Northeastern and Midwestern residents tend to have higher physical, social, and financial—i.e., "traditional"—wellness, while Southern residents have higher "existential" wellness, involving a sense of purpose and community identity, per an analysis of survey data from more than 325,000 U.S. residents. David Samson of the University of Toronto, Canada, and colleagues present these findings in the open-access journal PLOS One on September 10, 2025.
A growing body of research explores factors that may be linked with traditional and existential wellness. Many such factors, such as healthcare access and economic opportunities, vary according to where one lives. Meanwhile, scholars have proposed that the first settlers to colonize a region may play a major role in shaping its future cultural trajectory.
On the basis of these ideas, Samson and colleagues hypothesized that wellness may vary between U.S. regions that have distinct cultural norms and ideologies resulting from distinct colonization settlement patterns—an idea called the "First Settler Wellness Effect." To explore this possibility, they analyzed data on the wellness of 325,777 U.S. residents who participated in surveys as part of the Gallup-Healthways Well-Being Index between 2009 and 2016. The analysis followed the American Nations Model, which divides the U.S. into different cultural regions stemming from early settlement patterns.
The researchers found that wellness levels varied between different regions as defined by the American Nations Model. For instance, Northeastern and Midwestern regions had higher traditional wellness, while Southern regions had higher existential wellness. The researchers propose that these differences may stem from stable health infrastructure and economic security in the Northeast and Midwest, and an honor-based emphasis on personal autonomy, loyalty, and social reputation in the South.
Taking a closer look at minority racial populations, Black and Hispanic residents also had relatively higher traditional wellness in the Northeast and Midwest and had higher existential wellness in Southern regions. Compared to White residents, Black residents consistently exhibited lower traditional wellness across regions, and in the Northeastern and Midwestern regions, they also fared particularly poorly in existential wellness. The researchers say these findings may reflect limitations of material wealth, and suggest that systemic disparities may be offset in Southern regions by robust cultural or community support.
This work could help inform public health efforts and policies to boost wellbeing. Future research could examine what mechanisms may underlie the observations.
The authors add: "Our analysis shows that first-settler cultural legacies still shape how Americans feel and function today. These regional 'folkways' predict both traditional wellbeing (social support, community trust) and existential wellness (purpose and meaning) even after accounting for socioeconomic factors."
"What struck us most was the durability of culture—centuries-old settlement patterns continue to forecast modern lived experience. This doesn't imply destiny; it suggests policy works best when it aligns with local cultural ecologies."
In your coverage, please use this URL to provide access to the freely available article in PLOS One: http://plos.io/3Vv2ybr
Citation: Samson DR, Oesch N, Woodard C (2025) Wellbeing across the American Nations: First Settler Effects influence traditional and existential wellness. PLoS One 20(9): e0327972. https://doi.org/10.1371/journal.pone.0327972
Author countries: Canada, U.S.
Funding: This research was supported through Discovery Grants from the Natural Sciences and Engineering Research Council of Canada (RGPIN-2020-05942 to D.R.S.). Additional support was provided by the Department of Anthropology, University of Toronto Mississauga and The Pell Center's Nationhood Lab.
