Objective  To investigate geographical distribution of accredited healthy cities and towns in China and to provide evidences for developing healthy city construction related policies.

  Methods  We retrieved the data on accreditation and secret reexamination of China healthy cities and towns initiated by National Patriotic Health Campaign Committee from 1989 to 2019 for a retrospective study. SAS 9.4 software was used in statistical analysis on the data.

  Results  By June 2019, the coverage rate of national healthy cities (districts) was 43.38% across China and the rate was 54.36%, 32.31%, and 40.63% in eastern, central, and western China; the coverage rate of national healthy towns (counties) was 4.17% all over China and the rate was 6.75%, 2.53%, and 3.79% in the eastern, central and western China. The mean scores of secret reexamination were 818.59 ± 31.78, 804.40 ± 25.88, and 809.28 ± 23.89 for the accredited healthy cities and towns in in eastern, central, and western China, with a significant difference in the rate between the eastern and central China (P = 0.006).

  Conclusion  General progress has been achieved in the construction of healthy city in China but there is regional disparity in the progress; further effort should be made in healthy city construction in less developed regions such central and western China.