A survey of quality of life finds that wellness doesn't extend from sea to shining sea. With few exceptions, the most-rural parts of the nation rank lowest in well-being.
An international health business, the Gallup survey organization, and an association of insurance companies joined forces on a major national survey of life-styles, health, and work – measuring that elusive phenomenon “well being.” Their respondents in Hawaii described the highest levels of well being, West Virginians the lowest.
The Daily Yonder, taking a closer look at the survey results, finds that of the nation’s 435 congressional districts, Kentucky’s fifth district — the most rural in the U.S. — also scored at the very bottom in terms of its well-being. Those in Kentucky’s fifth district reported the poorest physical and emotional health in the nation, and also scored lowest on a more general measure of “life evaluation” – assessing both current living conditions and prospects for the near future.
Looking at all 435 congressional districts, we found the most-rural U.S. districts (with populations at least 1/3 rural) clustered at the bottom of the “well-being” rankings. Only four of the nation’s 125 most rural congressional districts scored in the top 1/5th: Minnesota’s 6th District, Tennessee’s 7th, Alabama’s 6th, and Wyoming (the entire state of Wyoming comprises one congressional district).
But 37 of these “most rural” districts ranked in the lowest fifth on the well-being index. They’re found in a swath through Appalachia, from western Pennsylvania through north Alabama, and along the southern stretch of the Mississippi River. Other rural districts that ranked low in their reports of well-being are in the eastern Carolinas, the Florida panhandle, and northern Michigan.
The Gallup-Healthways Well-Being Index is compiled from phone interviews with 355,344 people across the nation. A random 1000 people were questioned daily throughout 2008 about six core topics: Basic Access to food, safety, shelter, and health care; Emotional Health; Physical Health; Healthy Behaviors; Work Environment; and Life Evaluation – an assessment of one’s current situation and outlook on the future, five years hence.
In general, respondents in the West reported more healthy behaviors, and those in the upper Midwest scored high on their reports of emotional health. Texans and those in the Rocky Mountain states expressed generally more positive levels of work satisfaction. And in Utah there seems unanimity that life’s good and the future will be even better. Find much more information from the survey on the American Health Insurance Plans’ website, found here.
As one would expect, there’s a lot of overlap between districts that are poor and those reporting low levels of well-being. After Kentucky’s mountainous Fifth District, the next lowest ranking area is New York ultra-urban 16th, located in the Bronx, with 42% of residents below the poverty line.
According to America’s Health Insurance Plans’ own graphics, the rural counties with very low scores of well-being are also those with very low rates of educational attainment. The green districts on the AHIP map are those where the highest numbers of residents have not completed 9th grade. This pattern nearly matches Yonder’s map of most rural counties in the lowest fifth on the well-being measure. (Similarly, in New York’s 16th district — too small geographically to spot on this map — 22% of residents have not completed 9th grade.)
So what about those very rural anomalies with super “quality of life”? Wyoming scores very high on reports of physical and emotional well-being, as well as work quality and life prospects; also, only 3% of Wyoming residents failed to complete the ninth grade (in comparision with 22% of 5th District Kentuckians).
The other three well-est rural counties, where more than a third of residents are rural, are located in well-to-do exurbs of large cities: surrounding Birmingham, west of Minneapolis, and between Memphis and Nashville. (Tennessee’s 7th, shaped like a windblown palm tree, is a gerrymandered district, and the wealthiest in the state).
Despite the tremendous resources, financial and statistical, that went into this project, it may not come as a shock that people in Appalachia and the Mississippi Delta aren’t out snowboarding or visiting the dentist, or than residents of the Rust Belt doubt that conditions in their communities will look a lot better five years from now. Still, a study this extensive and rigorous makes it possible to see “well-being” more closely — regional inequality, also: living day-to-day with clean or dirty water, work or idleness, songbirds or sirens, a clear head or an aching one.