Psychiatrist Stephen Dwindle conducted a recent study of the top 40 urban areas within the U.S. and has determined the 5 most stressful cities. Based on the records, the most stressful city in America is Chicago, Illinois, followed by Los Angeles, New York City, Cleveland, and Providence. Residents of these cities are finding that life isn’t as easy as it used to be.

A number of factors were taken into consideration in the report. For one thing, quality of life factors were considered. Joblessness figures from the Bureau of Labor and Statistics were also considered. Researchers also used cost of living through figures from the Community and Economic Research Council plus population density, the number of sunny verses cloudy days, and air quality.

Based on these identical factors, in a huge endorsement of the Lone Star State, San Antonio and Austin, Texas were rated as the two least stressful of the 40 metropolitan areas included in the study.

Researchers concluded that the cities ranked supreme in stressfulness were hit intensely by the recession and heavy joblessness. Tumbling home values and growing foreclosures were also considered to have added significantly to stress levels in these cities. In San Francisco alone, the real-estate market has dropped 43 percent compared to a national median home price dip of 14.7 percent.

Participants in a National Sleep Foundation report, also considered in the study, said that they sleep less because of monetary woes. Not only are people sleeping less, but they are trying to re-evaluate their lives and cut down on what are viewed as avoidable expenses. Over 53 percent of persons surveyed by the Kaiser Family Foundation reported that they had cut down on health care expenses by avoiding doctor visits, skipping checkups, and not refilling prescriptions.

The constant worry in these cities can sometimes be difficult to bear because of the traffic, air pollution, not seeing the sun, rising unemployment, and declining home prices. There are many factors that make these cities stressful, but, when you’re dealing with these circumstances and very pricey living costs, it can be difficult to stay afloat financially.

Most worrying, researchers say, are the ill effects of such rampant, intense stress. Excessive stress levels are known to add to patients’ risk of high blood pressure, heart disease, diabetes, obesity, depression, stomach cramping, insomnia, and irritability.

Even worse are the increasing effects of high stress levels in an entire population. Historically, such collective stress levels have coordinated with crime waves, huge-scale civil unrest, and pandemic family abuse. Given this trend, researchers suggest that these cities take action to reduce population stress levels. City-sponsored exercise programs, time management programs, entertainment, arts programs, or noise lessening programs have been advocated.

This post was written by Diane Johnson. She graduated with a bachelor’s degree from the University of Utah in Political Science. She specializes in writing about online schools, online education, politics, and the economy.