Even cities that provide parks and trails for people to exercise and stay fit suffered worsening mental health during the pandemic.

The annual ranking of the nation’s fittest cities for the first time included data on the pandemic’s toll on mental health. With social isolation, job losses and supply chain challenges stressing Americans, nearly 40% of adults in the nation’s 100 largest cities reported poor mental health. 

“We found cities ranked in the top 25 tended to score well in personal health indicators, but the one exception was mental health,” said Stella L. Volpe, chair of the American Fitness Index advisory board.

She said the finding does not undercut evidence linking exercise and physical activity to improved mental health. “Beyond the benefits of physical health, we also know that regular physical activity can provide mental health and social health benefits,” she said.

The American College of Sports Medicine and Elevance Health Foundation has published the annual American Fitness Index ranking the nation’s 100 most populous cities for the past decade and a half. The ranking scores communities using city and county data for 34 variables of personal, community and environmental indicators. 

Arlington, Virginia, was the nation’s fittest community for the fifth consecutive year. Rounding out the top five: Madison, Wisconsin; Minneapolis; Washington D.C.; and Seattle.

Oklahoma City ranked at the bottom of the list. North Las Vegas, Nevada, Tulsa, Indianapolis and Louisville ranked in the bottom five. People can see how their city fared at americanfitnessindex.org/rankings.

How much did mental health suffer? 

Adults who had not previously reported anxiety or depression were more likely to report poor mental health during the pandemic. Some common causes might include social isolation, job loss or working in high-risk service jobs that were more likely to expose individuals to COVID-19, the report said. 

Among adults who never had a mental health struggle, 58% perceived the pandemic negatively affected emotional or mental health.

More than 51% of adults in New Orleans and Laredo, Texas, had at least one poor mental health day the previous month. Residents of San Francisco, Washington D.C. and San Jose, California, rounded out the lowest-scoring cities on mental health even though the three cities ranked among the healthiest, the report said.

The finding follows a Centers for Disease Control and Prevention survey of nearly 800,000 adults through Feb. 1, 2021 that found an increasing share of the population reported symptoms of anxiety and depression.