Regional location plays a role in stress, as factors like disability or diabetes, untreated mental conditions like anxiety or depression, high unemployment rates, risky behaviors including cigarette smoking and alcohol abuse, and/or social circumstances such as lower incomes contribute to stress levels. 

States ranking higher in mental stress percentages were struggling more-so economically than their low-stress neighbors. Health services, medications, and hospital visits are all mighty expensive without health insurance, and those in economically dire situations more often than not do not have the means to afford the insurance.