U.S. Mood Map: Kentucky Saddest, Hawaii Gladdest?

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April 29, 2009—Never mind depressed real estate values—the old mantra "location, location, location" may be just as important to your mental health, a new U.S. government report suggests.

This county-by-county map shows the percentages of residents who reported "frequent mental distress" (FMD)—defined as 14 or more days of emotional discomfort, including "stress, depression and problems with emotion," during the previous month. Three days of mental distress is considered average, the researchers say.

Over the course of two random telephone surveys—one administered between 1993 and 2001, the other between 2003 and 2006—a team from the Centers for Disease Control and Prevention (CDC) asked a total of 2.4 million adults about their mental health.

The data depicted above come from the most recent of the surveys.

(Related: "Want to Live Longer? Stop Worrying.")

Kentucky: Bluegrass, Blue Mood?

The study found that you're most likely to suffer periods of depression, stress, or other emotional problems if you live in the United States' Appalachian or Mississippi Valley regions—or at least that you're most likely to admit it to government survey takers.

Kentucky had the highest level of frequent mental distress, with 14.4 percent of residents reporting prolonged mental health problems, according to the report, to be published in the June 2009 issue of the American Journal of Preventive Medicine (U.S. map with state names).

In the continental U.S., FMD prevalence was lowest—below 8 percent—in the upper Midwest, including Wisconsin, Nebraska, and Iowa, the team says.

Perhaps not surprisingly, Hawaii residents were least likely to report periods of mental distress.

Geography of Despair

While the new study identifies an intriguing pattern of gloom and glee across the country, the factors behind the pattern are less clear.

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.

But that's probably not the whole story, he added.

For example, communities with low FMD 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."

—Ker Than

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