Liu SH, et al. - In view of the observation that reducing chronic disease is a major health challenge, researchers use an ecologic study design with city-level data, to simultaneously assess the relative impact of unhealthy behaviors and preventive care measures on multiple chronic disease health outcomes. The associations between city-level prevalence of unhealthy behaviors, clinical preventive service use, and all chronic disease health outcomes were examined in 500 of the largest U.S. cities for year 2014. The top three risk factors for all health outcomes included smoking, lack of physical activity and binge drinking. They noted lower prevalence of chronic disease in correlation with higher prevalence of dental checkup.