Hawaii has ranked highest on a well-being survey for the fourth year in a row, according to a new Gallup poll.
Weather wasn't even a variable. On a local level, in fact, the Gallup-Healthways Well-Being Index showed that Lincoln, Neb., ranked number one, a state that doesn't share Hawaii's sultry breezes.
"It's safe to say weather probably isn't a factor there," Bruce Middlebrooks, Healthways spokesman, told ABCNews.com.
Colorado took the runner-up position, on a slate of 50 measures that looked at factors including emotional health, work environment and access to healthcare. West Virginia placed at the bottom of the list, with Kentucky, Mississippi and Tennessee not far behind - states with low median household incomes, said the survey, released Thursday.
Residents of Hawaii ratcheted up their happiness in 2012 compared even with a year earlier, with a score of 71.1 out of 100 compared with 70.2 in 2011.
Western, Midwestern and New England states in general ranked higher than the rest of the country, while Southern states placed in many of the lowest spots. Rankings remained mostly unchanged since 2008 when Gallup and Healthways began the survey, Gallup said.
The motivation behind the research is to help improve people's health through awareness and pilot projects on a community level, Dr. James Pope, vice-president and chief science officer of Healthways, told ABCNews.com.
"We knew that people in the U.S. were getting more unhealthy over time and we recognized that there are differences around the country in terms of chronic disease," Pope said.
Things might be looking up nationwide as the Affordable Care Act of 2010 gets into gear, the Gallup statement noted. The act, which requires all individuals to have health insurance or pay a fine, will make it easier for people to get treatment at no cost for everything from smoking cessation to obesity counseling.
"Certain provisions of the Affordable Care Act … may help low-income individuals improve their wellbeing, if they aware of and take advantage of them," Gallup said.
Massachusetts, the state with the highest percentage of residents with health insurance in the country, scored the top rank for access to "basic necessities," the survey noted. This category also looked at whether residents believed they had enough money for food, shelter and medicine, a safe place to exercise and access to clean water. Mississippi ranked lowest here.
Vermont wins when it comes to healthy behaviors. Residents in that state had the highest percentage of residents who ate five or more servings of fruits and vegetables at least four days per week, according to the survey, which was based on telephone interviews with 350,000 Americans. On an individual level, the survey found that doctors were typically in better health than the average person and those who "are engaged in their work" were likely to lead healthier lifestyles.
In 2011, the index defined the happiest person in America as a tall, Asian-American male 65 or older, a resident of Hawaii who's married with children, religious, owns a business and earns more than $120,000 a year.
It's important to note that individuals and communities are malleable, however, said Dr. Lindsay Sears, principal investigator at Healthways. With the right policies put in place by healthcare groups and local businesses, especially, big changes can happen.
"People can really change over time," she said. "You might think people or even communities are the way they are, but we've seen from five years of research that people are able to change and sustain that change."
A Hawaiian psychologist chalked up her native state's top spot to a relaxing natural landscape and a local culture that prizes collectivism.
"Thank aloha spirit that's hard to define," June Ching, a Honolulu-based clinical psychologist, told ABCNews.com.
As Ching spoke, she was driving into a parking lot and an attendant left her booth to hand the ticket to Ching, who couldn't reach it.
"A perfect example of what I mean," said Ching, a former president of the Hawaii Psychological Association. "[Hawaiian culture] has been composed of a lot of people with values that have to do with the family and a sense of collectivism. We're working together."
As for the stunning scenery, "I love not having seasonal affective disorder because we have the sun," Ching said. "The sky has a different kind of blue that soothes you."
Click here to see where your state ranks.
West VirginiaHighest-Ranked Metropolitan Areas
Burlington-South Burlington, Vt.
Fort Collins-Loveland, Colo.
Barnstable Town, Mass.
Ann Arbor, Mich.
Washington-Arlington-Alexandria, D.C., Va., Md., W. Va.
San Luis Obispo-Paso Robles, Calif.
- Society & Culture