We may be inclined to believe that people who are living in the countryside are healthier compared with those living in the cities since they have access to fresh food and produce, unpolluted air and all the benefits that nature has to offer.

This may be true at the onset of the industrial revolution when urban areas were still struggling with high population density, environmental pollution, and lack of proper sanitation, but fortunately, the condition has steadily improved today.

Note that while there are still city residents in poor countries who are still at risk of suffering from various health issues due to poor conditions, there are also numerous cities in the developed world that are enjoying the health benefits of living in urban environments, such as more access to fresh and healthy foods and better health care.

Are you curious if your city is one of the healthiest in the world?

We have here a list of the world’s healthiest cities as compiled by the financial news and opinion company, 24/7 Wall St. To determine who is included on the list, cities were rated based on three health outcomes and factors – infant mortality, life expectancy, and exposure to air pollution. See if your city made it to the top 20!

20 20. Shizuoka, Japan

Shizuoka is the capital city of Shizuoka Prefecture with a population of more than 731,000 people. The city’s infant mortality rate is considered one of the lowest in the world at 1.8 deaths per 1,000 live births. The average life expectancy of the residents in Shizuoka -- (81 for males and 87 years for females) -- is a lot longer than the world’s average of 68 years and 72 years for males and females, respectively. Citizens of Shizuoka are living healthy lives because of the city’s advantageous location, natural beauty (home of Mount Fuji), climate, as well as an abundance of natural produce like tangerine and greenhouse melons, spring water, green tea, and many others.

19 19. Niigata, Japan

Niigata is the capital and most populous city of Niigata Prefecture located in the Chubu region of Japan with a population of 1 million people. The city has the third lowest infant mortality rate of any major city in the world at 1.7 deaths per 1,000 live births. Niigata also has the longest average life expectancy in the world – 80 years for males and 87 for females. The air quality in Niigata is ideal for outdoor activities, which is perfect since there are tons to do in the city such as cycling, hiking, or just simply appreciating the beauty of nature.

18 18. Bilbao, Spain

Bilbao is the city in northern Spain with a population of 1 million people. At 2.8 deaths per 1,000 live births, Bilbao’s infant mortality rate is among the lowest in the world. Average life expectancy in the city is at 77 years for men and 83 for women, both are longer than the world average. Bilbao used to be a city of filthy buildings, foul air, and stinking rivers. In 1991, the city started and implemented its revitalization plan – eliminating pollution in the Nervion River, decontaminating and physically reconstructing large areas of land along the river, relocating shipping activity from the river to the bay, and investing in a public transportation system that connects communities. The plan was a success and Bilbao was awarded as European City of the Year at the 2018 Urbanism Awards.

17 17. Wakayama, Japan

Wakayama is located on the southern tip of the Kii Peninsula of Honshu island with a population of 521, 972 people. Just like many cities in Japan, Wakayama also has the lowest infant mortality rate in the world at 1.8 deaths per 1,000 live births and one of the highest average life expectancies at 80 for males and 86 years for females. The city is known for working on good health by helping the citizens increase their good nutrition and dietary habits, promoting healthy lifestyle like exercising regularly, and focusing on nutrition education. The quality of air in Wakayama is perfect for outdoor activities as it is rated good based on Air Quality Index (AQI).

16 16. Nagasaki, Japan

Nagasaki is the capital and largest city of Nagasaki Prefecture with a population of over 508,000. While it suffered tremendously after the atomic bombing of the United States in 1945, the city recovered and continue to prosper. Nagasaki has the 8th lowest infant mortality of any major city in the world. While the long-term health effects of the bombing continued to haunt the citizens, the people’s lifestyle, health habits, and the city’s environment condition (air quality is rated “Good” in Nagasaki) are factors as to why Nagasaki still has one of the highest average life expectancy in the world, 80 for males and 87 for females.

15 15. Nagano, Japan

Nagano is the capital city of Nagano Prefecture in the Chubu region of Japan with a population of more than 533,000 people. Infant mortality rate in this city is one of the lowest in the world at 1.6 deaths per 1,000 live births. Average life expectancy for women in Nagano is at 87 years for females and 80 for males, the longest average male life expectancy among the prefectures of Japan. Nagano locals’ long life can be attributed to the government’s aggressive campaign to reduce salt consumption and promotion of healthy habits like physical activity.

14 14. Las Palmas, Spain

Las Palmas or Las Palmas de Gran Canaria is a city and capital of Gran Canaria island and has a population of more than 683,000 people. Infant mortality rate in the city is one of the lowest in the world at 2.4 deaths per 1,000 live births. A weather data study conducted by Thomas Whitmore, the director of research on climatology at Syracuse University in New York, ranked Las Palmas as the city with the best climate in the world. Las Palmas also boasts of having the cleanest air of any Spanish city. With plenty of vitamin D-boosting sunshine, beautiful beaches, and a laid-back life, it is not surprising that people in Las Palmas live a longer and healthier life.

13 13. Hiroshima, Japan

Hiroshima is the capital of Hiroshima Prefecture with a population of 1.4 million people. Despite the long-term health effects of the atomic bombing during World War II, Hiroshima was able to recover from the devastation to become one of the healthiest cities in the world. People in Hiroshima has one of the highest average life expectancy in the world at 87 years for females and 80 for males. Its infant mortality rate is also one of the lowest in the world at 2.1 deaths per 1,000 live births. The city of Hiroshima is focused on fostering a culture wherein citizens live active and healthy lives.

12 12. Oslo, Norway

Oslo is the capital and most populous city of Norway with 1.3 million people. Oslo’s infant mortality rate is one of the lowest in the world at 2.5 deaths per 1,000 live births. The city is notable for its initiatives to reduce greenhouse gas emissions by 50% compared to 1990 levels by 2020 and by 95% in 2030. Today, Oslo’s air quality is rated excellent. According to Statistics of Norway, the healthiest part of the population of Norway lives in Oslo. Specifically, only 19% of the population in Oslo is overweight, most residents of the city have good dental health and lifestyle habits and the majority of the people walk at least half an hour a day.

11 11. Kochi, Japan

Kochi is the capital city of Kochi Prefecture located on the island of Shikoku in Japan with a population of over 487,000 people. Kochi’s infant mortality rate of 1.7 deaths per 1,000 live births is the 7th lowest of any major city. Average life expectancy in the city is also one of the highest not only in Japan but in the world at 87 years for females and 80 years for males. Kochi has everything nature has to offer from abundant coastlines and clear rivers to deep green forests. Kochi’s air quality is good and ideal for outdoor activities.

10 10. Gothenburg, Sweden

Gothenburg is the second-largest city in Sweden with a population of more than 898,000 people. Infant mortality rate in Gothenburg is the third lowest of any city in Europe and one of the lowest in the world at 1.8 deaths per 1,000 live births. Gothenburg was the first city in the world to issue green bonds, a financial tool to combat climate change designed by the World Bank. Gothenburg also significantly reduced its greenhouse gas emissions by shifting from oil to district heating. The city boasts of a district heating network that 745 miles long and responsible for heating 90% of the city’s apartment blocks and detached homes.

9 9. Osaka, Japan

Osaka is the third largest city in Japan with a population of 17.3 million people. The city has the fourth lowest infant mortality rate of any OECD city at 1.7 deaths per 1,000 live births and has one of the highest average life expectancies in the world at 79 years for males and 86 years for females. Osaka boasts of 540 hospitals with the Osaka Prefecture and the best medical facilities in the Kansai region. The city also has a full-service emergency health care system that includes national and prefectural public medical facilities.

8 8. Gold Coast, Australia

Gold Coast is a coastal city in Australia with a population of more than 560,000 people. While its infant mortality rate is relatively higher for a “healthy city” at 4.4 deaths per 1,000 live births, Gold Coast is notable for having a good quality air and high life expectancy, about 81 years for males and 85 for females. Gold Coast has numerous initiatives to protect the environment and build a strong and sustainable future. Apart from stressing the need to care for the environment, the city also has an active and healthy lifestyle program that provides residents with a large variety of free and low-cost sport, recreation, and fitness activities in their local area.

7 7. Stockholm, Sweden

Stockholm is the capital of Sweden and the most populous city in the Nordic countries. It is the first city to ever receive the European Green Capital award by the EU Commission in 2010 because of the city’s 25% reduction of carbon dioxide emissions since 1990; an integrated administrative system that ensures environmental aspects are considered in budgets, operational planning, reporting, and monitoring; and its efforts on being fossil fuel-free by 2050. Stockholm also boasts of having the sixth lowest infant mortality rate of any OECD city in Europe at 2 deaths per 1,000 live births. Research studies also show that residents of Stockholm can expect to live one year longer than 25 years ago because of cleaner air.

6 6. Oita, Japan

Oita is the capital and most populous city of Oita Prefecture. The city is blessed with a warm climate, bountiful nature from both land and sea, and abundant harvest of fresh food. The city of Oita is focused on creating a society wherein every child can be born and raised in good health and an environment wherein every citizen has access to medical services. The city also has a “Beautiful Oita Plan”, which is an initiative to preserve and protect Oita’s abundant nature. Oita’s air quality is deemed ideal for outdoor activities. The city’s infant mortality rate is one of the lowest in the world at 2.1 deaths per 1,000 live births. Average life expectancy in Oita is 81 years for men and 87 years for women.

5 5. Kagoshima, Japan

Kagoshima is the capital city of Kagoshima Prefecture at the southwestern tip of the island of Kyushu in Japan and is known as the “Naples of the Eastern World” because of its bay location, hot location, and emblematic stratovolcano. The average life expectancy in Kagoshima is much longer than the average life expectancy in the world (70 years). Life expectancy for females in Kagoshima is almost 87 years, while it is 80 years for males. The factors that contribute to the residents’ longevity include an abundance of minerals in the air that people breathe and in the water that they drink, a diet rich in seafood, seaweed, and brown sugar, and a sense of purpose among the elderly.

4 4. Okayama, Japan

Okayama is the capital city of Okayama Prefecture in the Chugoku region of Japan and is home to more than 891,000 people. The city is among the highest ranked in Japan when it comes to the number of doctors and hospitals per capita. Okayama boasts of a high number of medical institutions that provide advanced medical treatment and is working to develop the city into a place wherein everyone can live in a healthy manner. Okayama believes that health is the foundation for building a sustainable society and that companies and government need to engage in health promotion as a social issue.

3 3. Seville, Spain

Seville is the capital and largest city of Andalusia with a population of 1.5 million people. Lonely Planet’s Best in Travel ranked Seville as the number one city that everyone would be dying to visit in 2018. Apart from Gothic architecture and rich culture, Seville is also notable for its efforts to create a more sustainable and environment-friendly city. The most noteworthy of these initiatives include a community bike-sharing scheme, a surface tram, an underground metro, high-speed train links, electric car program, and the first commercial solar power plant in Europe. These projects resulted in a cleaner, greener, more breathable, and essentially, healthier Seville.

2 2. Toyama, Japan

Toyama is one of the largest cities in Japan and located in the northern Hokuriku region. Toyama has a population of more than 540,000 people, 30% of whom would be 65 years old by 2025. Considering their aging population, the city reinvented itself to become a vibrant city center with easily accessible amenities and services. Toyama also revitalized its public transportation system which significantly lessens the resident’s dependence on private cars. In terms of the environment, Toyama’s air quality is deemed ideal for outdoor activities. The city has also been recognized as an “Environmental Model City” by the Japanese government for making large cuts in greenhouse gas emissions.

1 1. Toulon, France

Toulon is a city in southern France with a population of over 560,000 people. It is large military harbor on the Mediterranean coast. Compared with other cities where residents live a fast, highly-competitive, and stressful life, those who work in Toulon have a much more relaxed attitude as the culture prioritizes leisure and family time rather than climbing the corporate ladder. Apart from the peaceful vibe, Toulon is also notable for its clean air and water. The city also has the most sunshine per year in France and due to Toulon’s proximity to the sea, freezing temperatures are rare and lasting frosts are non-existent.