If you crave more exercise, healthier food and neighbors who laugh and smile a lot, move to Hawaii. For the third year in a row, this state topped the Gallup-Healthways survey of the overall well-being of Americans. This phone survey, begun in 2008, measures six key areas including emotional health, job satisfaction, physical health and illnesses, access to healthy food and healthcare, and behaviors like exercise and diet. Over the four years of the poll, some trends have emerged. States in the Western, Mountain and Eastern seaboard regions—which have better physical health and access to healthcare—continue to score higher on the survey. The Midwestern and Southern states score less well, due to the higher levels of obesity and poverty. Hawaii scored 70.2 out of 100 on the survey. Other top states included North Dakota, Minnesota, Utah, Alaska, Colorado, Kansas, Nebraska, New Hampshire and Montana. At the bottom end of the survey, West Virginia ranked lowest again with a score of 62.3. Other low-scoring states included Kentucky, Mississippi, Delaware, Ohio, Alabama, Arkansas, Missouri, Florida, Tennessee and Nevada. The survey occurred throughout 2011, with calls made to cell phones and landlines each day from January 2 through December 29. A total of 353,492 adults were selected at random for the poll. The overall rating for the entire country dipped slightly from last year—the lowest rating yet—but there was no significant change in the individual states. This is largely due to the sluggishness of the economy, which continues to affect people in many ways beyond the workplace.