Many of the leading causes of premature death in the U.S. are related to lifestyle, among them poor diet and lack of adequate physical activity, both of which contribute to obesity and other morbidities. (The Centers for Disease Control and Prevention estimates the U.S. adult obesity rate to be nearly 42%, up from about 31% in 1999.)

Poor diet and lack of adequate exercise are leading causes of heart disease, stroke, type 2 diabetes, and some cancers. A balanced diet heavy with vegetables and light on sugars and foods containing fats that solidify at room temperature – like red meat, baked shelf-stable confections, and fried food – is crucial to preventing or mitigating these health conditions. So is regular physical activity.

To determine the least physically active cities in America, 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 384 U.S. metro areas. Both measures came from the 2021 County Health Rankings & Roadmaps, a collaboration between the Robert Wood Johnson Foundation and the University of Wisconsin Population Health Institute. (In contrast, these are the 50 most physically active cities in America.)

Of the 50 cities on our list, there are six each in Texas, Georgia, and West Virginia. The two least physically active cities – Pine Bluff, Arkansas, and Texarkana, a metropolitan area on the border with Texas and Arkansas – are also those with the highest rates of obesity. More than 42% of adults in these cities are obese. Four other cities have an obesity rate of at least 40%. Of all the cities on this list, only Jacksonville, North Carolina, has an adult obesity rate that’s below 30%. (Here’s a list of the most obese metro area in every state.) 

In most of these cities, more than one in ten adults has diabetes, led by 19% in Macon-Bibb, Georgia. Among all 50 cities, only Bowling Green, Kentucky, and Jacksonville, North Carolina, have adult diabetes rates below 10%. (Here are 10 warning signs you might have diabetes.)

The percentage of the population in these cities that has access to places for physical activity like nearby parks and gyms ranges from 44% in the metropolitan statistical area of Hanford-Corcoran, California, to 69% in Albany, Georgia.  

Click here to see the least physically active cities in America

At least 20% of local adults in these 50 MSAs don’t exercise at all; in Sherman-Denison, Texas, the rate is 35% – the highest.