A woman crying

A recent study maps where white, black, and Hispanic Americans experience the most pain and worry—and optimism.

It’s not just the economic gap between the rich and poor that has grown wider: America has seen an overlapping, and even more troubling, gap in desperation across class as well as racial and ethnic lines. Much has been made of America’s deepening opioid crisis, especially among rural and working-class whites. A recent Brookings Institution study pinpoints where poor Americans are feeling desperation the most across the country as a whole.

The study—developed by leading happiness researcher Carol Graham, along with Sergio Pinto and John Juneau II—uses detailed data from the Gallup Organization to measure the incidence of three key indicators of desperation: worry, pain, and optimism (or lack thereof). These indicators are tracked among poor whites and poor minorities across the 50 states between 2010 and 2015. The data come largely from the Gallup-Sharecare Well-Being Index, which surveyed roughly 175,000 people annually over this period.

The survey asked questions about the kinds of worry, pain, and optimism people experience in their daily lives, alongside a wide range of questions about their physical health and subjective well-being or happiness. The study defines “poor” based on an annual income of less than $24,000 for a family of four, and “minorities” as black and hispanic Americans. Researchers used regression to control for the effect of age, education, employment, religion, gender, and marital status, among other variables, on the levels of pain, worry, and optimism reported by each of the groups.

The Geography of Pain

Pain is a clear source of desperation and despair. The study measures pain according to respondents who said they experienced physical pain on the previous day. The two maps below (adapted from the study) show the geography of pain for poor whites and poor minority groups, respectively. Darker orange reflects a higher incidence of pain.

Maps courtesy of Carol Graham, Sergio Pinto, and John Juneau II/
Brookings Institution

As the map shows, there are three broad areas with a high level of pain for poor whites: upper New England; Appalachia and the Rust Belt; and the upper Northwest. In terms of individual states, poor whites report the highest incidence of pain in Maine, Alabama, Arkansas, Oklahoma, and the Appalachian states. These are states with lower levels of education, lower incomes, and more manufacturing-based economies. The states where poor whites report the lowest incidence of pain are New York, Illinois, Wisconsin, and South Dakota. There is also a relatively low level of pain in Florida, Texas, and California.

The pattern for poor minorities is quite different. They report the highest incidence of pain in more advantaged and more educated states like New York, Massachusetts, and Washington, as well as Michigan in the Rust Belt and Oklahoma and Arizona. Indeed, New York is one of the states where poor whites report the lowest incidence of pain. There is also a relatively high incidence of pain in the Rust Belt states of Ohio, Indiana, and Wisconsin, as well as Oklahoma and New Mexico. Poor minorities report the lowest incidence of pain in Utah, Iowa, Georgia, Louisiana, Mississippi, and the Carolinas. Indeed, there is little overlap between the high- and low-pain states for poor whites and minorities.

The Geography of Worry

Worry is another indicator of desperation. Gallup measures “worry” according to respondents who reported feeling worried the previous day. The maps below chart the geography of worry for poor whites and minorities. Darker purple on the map indicates greater worry.

There are two broad bands of worry for poor whites: across the Eastern Seaboard and into the Rust Belt, and on the West Coast and into the Mountain states. This is a mix of affluent and highly educated states like New Jersey, Massachusetts, and Maryland; Appalachian states like Kentucky and West Virginia; and Nevada and Utah in the West. Some of these fall within less advantaged areas like Appalachia and the Rust Belt, where deindustrialization and the loss of manufacturing jobs has hit hard, and which are also epicenters of the opioid epidemic. But others are affluent states, where poor whites may face anxiety over worsening housing affordability and a wider gap between the haves and have-nots.

For poor whites, there are a handful of states with lower levels of worry, in the Mountain West and South around Georgia and Florida.  The individual states where poor whites report the lowest occurrence of worry are Arizona, New Mexico, Minnesota, Wyoming, Nebraska, Kansas, Colorado, and Georgia. These states are, on balance, relatively affordable, and have reasonably performing economies based on a mix of service and resource industries.

Again, the pattern for poor minorities is almost the inverse. There are two broad bands of states that report high levels of worry for this group: The South and particularly Florida, and the West Coast, especially California and Washington. All of these states have relatively low to moderate levels of worry for poor whites. The individual states where poor minorities experience the highest level of worry are Washington state, Utah, New Mexico, Kansas (a low-worry state for whites), Florida (another low-worry state for whites), and Massachusetts.

A couple of factors may be at work here. On the one hand, California and Washington suffer from high levels of inequality and housing unaffordability, which have a strong impact on less advantaged minorities. On the other hand, these two states, plus Florida and New Mexico, have high levels of Hispanic immigrants who may be legitimately worried by Trump’s crackdown on immigration. Overall, poor minorities have a higher range of worry scores than whites, which means that where they live has significant bearing on their level of worry.

The Geography of Optimism

Optimism is the flip side of worry. It indicates hope for the future and lower levels of desperation. Gallup measures optimism in terms of “best possible life anticipated,” scored on a 0–10 scale. The maps below chart the geography of optimism for poor whites and poor minorities. On these maps, darker green indicates higher levels of optimism, while lighter colors indicate low levels of optimism.

For poor whites, the lowest levels of optimism are found in a combination of Appalachian states like West Virginia, Missouri, and Kentucky; and the Great Plains, Wyoming, Montana, the Dakotas, and Idaho. Again, these are places that are centers of the opioid epidemic, and they also correspond to the so-called “suicide belt” of the U.S. Conversely, the states with the highest levels of reported optimism for poor whites include California, Florida, Nevada, Texas, Maryland, Louisiana, and Georgia. The Southern cluster of states in which this group is the most optimistic is also where it experiences the lowest levels of worry.

The pattern for poor minorities is again quite different. Minorities report the lowest level of optimism in bigger states, especially in the West. The individual states where this group is the least optimistic include California, Oregon, Kansas, New Mexico, Colorado, and Washington. Poor minorities also report relatively low levels of optimism in Florida, Texas, and New York.

Overall, poor minorities reported optimism in a tight cluster of states surrounded by a wide range of places that are much less optimistic. This suggests that for poor minorities, where you live is a key determinant of how optimistic you are.


America is not only beset by growing spatial inequality, it also suffers from a widening geography of desperation. For poor whites, desperation is highest in Appalachia and the Rust Belt, places hard hit by an ongoing economic transformation. Poor minorities suffer more in relatively affluent and knowledge-based states on the coasts. Interestingly, there is a broad band of relatively high optimism in the Deep South, particularly Louisiana, Mississippi, Georgia, Alabama, Arkansas, and Tennessee. This is both counterintuitive and straight-out puzzling: Many, if not most, of these states have long histories of racism and anti-immigrant sentiment, and voted overwhelmingly for Trump last November. Perhaps their optimism reflects their own resilience.

Regardless of these more specific patterns and trends, America faces a widening desperation gap, which increasingly registers itself in everything from patterns of mental and physical health and crime to the increasingly divided nature of our politics and culture.

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