September 9, 2009 | Diane Johnson | 2 Comments Psychiatrist Stephen Dwindle has done a recent study of the top 40 metropolitan areas within the U.S. and has determined the 5 most stressful cities. Based on the data, 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 study. For one thing, quality of life factors were studied. Unemployment figures from the Bureau of Labor and Statistics were also considered. Researchers also included cost of living through figures from the Community and Economic Research Council in addition to population density, the number of sunny verses cloudy days, and air quality. Based on these same factors, in a huge endorsement of the Lone Star State, San Antonio and Austin, Texas were ranked as the two least stressful of the 40 metropolitan areas included in the study. Researchers concluded that the cities ranked highest in stressfulness were hit hard by the recession and heavy unemployment. Dropping home values and mounting foreclosures were also considered to have added greatly to stress levels in these cities. In San Francisco alone, the housing 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 economic woes. Not only are people sleeping less, but they are trying to reassess their lives and cut down on what are viewed as unnecessary expenses. Over 53 percent of individuals surveyed by the Kaiser Family Foundation reported that they had cut back on health care costs by avoiding doctor visits, skipping checkups, and not refilling prescriptions. The stress in these cities can sometimes be difficult to bear because of the traffic, air pollution, not seeing the sun, rising unemployment, and falling home prices. There are many aspects that make these cities stressful, but, when you're dealing with these circumstances and very expensive living costs, it can be difficult to stay afloat financially. Most troubling, researchers say, are the ill effects of such rampant, extreme stress. High stress levels are known to increase patients’ risk of high blood pressure, heart disease, diabetes, obesity, depression, stomach cramping, insomnia, and irritability. Even worse are the cumulative effects of high stress levels in an entire population. Historically, such collective stress levels have run parallel with crime waves, large-scale civil unrest, and pandemic domestic abuse. Given this trend, researchers recommend that these cities take action to reduce population stress levels. City-sponsored exercise programs, time management programs, entertainment, arts programs, or noise reduction programs have been advocated.