Introduction

In every region, stress is making an impact.

Regardless of where in the country they live,* Americans all have one thing in common when it comes to stress — they consistently report experiencing more stress than they believe to be healthy. Even though many people across the country are making efforts to manage stress and adopt healthy behaviors, they often find themselves struggling to succeed. And their challenges with stress management appear to be taking a toll. In the past year, as many as four in 10 adults in each region reported that their stress levels have increased.


*This report focuses on adults within the general population (2007 n=1848; 2008 n=1791; 2009 n=1568; 2010 n=1134; 2011 n=1226; 2012 n=2020), by the following regions: East (2007 n=467; 2008 n=448; 2009 n=362; 2010 n=274; 2011 n=299; 2012 n=539), Midwest (2007 n=342; 2008 n=355; 2009 n=340; 2010 n=235; 2011 n=259; 2012 n=419), South (2007 n=593; 2008 n=575; 2009 n=516; 2010 n=382; 2011 n=389; 2012 n=640) and West (2007 n=445; 2008 n=413; 2009 n=349; 2010 n=243; 2011 n=279; 2012 n=422).
Each region is broken down as follows: East (Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont); Midwest (Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Wisconsin); South (Alabama, Arkansas, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, Mississippi, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, West Virginia); and West (Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, Wyoming).
East coast stress

Adults in the eastern U.S. report higher levels of stress than those in other regions, and they are also more likely than people in other regions to say their stress level has increased or that they experience extreme stress (defined as an 8, 9 or 10 on a 10-point scale, where 1 is “little or no stress” and 10 is “a great of stress”).

For some from the East, stress levels are rising — 38 percent of Easterners say their stress level has increased in the past year compared with 33 percent of Midwesterners, 35 percent of Southerners and 33 percent of Westerners.

Like the rest of the country, average stress levels in the East exceed what people living in the region define as a healthy level of stress (5.2 average stress level vs. 3.8 healthy stress level on a 10-point scale). East Coast residents, however, do have a higher threshold for the level of stress they consider to be healthy stress (healthy stress level in the Midwest: 3.3, South: 3.6, West: 3.7).

Assessment of Personal StressTwenty-six percent of Easterners report extreme stress compared to just 19 percent in the Midwest and South, and 20 percent in the West.

Money (65 percent), work (62 percent) and the economy (59 percent) remain the most commonly reported sources of stress for people living in the East.

When asked what they do to manage stress, Easterners most commonly report exercising or walking (49 percent), listening to music (43 percent) and reading (39 percent).

While they have high stress, adults in the East recognize the benefits of managing stress and maintaining physical health. A sizeable majority placed more importance in 2012 on living healthy lifestyles than they did last year. However, there are notable gaps between the importance placed on healthy living goals and their ability to achieve these goals.

Eating healthy (64 percent vs. 49 percent in 2011), managing stress (65 percent vs. 59 percent in 2011) and being physically active or fit (59 percent vs. 52 percent in 2011) are healthy behaviors that Easterners increasingly report as important.

Despite the importance they place on healthy lifestyles, people living in the East are falling short of achieving their goals: Only 35 percent report doing an excellent or very good job at eating healthy, 36 percent at managing stress and 35 percent at being physically active.

Americans in the East appear to have some understanding of the impact of stress and are more likely than people living in other regions to recognize the role psychologists can play in helping them manage stress and live healthy lives — the increase in people who believe that psychologists can help in these areas was most dramatic in the East in 2012.

One-third (33 percent) of people living in the East believe that their stress level has a strong or very strong impact on their physical health and 39 percent believe that their stress level has a very strong or strong impact on their mental health.

Fifty-four percent of Easterners believe that psychologists can help a great deal or a lot with stress management, compared with 35 percent in 2011 (a 19 percentage-point increase compared with increases of only 1 percent in the West, 4 percent in the South and no change in the Midwest).

Forty-six percent of people living in the East believe that psychologists can help them a great deal or a lot in making lifestyle or behavior changes, compared with 33 percent in 2011 (a 13 percentage-point increase compared with increases of 4 percent in the West and South and 10 percent in the Midwest).

More people in the East have seen a mental health professional to help them manage their stress (8 percent vs. 6 percent nationally).

Stress in the midwest

Americans in the Midwest, on average, report lower levels of stress than people in other regions. The majority also say they are doing enough to manage their stress despite reporting that their stress levels have largely stayed the same this year. What’s more, they report fewer unhealthy behaviors as a result of stress.

More Midwesterners say that they are doing enough to manage their stress this year (62 percent in 2012 vs. 56 percent in 2011).

Stress Management: Midwest TrendEven still, average stress levels in the Midwest exceed what people living in the region define as a healthy level of stress (4.7 average stress level vs. 3.3 healthy stress level on a 10-point scale).

Midwesterners are more likely than other Americans to say that their stress has stayed the same over the past year (50 percent compared with 45 percent in the South and West and 42 percent in the East), but one-third (33 percent) still say their stress increased during that time frame.

Money (74 percent), work (65 percent) and the economy (65 percent) remain the most commonly reported sources of stress for Midwesterners.

When asked what they do to manage stress, Midwesterners most commonly report exercising or walking (51 percent), listening to music (50 percent) and spending time with friends or family (46 percent). Midwesterners are more likely than people living across the country to turn to friends and family for stress relief (46 percent vs. 39 percent nationally).

The number of Midwesterners who say they have lain awake at night or overeaten, eaten unhealthy foods or skipped a meal because of stress has declined in the past year.

  • Thirty-nine percent of people in the Midwest say they have lain awake at night due to stress (compared with 46 percent in 2011).
  • Thirty-seven percent say they have overeaten or eaten unhealthy foods because of stress (compared with 44 percent in 2011).
  • Twenty-four percent say they have skipped a meal because of stress (compared with 35 percent in 2011).

Despite their desire to live healthier lifestyles, many in the Midwest, on average, appear to be having difficulty reaching their healthy living goals. Midwesterners are also more likely than people in other regions to feel that a lack of willpower is preventing them from making these changes. They are, however, increasingly likely to recognize that psychologists can help with making lifestyle and behavior changes.

In the past five years, nearly three-quarters (74 percent) of people living in the Midwest have tried to exercise more, 64 percent have tried to lose weight and 62 percent have tried to reduce stress. Of those Midwesterners who decided to make a lifestyle or behavior change, the majority are still working toward their goals: 52 percent are still attempting to exercise more, 65 percent are still attempting to lose weight and 55 percent are still attempting to reduce stress.

One-third (33 percent) of Midwesterners who decided to make a lifestyle or behavior change say a lack of willpower is preventing them from making changes. More Midwesterners are also pointing to a lack of confidence in their ability to make changes as a barrier (16 percent vs. 10 percent in 2011).

Forty-four percent of Midwesterners believe that psychologists can help a great deal or a lot with stress management, and more Midwesterners than last year believe psychologists can help them make lifestyle and behavior changes (40 percent vs. 30 percent in 2011). However, only 5 percent have seen a mental health professional to help manage their stress.

Stress in the south

Though people living in the South report a lower average stress level than people in other regions, they have more difficulty managing their stress in healthy ways. What’s more, a vast majority of Southerners report being diagnosed with a health condition such as Type 2 diabetes, heart disease, overweight or obesity, chronic pain, high cholesterol, arthritis and anxiety disorders.

A majority of Southerners (69 percent) report that they have been diagnosed with a health condition.

Eating to Manage StressPeople in the South are more likely than people living elsewhere in the U.S. to report that they have been encouraged to exercise more (53 percent vs. 49 percent nationally) and eat a healthier diet (46 percent vs. 42 percent nationally). Of those who tried to make a change, 44 percent of Southerners are still attempting to exercise more and half (50 percent) are still attempting to eat a healthier diet.

Money, work and the economy are leading sources of stress for Southerners (money: 67 percent; work: 65 percent; economy: 60 percent), and more than one-third (35 percent) say their stress level has increased in the past year.

Like in other regions, average stress levels in the South exceed what people living there define as a healthy level of stress (4.8 average stress level vs. 3.6 healthy stress level on a 10-point scale). However, the gap between average stress and healthy stress is smaller in the South than elsewhere in the country (1.2 vs. 1.4 in all other regions).

Southerners are increasingly likely to say that managing stress is very or extremely important to them (64 percent compared to 60 percent in 2010 and 2011). At the same time, people living in the South are less likely than Americans overall to exercise or walk to help manage stress (47 percent vs. 52 percent nationally).

People living in the South are increasingly likely to eat to manage stress (27 percent in 2012 compared to 20 percent in 2010).

While many Southerners believe that stress can strongly impact a person’s health and report a variety of unhealthy behaviors as a result of stress, they have difficulty achieving stress management goals. At the same time, Southerners recognize the role that psychologists can play in helping them with stress management and lifestyle or behavior changes.

Seventy-seven percent of Southerners believe that stress strongly or very strongly impacts a person’s health.

People living in the South report a variety of unhealthy behaviors resulting from stress including having lain awake (44 percent), overeating or eating unhealthy foods (35 percent) and skipping a meal (26 percent).

Sixty-two percent of Southerners have tried to reduce their stress in the past five years, and of those who have tried, nearly half are still working at it (48 percent).

Increasingly, Southerners say a barrier to change is a lack of willpower (31 percent vs. 25 percent in 2011).

Forty-five percent of Southerners believe that psychologists can help a great deal or a lot with stress management and 41 percent believe that psychologists can help a great deal or a lot with making lifestyle or behavior changes. Only 4 percent of people living in the South, however, have seen a mental health professional to help them manage their stress.

West coast stress

Even though people on the West Coast have a reputation for being relaxed and less impacted by stress, they actually report the second highest average stress level in the country. Regardless, many on the West Coast still believe they are doing enough to manage their stress and they are more likely than people living in other regions to engage in healthy activities to manage their stress. At the same time, the number of Westerners who perceive that their health is very good or excellent is at its lowest point since 2009.

The average stress level reported on the West Coast is just behind the East Coast at 5.1 on the 10-point scale. What’s more, average stress levels in the West exceed what people living in the region define as a healthy level of stress (3.7 on a 10-point scale).

Almost 40 percent of Westerners say their stress level has increased in the past five years (38 percent).

Stress Management: West TrendMoney, work and the economy are leading sources of stress for people on the West Coast (money: 73 percent; work: 66 percent; economy: 60 percent), and one-third (33 percent) say their stress level has increased in the past year.

More people living on the West Coast say they are doing enough to manage their stress this year (63 percent vs. 58 percent in 2011).

The percentage of Westerners reporting they are in excellent or very good health is at its lowest point since 2009 (2009: 41 percent; 2010: 43 percent; 2011: 44 percent; 2012: 38 percent).

Westerners are far more likely than other people to exercise or walk to manage stress (61 percent vs. 52 percent nationally). Westerners are also much more likely to listen to music (53 percent vs. 48 percent nationally) and meditate or do yoga (16 percent vs. 10 percent nationally).

While many Westerners think it is important to manage stress, they are struggling when it comes to adopting healthy lifestyles. They report having trouble managing stress and getting enough sleep. Many report feeling overwhelmed by stress and that their eating habits are affected by stress.

Sixty-five percent of Westerners say it is important or very important to manage stress, but only 35 percent report doing an excellent or very good job at it.

Sixty percent of Westerners say it is important or very important to get enough sleep, but only 30 percent say they are doing an excellent or very good job at it.

More people living in the West report changes in sleeping habits due to stress compared with last year (32 percent vs. 23 percent in 2011). Another 35 percent of Westerners feel overwhelmed due to stress, which has increased from 29 percent in 2011.

Forty-two percent of Westerners have lain awake at night, 36 percent have overeaten or eaten unhealthy foods and 28 percent have skipped a meal due to stress.

Westerners continue to believe that psychologists can support their efforts to manage stress and help them make lifestyle and behavior changes.

Forty-five percent of Westerners believe psychologists can help with stress management (vs. 44 percent in 2011).

Forty percent believe that psychologists can help with making lifestyle and behavior changes (vs. 36 percent in 2011).

Seven percent of Westerners have seen a mental health professional to help them manage their stress.