The book looked at 351 metropolitan areas in the United States and Canada and ranked each in several categories, 1 through 351.
Here is how Spokane scored 20 years ago.
Costs of living: 164
Health care: 69
Overall rank: 98
Since then? If you actually care, I'd invite you to do an online search.
Me, I'm almost afraid to look and possibly discover that we have fallen out of the top 100.