Maybe we do need to make America great — to live in — again.

Global consulting firm Mercer has released its quality-of-living rankings, and, for a 10th year in a row, Vienna took the No. 1 spot. It was followed by Zurich, with Auckland, Munich and Vancouver tying for third place.

The company ranks hundreds of global cities based on a number of factors, including recreation, housing, economy, public services and transport, political and social environment, education, medical and health considerations, and the natural environment.

“European cities continue to have the highest quality of living in the world, with Vienna (1), Zurich (2) and Munich (3) not only ranking first, second and third in Europe, but also globally,” the report revealed, adding that “as many as 13 of the world’s top 20 spots were taken by European cities.”

20 cities with the highest quality of living

1. Vienna

2. Zurich

3. Vancouver/Munich/Auckland

6. Duesseldorf, Germany

7. Frankfurt

8. Copenhagen

9. Geneva

10. Basel, Switzerland

11. Sydney/Amsterdam

13. Berlin

14. Bern, Switzerland

15. Wellington, New Zealand

16. Toronto

17. Melbourne, Australia

18. Luxembourg

19. Ottawa/Hamburg

You’ll have to scroll all the way down to the 34th spot to find an American city. That honor goes to San Francisco, followed closely by Boston (36), Honolulu (37), New York (44), Seattle (46), Chicago (49), Washington, D.C. (53), Philadelphia (54) and Pittsburgh (59).

Read on:The best places to live affordably in the United States right now

Not only do U.S. cities rank pretty low down on the list, but they’re falling in the ranking. Indeed, all U.S. cities fell in ranking this year with the exception of New York, which climbed one place to 44th as crime rates in the city fell. Meanwhile, Detroit retained its spot as the lowest-ranking U.S. city.

In the Middle East and Africa, Dubai ranks highest, at 74th, closely followed by Abu Dhabi at No. 78. In Asia, Singapore takes the highest spot, 25th, followed by five Japanese cities: Toyko, Kobe, Yokohama, Osaka and Nagoya. New Zealand and Australia score highly on this list, with Auckland making the No. 3 spot, and Sydney, Wellington and Melbourne all making the top 20; Mercer notes that those cities all rank among the top 50 for safety.

From the archives (February 2018): Chicago, Porto and Melbourne ‘have it all,’ says Time Out — Chicago, especially