Stress by Region

Regardless of where they live*, Americans report experiencing comparable average levels of stress. They also report similarities in the recommendations they receive from health care providers: the most commonly reported lifestyle and behavior changes recommended by a health care provider are to exercise more, lose weight and eat a healthier diet, regardless of where people live. While many people report healthy behaviors are important to them, there tends to be substantial gaps between what they think is important and how successful they believe they are at achieving their goals. 

  • Housing costs are more frequently cited as a cause of stress among people living in the West (53 percent) and in the South (51 percent) compared with people living in the East (48 percent) and Midwest (47 percent). 

  • Those who live in the East report the lowest average stress levels, which have steadily declined for four years (6.2 on a 10-point scale in 2007, 5.8 in 2008, 5.5 in 2009 and 5.2 in 2010). Similarly, those living in the East are more likely than those living in other regions to report having little or no stress (35 percent compared to 25 percent in the Midwest, 21 percent in the South and 22 percent in the West). 

  • Those in the Midwest are substantially more likely than those in the West to feel as if they are doing an excellent/very good job at managing their stress (38 percent vs. 24 percent), and they are less likely than Americans in any other region to report having a “great deal” of stress. Just 17 percent say they do, compared to 28 percent of those who live in the East, 27 percent in the Midwest and 25 percent in the South. 

  • Those living in the Midwest also report declining trends in their average stress levels (6.1 on a 10-point scale in 2007, 6.0 in 2008, 5.6 in 2009 and 5.4 in 2010).

Living Healthy

  • In almost all areas, health care providers have recommended that people make lifestyle and behavior changes, but Westerners report receiving this advice more often than those living in other parts of the country. Westerners have been told to exercise more (46 percent compared with 34 percent in the South, 37 percent in the Midwest and 42 percent in the East), reduce stress (27 percent compared with 14 percent in the South, 23 percent in the Midwest and 22 percent in the East) and get more sleep (24 percent compared with 13 percent in the South, 12 percent in the Midwest and 18 percent in the East ). Smoking is an exception, however: fewer people in the West have been told to quit smoking  (8 percent) compared with 13 percent in the South, 17 percent in the Midwest and 14 percent in the East. 

  • Those living in the West (62 percent) are more likely to report that they exercise several times a week or more than people living in the East (52 percent), the South (54 percent) and the Midwest (55 percent). And those who do are more likely to say that it gives them energy (61 percent) and makes them happy (52 percent). 

  • Those in the Midwest are more likely than Americans in other parts of the country to report unhealthy behaviors related to food. More than half (53 percent) say they have eaten too much or eaten unhealthy foods in the past month as a result of stress, compared to 33 percent of those on the East Coast, 37 percent of Southerners and 37 percent of those in the West. Those in the Midwest are also more likely (35 percent) than those in other parts of the country to say they eat to manage their stress (compared with 22 percent in the East, 20 percent in the South and 29 percent in the West).

  • Regardless of where they live, Americans place considerably higher importance on every aspect of well-being than their reported success in these areas. Most significant, however, are the differences between the importance people place on getting enough sleep and their ability to do so. In the West, while seven in 10 (69 percent) people say that getting enough sleep is important, they are least likely to say they are successful in their efforts to get enough sleep (22 percent). Sixty-seven percent of people in the South say that getting enough sleep is important, while only 27 percent say they are successful; 65 percent of people in the Midwest say that getting enough sleep is important, while only 38 percent say they are successful; and 66 percent of people in the East say that getting enough sleep is important, while only 29 percent say they are successful.

Stress and Work

  • Work is the most commonly cited source of stress among those who live in the West (85 percent) and it appears to be on the rise as a source of stress. In 2009, only 65 percent of Westerners cited work as a source of stress.

  • The percentage of people on the East coast reporting feeling stressed during a typical workday dropped to 31 percent in 2010 compared with 42 percent in 2009. Even though the percentage of Americans who report experiencing stress during a typical workday has declined in the East, so have reports of job satisfaction. Seventy-one percent of people living in the East said they were satisfied with their jobs in 2009 compared with just 58 percent this year.

Urban/Suburban/Rural Differences

Regardless of whether Americans live in the suburbs, an urban area or rural area, they are all experiencing about the same levels of stress. However, those who live in urban areas are less likely to feel they are doing a good job managing it.

  • Fewer people in urban settings (44 percent) feel they are doing enough to manage their stress compared to those in the suburbs (59 percent) or rural areas (57 percent).

  • One-third (33 percent) of those living in urban areas perceive their health to be fair/poor — far more than those who live in suburban neighborhoods (18 percent) or rural areas (19 percent).

  • Money is cited more frequently as a source of stress for those who live in urban (80 percent) and rural areas (80 percent) than it is for those in the suburbs (71 percent).

  • People living in urban areas are more likely than those living in rural areas to cite work as a source of stress (78 percent vs. 62 percent).

On the following pages are snapshots of stress and its impact on the health and well-being of residents living in eight major metropolitan areas: Atlanta, Chicago, Denver, Detroit, Los Angeles, New York, Seattle and Washington, D.C.

*This section of the report focuses on adults within the general population (2007 n=1,848; 2008 n=1,791; 2009 n=1,568; 2010 n=1,134), by the following regions: East (2007 n=467; 2008 n=448; 2009 n=362; 2010 n=274), Midwest (2007 n=342; 2008 n=355; 2009 n=340; 2010 n=235), South (2007 n=593; 2008 n=575; 2009 n=516; 2010 n=382) and West (2007 n=445; 2008 n=413; 2009 n=349; 2010 n=243). In addition, the general population was examined by urbanicity using the following self-reported categories: urban (n=341), suburban (n=460) and rural (n=333).