Methodology:

To determine the cities getting the least exercise, 24/7 Tempo created an index consisting of the share of adults who are physically active and the percentage of the population with access to places for physical activity in all 381 metro areas in the United States. Both measures came from the 2019 County Health Rankings & Roadmaps (CHR), a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute.

Obesity rates — the share of adult residents who report a body mass index of 30 or greater — as well as the share of adults who have access to exercise facilities and the share of the population reporting to be in fair or poor health, also came from CHR 2019. All CHR data is for the most recent year available. The age-adjusted percentage of the total population 20 years and over diagnosed with diabetes in 2016 came from the United States Diabetes Surveillance System, provided by the CDC.

Diabetes age-adjusted rates were provided at the county level, which were then aggregated to the metropolitan level using a weighted average, based on the percentage of the 2016 5-year population of each county within each metro area. 2018 population figures, as well as median household income, and poverty rate came from the American Community Survey 2018 5-Year Estimates.

The number of fitness and recreational sports facilities that feature exercise and other active physical fitness conditioning per 100,000 people came from the Census’ County 2017 Business Patterns.