When cities create environments that encourage physical activity and moderate the use of cars, they improve the well-being levels of their residents, a new report shows. In effect, investments in walking, biking, parks, and transit are investments in health outcomes.

The finding comes from Gallup, the polling group, and Healthways, a corporate health plan provider. They created an “Active Living” score for 48 medium-to-large metro areas using data from four sources: Walk Score, Bike Score, and Transit Score (all owned by the Redfin real estate group) and ParkScore (managed by the Trust for Public Land). Then they compared the results with Gallup’s ongoing phone surveys of well-being across the country.

The Boston, San Francisco, and Chicago areas have the highest Active Living scores, and each also scores comparatively well for aspects of well-being and health. The top five cities by Active Living have a 19.3% higher physical well-being score, and plus-20% lower obesity and diabetes scores, compared to the bottom five Active Living scorers. The latter include Fort Wayne, Indiana; Oklahoma City; and the Indianapolis area.

Gallup and Healthways don’t say that installing a bike lane will magically make all residents feel better overnight. Many factors, economic to personal, affect well-being. It’s more that there are rough correlations between environment and health.

“Having robust built structure does not ensure well-being outcomes, but it does increase the chances of good well-being outcomes,” says Dan Witters, Gallup’s chief scientist of workplace management and well-being. “In concert with one another, the four metrics provide a pretty powerful lens into how cities are increasing or decreasing their chances of well-being success.”

Residents in the most active cities have lower rates of smoking, obesity, diabetes, high blood pressure, high cholesterol, and depression, and higher rates of exercise and healthy eating compared to communities with low Active Living scores. The strongest correlations were generally between park and bike scores and health, as opposed to the transit and walking indicators and health.

The highest scoring metros were spread across the country. But Southern cities tended to have somewhat lower scores, reflecting less transit, walking, and biking availability. Atlanta is the top city in the south, in 24th place (unless you count Florida as the south).