When the Nashville Area ETF (NYSEArca: NASH) debuted in August 2013, the fund did not lack for critics, many of which asserted the fund’s narrow regional focus would not be a selling point with potential investors.

Those critics may want to eat those words. Over the past year, NASH is up nearly 18.2%, a performance that tops the S&P 500 by about 350 basis points.

For people who have money in the area, who know the local economy and like the local companies and know them better than they know other publicly-traded companies, NASH makes sense, but the ETF’s performance is meriting of a wider audience.

NASH “realized a 12.8 percent net asset value return through Oct. 31, according to Lipper, a Thomson Reuters firm that provides fund ratings and commentary, as published in the Wall Street Journal. The fund also had the greatest one-year return, at 20.4 percent, out of more than 700 funds, according to a statement from fund’s founding company, LocalShares,” reports Jamie McGee for The Tennessean.

NASH’s underlying LocalShares Nashville Index utilizes an algorithm to identify and weight companies based on positive earnings, momentum and valuation metrics. [Nashville ETF Debuts]

As The Tennessean notes, ongoing bullishness by the health care sector has been a significant driver of NASH’s performance. The ETF, which only includes companies with market values of at least $100 million and average daily volume of at least 50,000 shares, features 10 health care stocks among its nearly 25 holdings.