Tulsa ranks among the least healthy U.S. cities

Tulsa has once again landed near the bottom of a nationwide ranking of the country’s healthiest cities, according to a new report from the American College of Sports Medicine.

The annual American Fitness Index evaluates the 100 largest U.S. cities on how well they support active, healthy lifestyles. While Tulsa ranked low overall—coming in at No. 90—experts say the data also show areas where the city is making progress.

What the study measures

The Fitness Index considers 35 factors to determine a city's overall ranking. These include:

1. Walkability
2. Air quality
3. Food access and insecurity
4. Mental and physical health statistics
5. Public recreation resources like trails, splash pads and pickleball courts

Researchers say the index is meant to gauge “community fitness,” a term they compare to personal fitness but applied to entire populations. Cities with higher scores tend to have more resources and fewer barriers to healthy living.

Tulsa’s 2025 ranking: The good and the bad

Tulsa ranked 90th out of 100, which is an improvement of five spots from the previous year.

While the city performed relatively well in the environmental and community resources category—placing in the top 50—its personal health indicators brought the overall score down.

Key data points include:

1. Only 6% of Tulsans eat more than three servings of vegetables per day
2. Fewer than 21% eat more than two servings of fruit daily
3. Just half of residents meet basic aerobic activity guidelines
4. Less than half report being in excellent or very good health
5. About 45% reported experiencing poor mental health in the past month
6. Tulsa has a higher-than-average rate of pedestrian deaths from traffic accidents

Additionally, the city spends less than the national average on parks, although it does offer more trail mileage than most cities its size.

OKC remains last; Arlington stays on top

Tulsa wasn’t the lowest-ranked city. That spot once again went to Oklahoma City, which placed 100th for the seventh consecutive year—a consistent pattern since the index’s inception.

RELATED STORY: Oklahoma City ranks as least healthy large U.S. city, new report says

The rest of the bottom five included:

1. Lubbock, Texas
2. North Las Vegas, Nevada
3. Memphis, Tennessee
4. Wichita, Kansas

At the top of the list was Arlington, Virginia, ranked No. 1 for the eighth straight year. Rounding out the top five were Washington, D.C., Seattle, San Francisco, and Denver.

A mixed picture for American fitness

Nationally, the report noted a growing interest in physical activity, with more Americans walking briskly, lifting weights or playing sports like pickleball.

However, troubling trends also emerged:

1. Air quality is getting worse in many cities
2. Food insecurity is becoming more widespread

How cities—and residents—can improve

The ACSM encourages city leaders to use the Fitness Index as a baseline for change. Recommendations include:

1. Investing in public green spaces and recreation areas
2. Expanding access to fresh produce and nutritious food
3. Promoting mental health services
4. Engaging residents in policy advocacy and neighborhood health programs

“By strengthening the community environment, cities make it easier for individuals to adopt healthier behaviors,” the report states.