WASHINGTON, D.C. (CBSDFW.COM) – One Texas city cracked the Top 20 and two others were at the very bottom of the list when the most populated U.S. cities were compared when it comes to health.

WalletHub released the Healthiest & Unhealthiest Cities in America rankings this week. The study used more than 40 indicators of good health and focused on four key dimensions: healthcare, food, fitness and green space.

In all, 174 cities were rated and after the scores were tallied San Francisco was given the honor of healthiest city in America.

Austin was in 11th place among the country’s healthiest cities and first place in Texas. The capital of the Lone Star State scored highest in the green space (No. 13), fitness (No. 15), and food (No. 16).

Austin held the same positions (No. 11 and No. 1 in Texas) in last year’s study.

The Collin County city of Plano came in at No. 40 — the only North Texas city to crack the top 50. When ranked with all the other cities on the list, Plano ranked 5th when it came to the low cost of medical visits.

Dallas managed to hold on in the Top 100 — ranking No. 92.

The remaining North Texas cities ranked as follows –

  • Fort Worth, No. 117
  • Arlington, No. 135
  • Irving, No. 136
  • Grand Prairie, No. 137
  • Garland, No. 141

The really bad news for Texas came when looking at the most unhealthy cities in the nation.

Amarillo and Lubbock came in at No. 155 and No. 155 respectively. Corpus Christi ranked 163 of the least healthy U.S. cities. Laredo — which has the lowest cost per doctor’s visit at $58.33 — was ten notches lower at 173.

Positioned at the next to the last spot on the list was Laredo, Texas at 173.

The study gave the dishonorable distinction of unhealthiest American city to the Mexican Texas border city of Brownsville. The Cameron County locale ranked last or next to last in each of the four key health dimensions and also ranked near the bottom of the list for the fewest dietitians and nutritionists per capita and percentage of physically active adults.

Click here to check out the complete 2020 Healthiest & Unhealthiest American Cities list.