According to a Gallup poll released today, the United States has shown almost no improvement in well-being in the past five years, increasing slightly from 2011 when Americans reported the most miserable scores since the survey began. The top and bottom states have also remained nearly the same. West Virginia, which received the lowest well-being score in 2012, has routinely been in the bottom two, and Hawaii ranked highest for the fourth year in a row.

The Gallup-Healthways Well-Being Index, which has surveyed 1.7 million Americans since the survey was first conducted in 2008, reflects the physical and emotional health of residents in each of the 50 states. 24/7 Wall St. reviewed the scores of each state in the six categories that comprise Gallup’s index to identify objective measures that impact well-being.

This content was originally published on 24/7 Wall St.

Gallup Editor-in-Chief Frank Newport explained to 24/7 Wall St. that well-being is important because happier, healthier citizens tend to have positive social and economic impacts on the places they live. “Well-being is important because of the hypothesis that it leads to good outcomes,” Newport said. “If your citizens have high well-being, they’re more likely to be better citizens and engage in better behaviors and make things better all the way around. It’s a positive goal for those that look at what we ought to emphasize in society.”

Among the 55 questions Gallup asked residents in each of the past five years, there were certain categories that the states with low well-being tended to do poorly in and high well-being states tended to do well in. States with high well-being had populations that smoked less, exercised more and tried to learn new things each day. These states also tended to share the outcomes of those behaviors and activities — residents had lower levels of key health problems such as high blood pressure, diabetes and heart attacks, and had more energy.

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Of the data 24/7 Wall St. considered in addition to Gallup’s indices, several showed a strong relationship with well-being. It appears that states with happy residents tended to have much lower poverty rates and higher median income. The states with the highest levels of well-being all have poverty levels below the national rate. Having stable income is important because it enables people to meet basic needs such as healthy food, clean water, medicine and health care.

We also found a strong relationship between employment and high school graduation rates and well-being. All 10 high well-being states had unemployment rates lower than the national average. All 10 states were in the top 15 for adults with a high school diploma.

In an interview with 24/7 Wall St., Gallup research head Dan Witters explained how these may be connected. Health and emotional well-being, he noted are more likely to be present in “a more vibrant, more intellectually and psychologically attuned citizenry.” These people are more likely to be attractive to employers and to lead fulfilling lives. Witters added that healthier populations attract employers because they present less of a health care expense.

While many of the happiest and most miserable states have remained the same, many other states, Witters added, have seen significant improvement over time. In particular, seven states — Colorado, Indiana, Nebraska, New York, Pennsylvania, Vermont and Wisconsin — have shown statistically significant improvement. What’s more, these states all improved in the same few categories. These included obesity, smoking, access to basic needs and safety. “I think there’s a good learning opportunity there for other states,” said Witters. “If you look at those states that have moved the needle, they’ve gotten there through similar means.”

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According to 24/7 Wall St.’s analysis, states in some areas of the country continue to do better than others. Of the 10 states with the highest levels of well-being, the majority are either in the West or Midwest. Of the 10 states with the lowest well-being scores, eight are located in the South. This has been the case since the survey began.

24/7 Wall St. reviewed all 50 U.S. states based on their scores in Gallup-Healthway’s 2012 Well-Being Index. 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 increased marginally in 2012, from 66.2 in 2011 to 66.7 in 2012. In generating the rank, Gallup combined six separate indices, measuring access to basic needs, healthy behavior, work environment, physical health, life evaluation and optimism, and emotional health. In addition to the index, we considered data from the U.S. Census Bureau, including income, poverty and the percentage of adults with a high school diploma or higher, all for 2011. From the Bureau of Labor Statistics, we reviewed state unemployment rates as of December 2012. We looked at life expectancy at birth, as of 2007, from the Kaiser Health foundation. We also considered violent crime rates for 2011 by state from the FBI Uniform Crime Report Program. All data are for the most recent period available.

These are America’s Happiest and Most Miserable States.

1. Hawaii
> Well-being index score: 71.1
> Life expectancy: 81.5 years (the highest)
> Obesity: 25.7% (20th lowest)
> Median household income: $61,821 (8th highest)
> Adult population with high school diploma or higher: 90.6% (10th highest)

In Gallup’s 2012 well-being index, Hawaii performed better than any other state. It ranked first or second in five of the six categories that make up the index, and 14th in basic access to care. Hawaii’s residents reported being generally happier with their current lives than those of any other state. They were also a more optimistic group. More than two-thirds of Hawaiians reported not feeling stressed, compared to just 52.8% of West Virginians who could say that. A larger proportion of Hawaiians exercise than any state but Alaska, and residents also eat healthily and do not smoke. At the latest count, life expectancy at birth in the state was 81.5 years, by far the best in the country.

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2. Colorado
> Well-being index score: 69.7
> Life expectancy: 79.9 years (9th highest)
> Obesity: 18.7% (the lowest)
> Median household income: $55,387 (15th highest)
> Adult population with high school diploma or higher: 90.2% (15th highest)

Coloradans were among the most likely Americans to practice healthy behaviors, such as exercising regularly and eating fruits and vegetables. They were also among the least likely to smoke and among the most likely to report easy access to a safe place to exercise. Their healthy behavior appears to be paying off. Colorado was rated the best state for physical health in the United States, having some of the nation’s lowest rates of high blood pressure, high cholesterol, diabetes and obesity. Colorado residents were also among the nation’s healthiest emotionally, and they had high evaluations of their own lives.

3. Minnesota
> Well-being index score: 68.9
> Life expectancy: 80.9 years (2nd highest)
> Obesity: 24.7% (13th lowest)
> Median household income: $56,954 (11th highest)
> Adult population with high school diploma or higher: 92.0% (2nd highest)

Gallup found that Minnesota had better emotional health than all but two states. Some 86% of Minnesotans reported they did not feel an excessive amount of sadness during the previous day, a higher percentage than all but one state. In addition, Minnesotans ranked third in the physical health category. Nearly 83% of survey respondents said they did not have health problems that prevented them from doing activities typical of their age group — a higher-percentage than any other state. According to the most recent data, Minnesotans had the second-highest life expectancy of any state. Also, more than 78% of respondents said poor health did not get in the way of their usual daily activities, a higher percentage than all but one state.

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4. Utah
> Well-being index score: 68.8
> Life expectancy: 80.1 years (8th highest)
> Obesity: 23.9% (6th lowest)
> Median household income: $55,869 (14th highest)
> Adult population with high school diploma or higher: 90.3% (14th highest)

Utah residents had higher evaluations of their present lives and higher expectations for the future than residents of nearly every other state. More than 55% of respondents were thriving, while less than 3% were considered to be suffering based on their assessments of their present and future quality of life. In addition to strong evaluations of their own lives, Utah residents had better emotional health and a higher quality of their work environment than residents of most other states. Nearly 70% of respondents told Gallup they had recently learned something new or interesting, a higher percentage than any other state.

5. Vermont
> Well-being index score: 68.6
> Life expectancy: 79.7 years (12th highest)
> Obesity: 25.7% (20th lowest)
> Median household income: $52,776 (19th highest)
> Adult population with high school diploma or higher: 91.8% (4th highest)

Vermont residents display healthier behaviors than any other state in the United States. For example, nearly 72% of Vermont residents told Gallup that they ate healthily all day during the previous day, a higher percentage than any other state except Rhode Island. In fact, nearly two-thirds of respondents said they had at least at least five or more servings of fruits and vegetables in four of the past seven days, a higher proportion than any other state. Nearly 60% of residents said they exercised for at least 30 minutes in three of the past seven days, a higher percentage than all but two other states. The state had among the lowest poverty rates in the country, which may help explain why Vermont residents reported having good access to most basic needs. The state had the second-smallest proportion of residents say they did not have enough money to feed their families.

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6. Montana
> Well-being index score: 68.5
> Life expectancy: 78.4 years (24th lowest)
> Obesity: 22.0% (3rd lowest)
> Median household income: $44,222 (13th lowest)
> Adult population with high school diploma or higher: 92.3% (the highest)

Montana appears to have a healthy, well-educated workforce. The state has low unemployment and the highest proportion of adults with a high school degree in the country. State residents were among the most likely to report being in a good work environment. Over 92% of individuals surveyed said they were satisfied with their jobs or the work they did, more than in any other state. Additionally, over 60% stated they felt treated like a partner by their supervisor, higher than all but one other state. Residents also practiced healthy behavior and were more likely than residents of nearly all other states to exercise 30 minutes a day for three days each week. Montanans were among the most likely Americans to eat five servings of fruit and vegetables at least four times a week — even though residents were also among the most likely to claim that finding affordable fruits and vegetables was difficult.

7. Nebraska
> Well-being index score: 68.5
> Life expectancy: 79.2 years (21st highest)
> Obesity: 27.9% (18th highest)
> Median household income: $50,296 (22nd highest)
> Adult population with high school diploma or higher: 91.0% (7th highest)

When it comes to making healthy choices, Nebraska is actually among the worst states in the country. In only one other state did a smaller percentage of those surveyed report eating a healthy amount of fruits and vegetables. The state also performed poorly in the exercise category, with nearly 49% of residents not exercising a healthy amount each week. Despite this, Nebraska residents were in the top 10 for physical health. While the state predictably had issues with certain conditions such as diabetes and obesity, state residents were rarely kept out of work due to physical ailments, and they reported feeling well rested. This might be explained by the low workplace stress levels residents experienced. A full 92% of residents reported being satisfied with their job, and 72.7% were worry-free the previous day, both among the best rates in the country.

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8. New Hampshire
> Well-being index score: 68.4
> Life expectancy: 79.7 years (12th highest)
> Obesity: 25.1% (17th lowest)
> Median household income: $62,647 (6th highest)
> Adult population with high school diploma or higher: 91.4% (6th highest)

New Hampshire scored higher than nearly all states in terms of basic access to necessities. Almost 88% of survey respondents in the state said they had a personal doctor, higher than all but three states and well above the 78.3% of people across the country who answered yes to that question. Furthermore, 73.1% of residents said they had visited a dentist within the past 12 months, a higher percentage than all states except for Connecticut and Massachusetts. The low poverty rate of just 8.8% may explain why more of these residents have access to quality health care. The state also ranked seventh highest in terms of healthy behaviors. For instance, nearly 62% of respondents reported they had five or more servings of fruits and vegetables in four of the past seven days, the third highest of all states.

9. Iowa
> Well-being index score: 68.1
> Life expectancy: 79.68 (15th highest)
> Obesity: 29.0% (10th highest)
> Median household income: $49,427 (24th highest)
> Adult population with high school diploma or higher: 90.6% (10th highest)

Iowa ranked behind only Massachusetts and Minnesota in the basic access to necessities category. Almost all residents felt they had access to clean water, while more than 83% felt safe walking alone at night — both among the best in that category. Further, more than 85% of Iowans stated they could afford food at all times over the preceding 12 months — well above the 81.6% for the U.S. overall. Nearly 94% felt they could afford shelter at all times as well, a figure that trails only New Hampshire and South Dakota. Iowans are also among the happiest with their work environments, generally feeling that they are satisfied by their jobs, treated well by their bosses, and using their strengths. However, residents were also more likely to smoke and less likely to eat healthily than the average American.

10. Massachusetts
> Well-being index score: 68.1
> Life expectancy: 80.1 (6th highest)
> Obesity: 21.5% (2nd lowest)
> Median household income: $62,859 (5th highest)
> Adult population with high school diploma or higher: 89.2% (19th highest)

Massachusetts residents feel things are moving in the right direction for them, expressing a high degree of optimism. Massachusetts residents also had better access to resources ensuring their well-being. The state had the highest health insurance coverage rate in the country, together with the fifth-highest median income in 2011, less than 15% of residents reported being unable to pay for health care. However, the state did not do so well in terms of emotional health, scoring seventh worst in the country. Nearly 35% of respondents reported feeling worry in a given day, a higher percentage than all but four states.

Click here to read the rest of the list on 24/7 Wall St.