The Most Miserable Cities In America

Gallup is out with its latest Well-Being Index, a look at how Americans in various metropolitan areas perceive their own wellbeing based on a variety of factors, including health, work environment, and access to basic necessities.

This year, Provo-Orem, Utah, topped the list, followed by two cities in Colorado and Honolulu.

On the other end of the spectrum however, are communities whose residents feel they lack many of the factors that go into wellbeing. Last year, Charleston, W. Va. came in last. This year, it was displaced by Huntington-Ashland, W.Va-Ky.-Oh., which was second-from-the-bottom on last year's index.

Gallup ranked all 189 U.S. metro areas, as defined by the U.S. Office of Management and Budget, by conducting 178,000 interviews nationwide. It asked people to consider a set of six sub-indexes, which examine life evaluation, emotional health, work environment, physical health, healthy behaviors, and access to basic necessities.

The map below shows the metropolitan areas that fell in the bottom quintile on this year's ranking.

Gallup noted three major trends:

• A decrease in the rate of Americans with health insurance. This is partially due to higher rates of unemployment, thought it has continued even as the labor market has recovered. Personal doctor usage has also decreased over time, according to Gallup.

• An increased rate of obesity. Physical health reached its lowest point in six years in 2013, and obesity rose at an "alarming" rate, according to Gallup. The company also noted national decreases in rates of healthy eating and exercise.

• Declining perception of work environment. "Working Americans are making it clear that a weak labor market has had an adverse impact on managerial and labor relationships," the report said.

On the other end of the spectrum, these are the communities that reported the highest levels of wellbeing:

For more detailed methodology and a complete ranking of states, congressional districts, and communities based on wellbeing, you can download Gallup's full report here.