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Honolulu Tops Nation for 'Emotional Health'
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Lincoln, Neb., Bests All Cities in Wellbeing in 2012

Washington, D.C., and San Francisco-Oakland-Fremont, Calif., top large metro areas

by Dan Witters, March 26, 2013

WASHINGTON, D.C. -- Lincoln, Neb., had the highest Well-Being Index score (72.8) in the U.S. across the 189 metropolitan areas that Gallup and Healthways surveyed in 2012. Also in the top 10 are Boulder, Colo.; Provo-Orem, Utah; Ann Arbor, Mich.; Honolulu, Hawaii; Fort Collins-Loveland, Colo.; and Burlington-South Burlington, Vt.

Top 10 Cities in Wellbeing 2012

At 60.8, Charleston, W.Va., had the lowest Well-Being Index score, displacing Huntington-Ashland, W.Va.-Ky.-Ohio, which held this position the two previous years. Huntington-Ashland's score of 61.2 is up from 58.1 in 2010, which is the lowest score on record for any metro area across five years of data collection. Mobile, Ala.; Utica-Rome, N.Y.; Hickory-Lenoir-Morganton, N.C.; and Fort Smith, Ark.-Okla.; join Charleston and Huntington-Ashland as frequent occupants of the bottom 10 list each year.

Bottom 11 Cities in Overall Wellbeing, 2012

The regional breakdown in wellbeing scores is largely consistent with Gallup and Healthways state-level results, which find wellbeing generally higher in Western and Midwestern states and lower in Southern states. West Virginia, which has the two lowest-rated metro areas (Charleston and Huntington-Ashland) in the U.S., was ranked last in the nation among states for the fourth consecutive year in 2012.

The "cities" this article references are based on the Metropolitan Statistical Areas (MSAs) as defined by the U.S. Office of Management and Budget. In many cases, more than one city is included in the same MSA, and the same MSA can cross state borders. All reported MSAs encompass at least 300 completed surveys, and Gallup has weighted each of these MSA samples to ensure it is demographically representative of that MSA.

The Gallup-Healthways Well-Being Index score is an average of six sub-indexes, which individually examine life evaluation, emotional health, work environment, physical health, healthy behaviors, and access to basic necessities. The overall score and each of the six sub-index scores are calculated on a scale from 0 to 100, where a score of 100 represents the ideal. Gallup and Healthways have been tracking these measures daily since January 2008.

Ann Arbor No. 1 in Life Evaluation Again; Honolulu Best Off Emotionally

Residents of Ann Arbor rate their current and future lives the best and residents of Hickory-Lenoir-Morganton rate theirs the worst, giving the two cities the highest and lowest Life Evaluation Index scores in the nation for the second year in a row, respectively.

Honolulu again led the nation with the best Emotional Health Index score. Charlottesville, Va., displaced Fort Collins, Colo., with the highest Physical Health Index score in the nation. Lincoln, Neb., had the highest Work Environment Index score, and residents living in Salinas, Calif., had the highest Healthy Behaviors Index score. Holland-Grand Haven, Mich., led the nation in access to basic necessities as it did in 2008-2010. (Gallup did not conduct enough surveys in Holland-Grand Haven to report on it in 2011.)

Best and Worst Scoring Metro Areas

Compare wellbeing across large, medium, and small metro areas.

Residents of Hickory-Lenoir-Morganton rated their lives about half as well as those in Ann Arbor. Elsewhere in North Carolina, residents of Fayetteville similarly reported roughly half of the workplace wellbeing found in Lincoln.

Huntington-Ashland residents again reported the worst physical health, although the city's score of 68.0 is an improvement over the 64.6 measured in 2010. These results align with West Virginia's position as the state with the highest obesity rate.

Charleston, W.Va., had the worst Emotional Health Index score, with Huntington-Ashland coming in second-worst for the second consecutive year. Healthy behaviors were least prevalent in Lafayette, La.

McAllen-Edinburg-Mission, Texas, residents reported the worst access to basic necessities for the fourth year in a row, due in part to 50% of residents who reported lacking health insurance, by far the lowest healthcare coverage rate in the nation. The U.S. metro area with the lowest score on the Basic Access Index has come from the state of Texas in all five years of measurement.

Washington, D.C., and San Francisco Top All Large Cities in Wellbeing

Washington, D.C.-Arlington-Alexandria, Va.-Md.-W.Va., residents reported the highest wellbeing among the nation's 52 largest metropolitan areas, defined as those with 1 million residents or more, followed by San Francisco-Oakland-Fremont, Calif. These two metros have been in the top five among large metro areas in each of the past five years.

Tampa-St. Petersburg-Clearwater, Fla., displaced Las Vegas-Paradise, Nev., for the large metro area with the lowest wellbeing, due mostly to low life evaluations and emotional health scores. Las Vegas-Paradise residents again reported the worst access to clean and safe water in the U.S. among large cities -- a recurring characteristic for this metro area and a principle reason why it ranks last nationally among large metro areas in basic access for the fifth-straight year. In general, though, the gaps in wellbeing between the highest and lowest rated large metro areas are not as large as the gaps found between all cities.

Top Five and Bottom Five Large Metro Areas


High wellbeing cities tend to exhibit many shared characteristics, including positive health and wellbeing outcomes -- like low chronic disease rates and high life ratings -- and behaviors such as frequent exercise and less smoking. These commonalities consistently demonstrate a mutual foundation upon which the top cities ascertain and maintain their status as standard bearers of wellbeing in America.

Compared to low wellbeing cities, residents of high wellbeing cities usually have much lower rates of obesity, high blood pressure, diabetes, and physical pain. They rate their lives higher today and in the future, and are much more likely to think that the city or area where they reside is "getting better as a place to live." They are more likely to have enough money for food, medicine, and shelter. They are less likely to be depressed and are more likely to report positive workplaces.

The behaviors and choices occupants of high wellbeing cities make also distinguish them from their low wellbeing counterparts, and can serve as a good example for the leaders of other cities to pursue in their own communities. For example, residents of high wellbeing cities exercise more, but their leaders also create more safe places for people to go to exercise. They eat more fruits and vegetables, but their leaders also establish safer, more readily accessible places to access their produce. They are more likely to have health insurance and to go to the dentist, but they also have leaders who help ensure that all have enough money for healthcare. And residents in high wellbeing cities are less likely to carry sadness on any given day, but also live in communities where their leaders afford them more opportunities to learn and do interesting things. The fact that many of the highest wellbeing cities continue to be university towns or cities with a robust academic presence may not be a coincidence, given the potential that local colleges can have on the local culture of wellbeing.

High wellbeing cities such as Lincoln, Boulder, Burlington-South Burlington, Provo-Orem, and Fort Collins-Loveland provide models to emulate and goals for others to aspire to, including the many U.S. metro areas that lag far behind in health and wellbeing.

View and export complete wellbeing data by metro area using Gallup's U.S. City Wellbeing Tracking interactive.

About the Gallup-Healthways Well-Being Index

The Gallup-Healthways Well-Being Index tracks wellbeing in the U.S. and provides best-in-class solutions for a healthier world. To learn more, please visit


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