The annual report, published by the American College of Sports Medicine, measures health and fitness levels in 50 of the country's major metropolitan areas. Researchers rank the cities by looking at obesity, smoking and diabetes rates, as well as access to healthy environmental factors, such as farmers markets, parks and recreational facilities.
Overall, the U.S. has seen a shift toward healthier lifestyles since last year's report. The amount of people smoking dropped 4.7 percent, the number of diabetes-related deaths dropped 7.4 percent, and twice as many states had policies that required schools to teach physical education.
The researchers also found that the policies and physical layout of a city can determine how healthy its residents will be.
"Cities with a built-in environment that supports people who want to be healthy, generally have a healthier population," Walter Thompson, professor of kinesiology and health at Georgia State University and AFI advisory board member, told The Huffington Post.
"Cities that fall on the low end of our rankings have the opposite of that," he added. "They don't have the same number of parks, their cities aren't walkable, or they don't spend as much money [maintaining] their parks."
D.C., for example, spends $346 per resident on park-related expenditures, and 96.3 percent of residents live within a 10-minute walk to a park. Compare that to the report's lowest ranking city, Indianapolis, which only spends $24 per resident on park upkeep and has only 31.6 percent of its population living near a park.
The American College of Sports Medicine began publishing the AFI report in 2008 so policy makers could see what the country's fittest cities are doing differently and use that information in their own city planning.
The organization publishes the report with a downloadable Community Action Guide so that community leaders and residents can make significant changes in their city and boost public health initiatives.
Thompson says that residents in cities like Charlotte -- which has moved up from No. 43 in 2014 to No. 39 in 2016 -- have used the AFI guide to inspire change.
"A few years ago, the people of Charlotte wanted to see more farmers markets," Thompson told Huffpost. So some grassroots organizations came together and are "now a powerful voice to the city and to the mayor. They are demanding change and the mayor's listening."
Below, find out if your hometown made the cut:
San Diego, California
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Total Score: 64.1
Not only do the residents of San Diego eat more fruits and vegetables daily, they also engage in enough physical activity to meet the Center for Disease Control and Prevention's aerobic and strength activity guidelines.
Salt Lake City ranks high in walkability and offers its residents a number of options for physical activity with its many playgrounds, dog parks, golf courses and tennis courts. Its residents also smoked less than the rest of the country, while a lower percent of the population suffered from angina or coronary heart disease.
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Total Score: 67.0
Boston spends a lot on park-related expenditures per capita, giving its residents access to ball diamonds, playgrounds and city parks. It's also easy to get around the city on foot, which Bostonians take advantage of by biking or walking to work.
San Francisco, California
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Total Score: 69.3
With lots of parks and farmers' markets, San Fransisco makes it easy for its residents to make healthy decisions. A high number of San Franciscans eat veggies daily and make use of the city's public transportation system.
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Total Score: 69.0
Seattle had a high percentage of residents who were able to fit in exercise in the last 30 days. The also city has high level of requirements for Physical Education classes, with a good deal of residents who live near a park.
The walkable city of Denver has some of the lowest obesity rates, as well as low death rates for diabetes and cardiovascular disease. Lots of its residents live within walking distance of a park, making it easier to go for a healthy stroll.
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Total Score: 76.7
Minneapolis was dethroned as AFI's No. 1 fittest city in America in 2012, but that doesn't mean its residents are any less healthy. The Twin Cities continue to have low death rates for cardiovascular disease and diabetes and a high number of residents prefer to walk or bike to work.
District of Columbia
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Total Score: 77.9
For the last three years, Washington D.C. has led the pack as the country's fittest city, with some of the lowest rates of smokers and lowest death rates for cardiovascular disease and diabetes. The capital's residents have access to many parks, recreation centers and farmers' markets and the walkability of the city makes it easy to get around without a car.
Find out how all 50 major metropolitan areas ranked in the full report here.
This list has been edited for clarity to remove secondary municipalities that were initially included with the major cities in the MSAs above. For additional information about the statistical areas included with each city, please refer to The American Fitness Index.