The Gloom Belt: Kentucky Is the Saddest State

Posted on Apr 30, 2009 in Health & Wellness

By Jeffrey Kluger Wednesday, Apr. 15, 2009It’s not absolutely certain why folks are in such a bad mood in Oklahoma, but they are. They’re even gloomier in Mississippi. As for Kentucky? Just try and find a smile. Things are a whole lot cheerier, though, in Iowa, Nebraska and the Dakotas. And not surprisingly, the happiest state in the nation is sunny Hawaii.
Kentucky is going to build an equestrian arena
Those findings are part of a sweeping study of the national mood just released in the American Journal of Preventive Medicine. If the data reveal anything, it’s that while the Rust Belt and Sun Belt may have been the geographic definers of their day, in the current era of economic crisis, it’s the Gloom Belt that matters more. Financial distress, after all, usually leads to emotional distress, and epidemiologists are working to identify which populations are hardest hit. (See 50 authentic American experiences.)

The analysis was led by Dr. Matthew Zack and David Moriarty of the Centers for Disease Control and Prevention (CDC), and the investigators had a lot of data to mine for their work. From 1993 to 2001 and then again from 2003 to 2006, the CDC conducted two nationwide surveys of a total of 2.4 million people in more than 3,100 counties across all 50 states. Respondents were asked to think about their general mental state, including “stress, depression and problems with emotion,” and then asked how many days in the past month their mental health was generally not good.

What the researchers were looking for was what they called frequent mental distress (FMD), which they defined as 14 or more bad days out of 30. And while the questions they asked were broad, when you ask them nearly 2½ million times, some patterns start to emerge. Between 1993 and 2001, 9% of Americans were found to be suffering from FMD; by 2006, that number had nosed up to 10.2%. The saddest state was Kentucky, with a steady 14.4% of residents reporting FMD in both surveys. West Virginia was next. Its score of 9.6% in the first sample soared to 14.9% in the second, for an average of 11.2% of the population reporting FMD. The mood of Mississippians worsened similarly, with melancholy spreading from 9.4% of residents to 13.7%.

Hawaii’s average score of 6.6% topped the happy list – though even in the Aloha State, that represented a slight darkening from the positively giddy 6.3% in the earlier survey. The next sunniest states were Kansas and Nebraska, which tied at 7.5%. Almost everywhere, though, the trend lines were down. Overall, 44 states plus the District of Columbia scored worse on the second survey than on the first; one remained unchanged; and only five (Colorado, Minnesota, North Dakota, Texas and Iowa) improved. Even then, the downtick in FMD was less than 1%. And while it’s true that even in a state like Kentucky, a 14.4% score means 85.6% did not suffer from FMD, plenty of people may still be experiencing mental distress regularly, just not as frequently as 14 days per month. (See pictures of Americans in their homes.)

“Lower FMD can result from physical conditions like disability or diabetes or stressful life events like unemployment,” says Zack. “It may also be a result of state and county policies that don’t provide social safety nets like unemployment compensation and community mental-health services.”

While the numbers might give one state bragging rights over its neighbors, the researchers were less concerned about lines on the map. “Health conditions and risk factors do not respect state boundaries,” they wrote. What counts more, Zack and Moriarty stated, are regional trends. They tracked the worst emotional storm fronts moving across the Mississippi Valley, the Appalachians and the Four Corners region of the West; the far north and portions of the plain states had the fewest clouds.

But within those macro areas, not every segment of the population was hit equally hard by gloom. The most anxious folks were between the ages of 18 and 24; the least anxious were the oldest: 65-plus. Native Americans were the most-stressed ethnic group; the least stressed were Asians and Pacific Islanders. Of all the drivers of FMD, unemployment and other economic woes are the most powerful – hence lower-income Native Americans and higher-income Asians wound up on opposite ends of the FMD scale. Similarly, while there is legitimate economic distress among seniors living on fixed or declining incomes, it’s students and recent grads who face the longest haul in economically unstable conditions. And the worst might be yet to come.

“Frequent mental distress has probably increased since 2006,” says Zack, “though whether the recent worsening of the economy will affect all areas equally is uncertain.”

There’s no quick fix for any of this, just as there’s no quick fix for the rest of the economy. Still, it’s clear that for all the leading indicators that can be helped by stimulus packages and bailout money, it’s the national mood that could get the biggest boost.