stand out for their commitment to fitness, but they also underscore ongoing challenges in promoting equitable access to health resources across urban and suburban areas.

The ACSM Fitness Index evaluates the 100 largest U.S. cities based on a multifaceted set of criteria, drawing from data sources like the Centers for Disease Control and Prevention (CDC), the U.S. Census Bureau, and various health surveys. Key indicators include personal health metrics such as rates of exercise, fruit and vegetable consumption, prevalence of obesity, diabetes, and cardiovascular diseases, as well as community and environmental factors like walkability scores, availability of parks and recreational facilities, air quality, and even policies supporting active transportation such as biking and public transit. The index aims not just to rank cities but to inspire actionable improvements in public health infrastructure.

Topping the list for California in 2025 is San Francisco, which secures a spot in the national top five overall. The city's high ranking is attributed to its exceptional walkability—think steep hills that double as natural workouts—and a robust network of bike lanes and public parks like Golden Gate Park. Residents here report some of the highest rates of meeting aerobic activity guidelines, with over 80% engaging in regular physical exercise. Nutrition plays a big role too; San Francisco boasts farmers' markets on nearly every corner, contributing to above-average fruit and vegetable intake. However, the index notes that high living costs can limit access for lower-income populations, creating disparities in health outcomes.

Close behind is San Diego, often dubbed "America's Finest City" for good reason. Ranking in the national top 10, San Diego excels in outdoor recreation opportunities, with its mild climate encouraging year-round activities like surfing, hiking in Torrey Pines State Natural Reserve, and beach volleyball. The city's emphasis on active commuting is evident in its expanding trolley system and bike-sharing programs, which help reduce sedentary behaviors. Community health initiatives, such as free yoga classes in Balboa Park, have boosted participation rates, particularly among families. Yet, the report highlights air quality concerns due to occasional wildfires and traffic congestion, which can deter outdoor exercise during peak pollution periods.

Los Angeles, the sprawling metropolis, makes a notable climb in the rankings this year, landing in the top 20 nationally. This improvement reflects concerted efforts to enhance green spaces amid urban density. Projects like the revitalization of the Los Angeles River and the expansion of Griffith Park have increased access to trails and open areas. LA's diverse population benefits from culturally tailored fitness programs, including community centers offering Zumba and tai chi classes that resonate with immigrant communities. On the nutrition front, the city's push for urban gardens and farm-to-table initiatives has helped combat food deserts in underserved neighborhoods. Despite these gains, challenges persist with traffic-related inactivity and higher rates of chronic conditions in certain districts, prompting calls for more inclusive policies.

Sacramento, the state capital, emerges as a surprise contender in the top 30, driven by its flat terrain ideal for cycling and a growing emphasis on riverfront recreation along the American River Parkway. The city's residents show strong adherence to physical activity recommendations, with many incorporating daily walks or runs into their routines. Public health campaigns have successfully reduced smoking rates and promoted healthier eating through school lunch reforms and community-supported agriculture. However, the index points out vulnerabilities to extreme heat waves, which can limit outdoor activities during summer months, emphasizing the need for climate-resilient fitness infrastructure.

Further down the coast, Santa Barbara shines with its Mediterranean climate and scenic beauty, ranking highly among mid-sized cities. The area's beaches and hiking trails in the Santa Ynez Mountains encourage a lifestyle centered on movement. Local policies supporting pedestrian-friendly downtown areas and low obesity rates contribute to its strong performance. In contrast, inland cities like Fresno and Bakersfield face hurdles, often ranking lower due to agricultural pollution affecting air quality and limited access to recreational facilities in rural-adjacent zones. These disparities highlight how geography influences fitness outcomes in California.

What sets the 2025 index apart is its deeper dive into mental health integration with physical fitness. For instance, cities like Oakland have invested in mindfulness programs combined with exercise, such as outdoor meditation sessions in regional parks, which correlate with lower stress-related health issues. The report also examines the role of technology in fitness, noting how apps and wearable devices have boosted engagement in tech-savvy hubs like Silicon Valley's San Jose. Here, corporate wellness programs from tech giants encourage employees to log steps and participate in group fitness challenges, leading to impressive metrics in workplace health.

Experts featured in the index emphasize that fitness is not just an individual pursuit but a community effort. Dr. Stella Volpe, ACSM president, notes that high-ranking cities demonstrate how policy can shape behavior: "Investments in safe, accessible spaces for movement pay dividends in reduced healthcare costs and improved quality of life." This sentiment is echoed in California's state-level initiatives, such as the expansion of CalFresh programs to include more fresh produce incentives, which directly impact nutritional scores.

Comparatively, California's cities outperform many in the Midwest and South, where factors like harsh winters or car-dependent sprawl hinder activity levels. Nationally, Arlington, Virginia, claims the top spot, but California's contingent holds its own, with multiple entries in the upper echelons. The index reveals trends like increasing vegetable consumption across the state, up 5% from last year, attributed to awareness campaigns post-pandemic.

For residents and policymakers, the Fitness Index serves as a roadmap. In high-scoring areas, maintaining momentum involves addressing equity—ensuring that fitness resources reach all demographics, including seniors and low-income families. Cities like Irvine in Orange County exemplify this with inclusive programs for adaptive sports, catering to people with disabilities. Meanwhile, lower-ranked spots like Riverside are encouraged to leverage their natural assets, such as the Santa Ana River trail, to climb the ranks.

The report also delves into the economic implications of fitness. Healthier populations mean lower absenteeism at work and reduced strain on healthcare systems. In California, where healthcare costs are among the nation's highest, improving fitness indices could save billions annually. Community leaders are urged to prioritize bike infrastructure, as seen in successful models like Davis, a smaller city not in the top 100 but often cited for its cycling culture.

Looking ahead, the ACSM predicts that climate change will increasingly factor into rankings, with cities adapting through shaded pathways and indoor recreation options. California's proactive stance on environmental health, including anti-pollution measures, positions it well for future gains.

In essence, the 2025 ACSM Fitness Index paints a vibrant picture of California's health landscape—one where innovation, nature, and policy intersect to foster fitter communities. While challenges like urban inequality and environmental threats remain, the progress in cities from north to south signals a promising trajectory toward widespread wellness. For Californians, these rankings are more than numbers; they're a call to lace up those sneakers, hit the trails, and build healthier habits together.

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