Wellbeing across the American Nations: First Settler Effects influence traditional and existential wellness

This study investigates the "First Settler Wellness Effect," exploring how cultural geography impacts traditional wellness (physical health, social relationships, and financial stability) and existential wellness (purpose, meaning, and community identity) across the United States. Using data from the Gallup-Healthways Well-Being Index, which includes responses from over 325,000 individuals across 110 Metropolitan Statistical Areas (MSAs) from 2009 to 2016, we analyze wellness outcomes through the lens of the American Nations Model. This model categorizes the United States into distinct cultural regions shaped by early settlement patterns, emphasizing the enduring influence of regional norms and ideologies. Our findings, in support of the American Nations Model, reveal significant regional variation in wellness outcomes. Northeastern and Midwestern regions, characterized by communal norms, high educational attainment, and institutional trust, exhibit elevated traditional wellness scores (e.g., β = 0.371, p = 0.002). These regions reflect a stability rooted in health infrastructure and economic security. In contrast, Southern regions, shaped by honor-based values emphasizing personal autonomy, loyalty, and social reputation, show significantly higher existential wellness (e.g., β = 0.590, p = 0.011). This divergence highlights a tradeoff between material stability and existential fulfillment shaped by cultural norms. Interestingly, Southern regions demonstrate elevated existential wellness for Black and Hispanic residents compared to other regions, suggesting localized cultural or community support may offset systemic disparities. Conversely, Northeastern and Midwestern regions report higher traditional wellness yet fail to foster similar levels of existential fulfillment, underscoring the limitations of material prosperity alone. These findings emphasize the interplay between cultural history, regional identity, and human flourishing, offering insights for targeted public health and policy interventions.