Americans are not any happier than they were last year. In fact, they are slightly more miserable. At least, that’s what the recent Gallup-Healthways Well-Being Index shows. The annual index measures six areas of well-being, including life evaluation, physical health and work environment. In 2011, the national well-being score declined slightly from 2010 and was the lowest since the survey began in 2008.

Read America’s Most Miserable States
Read America’s Happiest States 

On top of calculating an overall national level of well-being, the index also calculates the well-being for each state, assigning scores from 0 to 100, with 100 representing ideal well-being. The national score dropped slightly in 2011 to 66.2 from 66.8 in 2010. Like the national score, the best-off and worst-off states are largely unchanged. Hawaii remains in first place and West Virginia is in last.

24/7 Wall St. reviewed Gallup’s findings in order to identify objective measures that appear to impact well-being. Many of the states where people report having the lowest levels of well-being suffer from many of the same financial, health and social ills. Eight of the 11 fall within the 15 states with the lowest median household incomes. Poverty is particularly high in many. Many of the worst-off states also have relatively low levels of education. Seven of the 11 have some of the lowest rates of residents with at least a high school diploma.

Well-being has not improved since the financial crisis began in 2008, reflecting the moribund U.S. economy. Most states have imposed austerity measures to combat budget shortfalls. Gallup notes that “reductions in public services, public-sector layoffs or salary cuts, and decreases in federal aid” have hindered improvements in well-being across the country.

According to Gallup, states in some areas of the country continue to do better than others. Of the 10 states with the highest levels of well-being, nine are either in the West or Midwest. Of the 10 states with the lowest well-being scores, five are located in the South — a reality since the survey began.

Perhaps the most common shared factor among the states that report the lowest well-being is poor health. Nine of the states on this list are among the 15 states with the lowest life expectancy. Obesity is exceptionally high in seven. Seven also fall within the top 10 states that have the highest rates of smoking. Rates of heart disease, cancer and diabetes are also all particularly high.

In addition to the information from Gallup, 24/7 Wall St. used data from the Census Bureau, the Bureau of Labor Statistics, the Social Science Research Council, the Centers for Disease Control and Prevention, and the Federal Bureau of Investigation.

These are America’s most miserable states.

11. Nevada
> Well-being index score: 65
> Life expectancy: 77.6 (14th lowest)
> Obesity: 22.4% (2nd lowest)
> Median household income: $51,001 (19th highest)
> Adult population with high school diploma or higher: 84.7% (15th lowest)

Nevada had the lowest score in the well-being basic access category, which measures how residents feel about access to basic necessities, such as access to a doctor, having enough money for food and satisfaction with one’s community or area. This may not be surprising when considering that Nevada currently has an unemployment rate of 12.6% — the highest in the country. The state was among the worst hit by the housing crisis, with home prices dropping 60% since their peak in the first quarter of 2006. Again, this is the worst in the country. An additional burden on those living in Nevada is the violent crime rate. In 2010, there were 660.6 incidents of violent crime per 100,000 residents, the highest rate in the nation.

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10. Tennessee
> Well-being index score: 65
> Life expectancy: 76.2 (8th lowest)
> Obesity: 30.8% (9th highest)
> Median household income: $41,461 (6th lowest)
> Adult population with high school diploma or higher: 83.6% (21st lowest)

Since last year, Tennessee residents feel their situation has gotten significantly worse. The state’s already-poor scores in the well-being categories that measure life evaluation, emotional health and physical health have all declined in 2011 compared to 2010. The state’s economy is in very poor shape. Unemployment is above the national average, the poverty rate is the 10th highest in the country and median income is the sixth-lowest in the country. Physical health and healthy behavior, two categories measured by the index, are among the poorest. Tennessee residents have the 14th-highest rate of smoking in the country. The obesity rate is ninth-highest rate in the country with 30.8% of residents considered obese. The state also has the fifth-highest rate of heart disease in the country.

9. Florida
> Well-being index score: 64.9
> Life expectancy: 79.7 (12th highest)
> Obesity: 26.6% (23rd lowest)
> Median household income: $44,409 (15th lowest)
> Adult population with high school diploma or higher: 85.5% (17th lowest)

Florida’s state of well-being dropped significantly from last year, moving the state’s rank from 12th worst to ninth worst. The state had among the lowest scores in the well-being category that measures the work environment. Many Floridians do not have any work, as the state has the sixth-highest unemployment rate — currently 9.9%. State residents also are relatively unhealthy in many aspects when compared to other states. Florida has the eighth-highest rates of both heart disease and diabetes. The state also has one of the highest rates of violent crime in the U.S.

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8. Missouri
> Well-being index score: 64.8
> Life expectancy: 77.4 (12th lowest)
> Obesity: 30.5% (10th highest)
> Median household income: $44,301 (14th lowest)
> Adult population with high school diploma or higher: 86.9% (22nd lowest)

Between 2010 and 2011, Missouri’s well-being score went from 17th worst in the country to eighth worst. Conditions in the state declined in every category Gallup measured. Missouri residents polled rated their emotional health as 14th worst in the country, down from 25th worst last year. The state also declined from 18th worst in life evaluation to third worst in the country. The state has the 11th-highest rate of smokers in the country at 21.1%. Heart disease, cancer and diabetes rates are all among the top 20, and life expectancy in the state is 77.4 years, the 12th lowest in the U.S.

7. Arkansas
> Well-being index score: 64.7
> Life expectancy: 76.1 (6th lowest)
> Obesity: 30.1% (12th highest)
> Median household income: $38,307 (3rd lowest)
> Adult population with high school diploma or higher: 82.9% (7th lowest)

Arkansan median household income is $38,307, the third lowest amount in the country. The share of residents living below the poverty line is 18.45%, the third highest in the country. Residents have a particularly low life expectancy of 76.1 years. The state has the fourth highest rate of smokers at 22.9% of adults, and it has the has the sixth-highest rate of cancer. Arkansas also has among the 10 lowest rates of adults with at least a high school diploma, and it is in the top 10 for violent crime.

6. Alabama
> Well-being index score: 64.6
> Life expectancy: 75.2 (3rd lowest)
> Obesity: 32.2% (3rd highest)
> Median household income: $40,474 (5th lowest)
> Adult population with high school diploma or higher: 82.1% (6th lowest)

Alabama is one of the poorest states in the U.S. In 2010, median income was just $40,474, the fifth lowest in the country, and 17.4% of the population lives below the poverty line. And state residents asked in the poll certainly feel it. The state is among the 20 worst for every category measured in Gallup’s well-being index, and is among the 10 worst for physical health, healthy behavior and work environment. This is easily explained when considering that Alabama has the third-highest rate of obesity in the country, with just under a third of the population considered overweight. The state also has the seventh-highest rate of heart disease, the seventh-highest rate of cancer, and the highest rate of heart disease. Alabama also has the third-lowest life expectancy in the U.S., at just 75.2 years.

5. Ohio
> Well-being index score: 64.5
> Life expectancy: 77.5 (13th lowest)
> Obesity: 29.2% (16th highest)
> Median household income: $45,090 (17th lowest)
> Adult population with high school diploma or higher: 88.1% (24th highest)

Ohio ranks within the 10 least well-off states in four of the six categories considered by Gallup in its Well-Being Index. This includes life evaluation, emotional health, healthy behavior and work environment. The state ranks quite poorly when it comes to health metrics, as it has among the highest rates of cancer, diabetes and smoking in the country. Its residents’ life expectancy is also relatively low, at 77.5 years. Median household income is fairly low in the state and the poverty rate is somewhat high; yet neither of these metrics are among the country’s worst.

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4. Delaware
> Well-being index score: 64.2
> Life expectancy: 78.3 (23rd lowest)
> Obesity: 28.0% (20th highest)
> Median household income: $55,847 (10th highest)
> Adult population with high school diploma or higher: 87.7% (24th lowest)

Delaware’s overall life satisfaction rank fell from seventh worst in the country in 2010 to fourth worst in 2011. The biggest reason for this was a major decline in self-reported health. Delaware’s physical health rank fell from 24th worst in the country to tenth worst. The state is among the 25 worst for diabetes, heart disease and obesity, and has the 11th highest rate of cancer. Delaware also has the worst score in the country for Gallup’s work environment ranking, which measures elements such as job satisfaction, the ability to use one’s strengths at work and the way supervisors treat their employees. Delaware also has the third-highest violent crime rate in the country.

3. Mississippi
> Well-being index score: 63.4
> Life expectancy: 74.8 (the lowest)
> Obesity: 34.0% (the highest)
> Median household income: $36,851 (the lowest)
> Adult population with high school diploma or higher: 81.0% (3rd lowest)

Mississippi is the poorest state in the nation by a number of metrics. Its median household income is $36,851, which is the lowest in the country. It also has the highest poverty rate in the country at 21.8%. Mississippi has among the lowest rates of adults with a high school diploma or more. Health is also a major issue in the state. Mississippi has the lowest life expectancy in the country, at 74.8 years — almost four years less than the national average. Mississippi has the highest obesity rate in the nation at 34%. It also has among the five highest rates of diabetes, heart disease, cancer and tobacco use among states. It is no wonder that Mississippi residents feel so poorly as measured by the third-lowest well-being score.

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2. Kentucky
> Well-being index score: 63.3
> Life expectancy: 76.2 (7th lowest)
> Obesity: 31.3% (5th highest)
> Median household income: $40,062 (4th lowest)
> Adult population with high school diploma or higher: 81.9% (5th lowest)

For the second year in a row, Kentucky’s well-being score is the second lowest. Residents consider themselves among the worst-off in the country in life evaluation, healthy behavior and both physical and emotional health. The state is relatively poor, financially speaking, with the fourth-lowest median household income and the fourth-highest rate of poverty. Residents have a low level of education compared to many other states, as only 81.9% of adults have at least a high school diploma — the fifth-lowest rate. The state also has a low life expectancy and among the highest rates of smoking, obesity and heart disease, as well as the highest rate of cancer in the country.

1. West Virginia
> Well-being index score: 62.3
> Life expectancy: 75.2 (2nd lowest)
> Obesity: 32.5% (2nd highest)
> Median household income: $38,218 (2nd lowest)
> Adult population with high school diploma or higher: 83.2% (8th lowest)

West Virginia residents feel the most miserable in the country. It appears that they have many reasons to feel this way. The state is particularly poor. It has the second-lowest median household income in the country at $38,218, and the sixth-highest rate of poverty. Residents also face a number of health issues. More than one in 10 West Virginians have had a heart attack or suffer from coronary artery disease — the highest rate in the country. The state has the third-highest rates of cancer and diabetes. It also has the highest rate of smokers, with 26.8% of adults indulging in the habit. It has the second-highest rate of obesity. These problems affect life expectancy, which at 75.2 years in West Virginia is the lowest in the country.

Now Read America’s Happiest States

Charles B. Stockdale, Michael B. Sauter, Ashley C. Allen

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