Appalachia has problems. Kentucky is the saddest state, with 14.4% reporting extended periods of mental discomfort, and a depression belt stretches right through the entire Upland South region from West Virginia to Oklahoma. This corresponds to a region with some of the highest rates of neuroticism, as well as some of the lowest rates of overall well-being.
At the other end of the spectrum, the most content states are Wisconsin, Iowa, Nebraska, and - happiest of all, for utterly inexplicable reasons - Hawaii. All of those states had fewer than 8% report sustained mental distress.
What strikes me about this map is that urban and suburban counties generally seem to rate consistently toward the middle of the mood spectrum throughout different regions of the country (albeit with a few exceptions, like Los Angeles, Detroit and Tampa). But rural areas vary dramatically - the happiest counties are rural areas of the Upper Midwest, and the saddest counties are, again, rural areas of the Upland South. So what accounts for the discrepancy? Well, broadly speaking, National Geographic says this:
Previous studies have linked regional income and education levels to well-being. And in general, people with higher incomes and college degrees report fewer instances of prolonged depression or stress, said study author Matthew Zack, a medical epidemiologist with the CDC.So are such support structures much more prevalent in places like the rural Midwest than in Appalachia? And if so, why? And what accounts for some of the intra-regional differences, like the fact that people in the Appalachian counties of Tennessee and North Carolina seem to be happier than their counterparts in Kentucky and Virginia? And why is it that Oklahoma is not just very sad, but appears to taint neighboring regions in other states? Lots of intriguing questions here.
But that's probably not the whole story, he added.
For example, communities with low [frequent mental distress] levels may have above-average support structures for residents—subsidized health clinics, for example, or job-retraining programs.
"There may be different influences in different communities," Zack said. "Once we find out what the most important ones are, we may be able to develop programs to reduce the levels of mental distress."
This study will be published in the June 2009 issue of the American Journal of Preventive Medicine.