Oklahoma City, Tulsa rank among least healthy large U.S. cities, new report says

A new study looking at America's 100 largest cities ranks Oklahoma City as the unhealthiest.

How do Oklahoma City and Tulsa rank?

An annual study examining the fitness of 100 of the largest cities in the United States ranked Oklahoma City in 100th place and Tulsa at 90th.

The American College of Sports Medicine (ACSM) published the 2025 American Fitness Index on July 22, which looked at how cities support healthy and active lifestyles and pinpointed ways city officials can improve residents’ quality of life.

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This year’s index weighed a city’s health, in terms of residents’ personal health and community assets, environment and its encouragement of healthy behaviors, including:

1. Health behaviors: e.g., percentage of people bicycling or walking to work, daily fruit and vegetable intake, and meeting aerobic and strength activity guidelines
2. Health outcomes: e.g., physical and mental health reports, obesity rates, and pedestrian fatalities vs. the resident ratio
3. Built environment: e.g., percentage of days with good air quality, food insecurity rates, and parks vs. resident ratio
4. Recreational facilities: e.g., the number of basketball hoops, splash pads and pickleball courts vs. residents
5. Policy and funding: local Complete Streets policy (how a community maintains safe streets for all ages), and park expenditure per resident

Based on personal and community health, Arlington, Virginia, came in first place. ACSM’s analysis named Oklahoma City the least healthy city, scoring 99th for personal health (22.9) and 96th for community/environment (27.9). The city retained its ranking from 2024.

Tulsa ranked 90th overall, scoring 98th for personal health (22.9) and 49th for community/environment (49.0).The report showed this was an improvement from the city’s 95th spot last year.

Based on personal and community health, Arlington, Virginia, came in first place, while Oklahoma City ranked last.

In a recent ranking by U.S. News & World Report, the city was named the "Best Big City to Live" in its report.

SEE ALSO: U.S. News & World Report ranks Oklahoma City as 'Best Big City to Live'

In that report, the city was praised for its affordability, short commutes, cultural growth and development projects.

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Key Findings for Oklahoma

Oklahoma City and Tulsa scored below average for all but one of the 9 indicators in this category. Notably, both cities scored significantly lower than the average and top-scoring city for:

Percentage meeting aerobic & strength activity guidelines

1. Average: 30.5
2. Oklahoma City: 26.2
3. Tulsa: 22.8
4. Richmond, VA (top): 40.2

Percentage using public transportation to work

1. Average: 4.8
2. Oklahoma City: 0.3
3. Tulsa: 0.8
4. New York, NY (top): 47.8

Percentage consuming 3+ vegetables/day

1. Average: 14.4
2. Oklahoma City: 8.9
3. Tulsa: 6.2
4. Lexington, KY (top): 21.5

Both metro cities scored around the average for percentage sleeping 7+ hours/day, with Oklahoma City scoring 66.7 and Tulsa scoring 65.7 in comparison to the 64.6 average. Arlington scored the highest at 76.4.

Health Outcomes

Oklahoma City and Tulsa scored around the average for the 10 indicators in this category. Some notable findings:

1. Percentage in excellent or very good health
2. Average: 47.8
3. Oklahoma City: 47.4
4. Tulsa: 45.1
5. Arlington, VA (top): 67.2
6. Percentage with obesity
7. Average: 31.6
8. Oklahoma City: 38.1
9. Tulsa: 34.7
10. San Francisco, CA (top): 20.1
11. Pedestrian fatalities/100,000 residents
12. Average: 3.6
13. Oklahoma City: 4.0
14. Tulsa: 4.9
15. Boise, ID (top): 0.0

Built Environment

Oklahoma City and Tulsa shared similar scores for some indicators in this category, including percentage with food insecurity (OKC: 14.7, Tulsa: 14.8, average: 12.9), and parks/100,000 residents (OKC: 2.8, Tulsa: 3.3, average: 4.0).

However, both cities differed greatly on other environmental indicators, with Tulsa scoring much higher on:

Percentage within a 10-minute walk to a park

1. Average: 72.3
2. Oklahoma City: 40.0
3. Tulsa: 65.0
4. Boston & San Francisco (top): 100

Trail miles/100,000 residents

1. Average: 27.8
2. Oklahoma City: 17.3
3. Tulsa: 35.4
4. Washington, D.C. (top): 235.3

Tulsa also scored at least 5 points higher than Oklahoma City for walk score (OKC: 34.1, Tulsa: 39.0, average: 47.9), bike score (OKC: 40.2, Tulsa: 47.2.3, average: 52.3), and percentage of days with good air quality (OKC: 50.9, Tulsa: 56.3, average: 47.8).

Recreational Facilities

Scores in this category also had a bigger difference between the two metro cities. Tulsa scored more than double of Oklahoma City when it came to splash pads/100,000 residents (8.4 vs. 3.4) and tennis/pickleball courts/20,000 residents (6.5 vs. 3.0). Tulsa also scored slightly higher for ball diamonds (3.2 vs. 1.2), basketball hoops (2.4 vs. 2.2), playgrounds (3.2 vs. 2.0), and swimming pools (1.2 vs. 0.8), 

Meanwhile, Oklahoma City only beat out Tulsa for recreational centers/20,000 residents (0.7 vs. 0.4), though the difference does not meet a point.

Policy & Funding

Data shows Oklahoma City spends more than Tulsa for parks, at $101 vs. $74 per resident. In comparison, ACSM reported the average city spends $150. Irvine, CA ranked at the top, spending $1,057 per resident for parks.

What Are America’s Fittest Cities?

1. 1: Arlington, VA
2. 2: Washington, D.C.
3. 3: Seattle, WA
4. 4: San Francisco, CA
5. 5: Denver, CO
6. 6: Minneapolis, MN
7. 7: Madison, WI
8. 8: Atlanta, GA
9. 9: Sacramento, CA
10. 10: San Diego, CA

What Are America’s Least Fit Cities?

1. 90: Tulsa, OK
2. 91: Bakersfield, CA
3. 92: Indianapolis, IN
4. 93: Port St. Lucie, FL
5. 94: San Antonio, TX
6. 95: Detroit, MI
7. 96: Wichita, KS
8. 97: Memphis, TN
9. 98: North Las Vegas
10. 99: Lubbock, TX
11. 100: Oklahoma City, OK

According to ACSM, the American Fitness Index was launched in 2008. You can find the full list of indicators and city rankings for this and past years on ACSM's website.

Read the 2025 American Fitness Index: