Can you guess how healthy your city is?

With the release of the 2018 American Fitness Index, you might not have to. The report, issued by the American College of Sports Medicine, ranks 100 cities in the United States from healthiest to unhealthiest. Each city is rated in three categories: Overall health, which combines the score of the other two categories; personal health, taking into account the diets, diseases, and weights of individuals; and community and environment, that studies the city itself, like accessibility to parks and locally sourced food. Unfortunately, it’s not all down to how many pounds of fries each city consumes per year.

You can probably guess that cities like Portland and Seattle, which took the top fifth and sixth places, respectively, would score high on the health scale, but you might be surprised that it was Arlington, Virginia, that was rated America’s healthiest city. What probably comes as no surprise is that Midwestern and Southern cities, famous for comfort foods or cold, isolating weather, tended to score relatively low.

Cities that did get low scores shouldn’t despair, however, because the report brings awareness to some easily remedied issues—like the implementation of a weekly farmer’s market. With a little change, these cities could be scoring at the top of the index in a few years’ time.

25 Chandler, Arizona

You probably haven’t heard of the stunning metropolis that is Chandler, Arizona, likely because it falls into Phoenix’s metro area. This Phoenix suburb of about 250,000 residents marks the beginning of America’s 25 unhealthiest cities, narrowly pushing out Phoenix itself.

Chandler was ranked poor for parks, outdoor spaces, and walkability, but its residents did make 45th place for personal health, meaning low rates of disease and a balanced diet. Then again, it’s probably not great for the city’s reputation if the most famous local restaurant is called “Heart Attack Grill.”

24 Corpus Christi, Texas

In the land of barbeque, it’s no great surprise that many Texan cities are on the lower half of the health index’s ranking. Plano was the only high-ranking city, coming in 12th place. Corpus Christi, however, marks the first city in Texas to make the unhealthiest list.

The city’s low score is due to its lack of fruit and vegetable consumption, leading to high rates of heart disease and obesity. It is a relatively accessible city, and its location on the Gulf of Mexico persuades many to take up beachgoing and keeping active outdoors.

23 Baltimore, Maryland

Baltimore, a city known more for its close presence to Washington, D.C. than being a major city on the east coast, struggles with maintaining its collective health. Baltimore pales in comparison to neighbouring cities Arlington and D.C., which both score very high on the index.

Baltimoreans seem to have little interest in fresh produce and physical activity, despite having a moderate amount of outdoor space to encourage residents to spend time outside. It may be the Baltic temperatures in winter that discourage locals from exercising year-round, wouldn’t you rather be curled up with some mac and cheese during a snowstorm than commuting to the gym?

22 El Paso, Texas

Nestled in a corner of West Texas, El Paso reaps the benefits of sitting on the border with Mexico by having access to authentic, high-quality Mexican food. El Pasoans need only take a quick car ride across the border to be fully engulfed in a fajita dream.

Unfortunately, indulging every day in heavy foods has proven harmful to locals, who neglect exercising and eating healthy. The city is nearby to some spectacular desert landscape, though, so those who do enjoy nature can get a close look at the wildlife—from cacti to coyotes.

21 Columbus, Ohio

Ohio's capital is often overlooked as another quiet, Midwestern city, but it’s actually a busy hub. It’s got industry and plenty of jobs, science and educational facilities, and riverside parks. Residents of Columbus don’t seem too eager to use the park space, because the city comes in 63rd place for community health.

Like other cities, a huge health risk is the lack of healthy eating, especially fruit, and not getting enough exercise, combined with unhealthy habits that lead to heart disease and strokes. The good news is that taking advantage of Columbus’s parks and recreational areas could easily improve the city’s score tenfold.

20 Mesa, Arizona

Mesa is a lively city east of Phoenix, and has been since prehistoric times. Here, dinosaur fossils and ancient sites from the Hohokam tribe dot the surrounding area, and desert spas attract tired office workers and A-List celebrities alike. The arid desert paradise nearby draws hikers from around the world to its unique landscape.

But residents seem disillusioned with their local landscape. Although Mesa seems to be the perfect place for farmers’ markets and locally sourced foods, there are hardly any that are readily available on a regular basis. Likewise, there’s little to do outdoors within the city, and locals don’t often venture out to hike.

19 Philadelphia, Pennsylvania

The Founding Fathers wouldn’t be so proud of the great city of Philadelphia if they saw its ACSM score. One of the most important cities during the US Revolution, and currently the sixth largest in the country, Philadelphia is the only place where you can soak in the glory of the Liberty Bell while munching on the city’s signature sandwich—the Philly cheesesteak.

As long as you don’t consume too many of the Italian sandwiches, you should be okay, because Philadelphia ranks well for walkability and open park space, despite low ratings for healthy eating.

18 Arlington, Texas

Falling west of the Dallas-Fort Worth area, Arlington is home to AT&T Stadium, home of the Dallas Cowboys football team, but not all of its residents train as hard as these athletes.

In fact, Arlington has some of the lowest levels of physical exercise in all of the cities on the index. That, combined with low fruit and vegetable consumption and too few hours of sleep regularly, and Arlington could find itself with serious health issues in the future. Instead of fresh food, locals favour broomstick hot dogs—extra-long hot dogs with extra fats.

17 Fort Wayne, Indiana

Fort Wayne suffers from the lethargy of many Midwestern cities, whether from the cold winters or plain landscape. The people of Indiana don’t get the chance to be excited by rugged mountains or relaxing beaches, and perhaps the reason the city is reluctant to exercise is that it's bored.

There are very few parks and outdoor spaces in Fort Wayne. There’s also little emphasis put on healthy food and accessibility to quality food and restaurants. It is, however close to many of the Midwest’s biggest cities, where it can perhaps draw inspiration from their cuisines and quality of life.

16 Stockton, California

California is usually depicted as the kale-worshipping, juice cleansing type of state, but it can’t be said for all Californians. Stockton, a city in California’s Central Valley, is the worst city for communal health in the state.

Although it’s known as the “Asparagus Capital of America,” that asparagus is probably going to come to deep fried in Stockton. The city has high rates of diabetes, despite eating the appropriate amount of fruit and vegetables. In 2009, Forbes reported that Stockton is one of the most dangerous cities in the U.S., and maybe it’s all related.

15 Newark, New Jersey

New Jersey’s largest city, Newark, has scored low in almost all categories—poor sleep, unhealthy diets, little physical activity, and few outdoor spaces, as well as high levels of diabetes and heart disease. Residents did, however, commonly utilise public transportation as a primary means of travel.

Jersey City, the only other city in the state, came in 69th place overall, not a particularly good score but still better than its neighbour. New York City, just across state lines, came in 52nd place, so Newark might learn something about health from The Big Apple.

14 Lubbock, Texas

Lubbock, located in Texas’s panhandle is famous for its rock and roll scene, and infamous for its people’s health. Despite having a wide range of ethnic cuisine and farm-to-table options, obesity rates in Hub City are high. The city falls behind in most health aspects, scoring low in every category.

Lubbock still manages to excel in some respects, though, and has low rates of health-related illnesses. Its high school is one of the best in the country according to Newsweek, and it may just be teaching its students to lead healthy lifestyles.

13 Memphis, Tennessee

Another city with a legendary music scene, not quite so much as Nashville, but still drawing massive crowds of blues and rock fans yearly, Memphis is one of those Antebellum cities that has a unique character: southern, but picking up on the Appalachia personality of other parts of Tennessee.

As a southern city, you can assume that local cuisine is heavily influenced by soul food and barbeque. A quick Google search for “Memphis cuisine” turns up a number of front-page results with “soul food” in the title. Let’s not even start talking about Memphis’s love affair with fried chicken.

12 Laredo, Texas

Like El Paso, Laredo sits near the border with Mexico, and its local culture is heavily influenced by its neighbour. The city of fewer than 300,000 is not the biggest or most exciting in Texas, but it’s got a cultural mix of Mexican and all-American.

Most of the city’s food, though, revolves around burger joints and diners. You’ll find a few unique food trucks driving about the city, as well. Laredo is just a bit too fond of its fried food, because it ranks low for poor diets and not enough exercise.

11 Winston-Salem, North Carolina

Winston-Salem, though a large enough city, isn’t widely known compared to Charlotte and Raleigh, North Carolina’s more famous cities. The city’s architecture and museums are time capsules beginning in the 18th century with the Moravian people.

Winston-Salem is just lacking a reputation for its food, or perhaps just a good reputation. The ACSM rates it very low for not getting enough fruits and vegetables, and a general lack of access to fresh, local foods. Its lack of parks and difficult access for pedestrians also earns it a low score overall.

10 Tulsa, Oklahoma

Tulsa is a Plains city that grew rapidly during the 20th century oil boom. Its Philcade and Philtower buildings downtown are a remnant of the wealth that flowed into the city during the last century, but the city’s economy now relies on sectors like finance and technology.

Tulsa certainly has a pleasant aesthetic, but it falls short in terms of health. Tulsa has a unique food scene, from its food trucks to its traditional foods. Among homestyle cooking with a southern, country vibe to it, Tulsa is also famous for its Lebanese food due to the large amounts of immigrants in the area.

9 North Las Vegas, Nevada

Las Vegas is famous for a lot of things, but you don’t usually think of its food. Sin City’s local health is almost as sinful as its reputation. We all know you don’t head off for a weekend in Vegas for a juice cleanse, but the people who live there should double check that they’re not indulging too much, particularly on the north side of the city.

Residents are more prone to diseases like high blood pressure, diabetes, and heart disease, though the index doesn’t report if that could be due to a poor diet. On the bright side, the city does have ample park space.

8 Gilbert, Arizona

Like Chandler, Gilbert sits in the Phoenix metro area and has developed quickly from farmland to a suburban centre. It used to be called the Hay Shipping Capital of the World until the late 20th century when a city started developing.

Gilbert was never developed to be a health-conscious community. When it grew, it grew for industry and business, and its founders weren’t exactly concerned with building it to accommodate walking and leisure. Add in the fact that fresh food is difficult to come by, and Gilbert takes the place for America’s 8th unhealthiest city.

7 Fresno, California

Fresno, a small city in California’s San Joaquin Valley, is situated roughly in the centre of the state, but it’s technically in Southern California, a region that tended to score much higher on the index.

Though it’s close to some major national and regional parks like Yosemite, its residents collectively don’t get enough physical activity, lowering the city’s score. Fresno isn’t suited for pedestrians, and isn’t great for parks within the city limits. High blood pressure and asthma rates are high as well, leading to a poor score on the health index

6 Wichita, Kansas

Wichita is a lot cooler than you might think, and it’s got farm-themed museums with historical reenactments, Chinese gardens, and a T-Rex skeleton. But its health ratings aren’t so cool. It scored low in all areas, from diet to disease, and even its sleeping patterns were off.

Despite all this, Wichita is a large city (the largest in Kansas, in fact), and a lot is changing for it. Its food scene is opening up, and a number of farm-to-table restaurants are making their way in. Vegetarianism and veganism are also starting to take off, as they are in other parts of the country.