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Where you live has a big impact on happiness and health

Special to The Washington Post

When my husband and I moved from Los Angeles to Washington for his job, I saw only the cons in our new city: Overcast skies, solemn monuments and women wearing an accessory I'd forgotten about from junior high dances: Pantyhose. The humidity was oppressive, the gray a wet blanket.

I wanted to move back to Los Angeles, where the sun gave a warm welcome, the open sky made me feel free and purple flowers hung like grape clusters from the jacaranda trees.

Ron wanted to stay put. Facing off, we planted our feet and tried to pull one another in opposite directions, a tug-o-war.

We weren't dealing with mere whims. Where we live is a matter of medical interest. Geospatial medicine, sometimes called geomedicine, studies how location affects our health and well-being. Just as a person has a genetic DNA, a person has an environmental DNA, says biologist and geographer Amy Blatt, author of "Health, Science, and Place." "I don't think people take into account how importantly a place impacts their health until it's too late," Blatt says.

In "The Blue Zones of Happiness," Dan Buettner wrote about pockets of the world where people live longer, happier, healthier lives: Enclaves that tend to have abundant sunshine, green spaces, an emphasis on fitness and access to whole foods. "Where a person lives determines their level of happiness more than any other factor," Buettner says.

I grew up in Ohio, near dreary Lake Erie. Once, after a blizzard, my dad placed my two younger brothers and me on a toboggan and tied the rope around his waist. We cheered with delight as he ran across the backyard, whisking us through a winter wonderland. Exhausted, he dropped the rope, and I volunteered to take over.

I slipped the loop around my puffy coat, lifted my foot and - splat! - face-planted in the snow. The toboggan hadn't budged. As a child, I wasn't strong enough to move my brothers.

As an adult, my strength was no match for Ron's, either. He was older, wiser and made more money. With all my might, I tried to drag him back across the country. Like my brothers, he didn't give way.

The average American may move almost a dozen times in a lifetime, according to the U.S. Census Bureau. Americans move for all sorts of reasons: Jobs, bigger houses, retirement, family or - as was the case in my early 20s when I packed my Jeep and headed to California - because we think it'll make us happier.

I still remember standing on a coastal bluff the first day I arrived. The air smelled like jasmine and honeysuckle. Sunlight sparkled like glitter on the Pacific. I tugged off my wool sweater, raised my arms to the heavens and decided on the spot I'd stay until I died.

Despite my mental-health boost, the move may have increased my risk of early death. According to the American Lung Association, 70 percent of California residents live in an area with unhealthy air. The jasmine-infused breeze I adored was contaminated with pollutants that have been linked to cancer, asthma, heart attack and stroke.

An article published in the New England Journal of Medicine reports that when it comes to premature death, genetics has only a 30 percent influence; the other 70 percent is attributed to nongenetic factors such as environment, access to health care and individual behaviors.

Although the article separated environment and individual behaviors, research suggests the two are linked. In a recent British study that examined data on more than 400,000 men and women, those who lived near gyms, pools and sport fields weighed less than the others, as did those who lived farther away from fast-food joints.

"To help people achieve good health outcomes, we have to take into consideration where they live, work and play," says Marie Lynn Miranda, head of the National Center for Geospatial Medicine at Rice University . Indeed, geography may soon be routinely included in electronic medical records.

"The next generation of health-care providers will be well versed in geospatial medicine," Blatt says. "Just as you get tested for cholesterol or glucose levels, doctors will ask your place history - all the places where you have lived."

In a 2009 TEDMED Talk, "Your Health Depends on Where You Live," health and human services expert Bill Davenhall said such an assessment will allow physicians to determine which environmental toxins and stressors a person has been exposed to and for how long.

Online tools can help reveal health risks of geographic locations: The Centers for Disease Control and Prevention maps chronic-disease risk factors for 500 American cities; the University of Cincinnati has a Web page about the quality of drinking water for major metropolitan areas; the Gallup-Sharecare Well-Being Index ranks the happiest areas of the country; and the Robert Wood Johnson Foundation website shows life expectancy by Zip code.

But the best tool may be Google Maps or real estate websites such as Zillow's, says Blatt. The zoom feature allows you to evaluate whether a neighborhood is set up to help you make healthy choices. When relocating, "think about how your health vulnerabilities match up against potential exposures and triggers," Miranda advises.

All this research might suggest it would be a good idea to pack up and move somewhere with parks, clean water and fresh mountain air. Yet that's precisely where the link between geography, health and happiness begins to tangle in its own roots.

Relocating is considered a type of loss - like death, divorce or a job layoff - because it disrupts social ties.

Stephan Goetz, a professor of agricultural and regional economics at Penn State , published a study that showed suburban residents were happier than rural or metro folks. Interestingly, people who hadn't moved at all in the past five years also reported being happier. "This may be related to not having to find new friends and social networks," Goetz says.

Another study shows that close friendships, even more than family attachments, are key to health and happiness, especially as we age.

Moving has been associated with adverse outcomes on the young, too, according to findings published in the Journal of Psychiatric Research. The study tracked more than 1.4 million Danes from age 15 to their early 40s. Researchers had a record of all the residents' moves from birth to age 14. A 14-year-old who moved even once had double the risk of abusing drugs or developing certain mental disorders by midlife compared with those who did not move at all; those risks increased with multiple moves.

When I was a teenager, my family relocated frequently for my dad's job. As an introvert, I preferred a good book to slumber parties, and the moves hit me hard. Home was my sanctuary, my safe place. Meaningful friendships came slowly. Every time we uprooted, those hard-won social networks were torn away, and I silently swore I'd never become a trailing spouse.

Over a sushi dinner a decade into my life in Los Angeles and 2 1/2 years into my marriage, Ron told me he wanted to take a job in D.C.

I pointed my chopsticks at the palm trees. "We're eating outside in February."

Despite the refrain that lapped inside me like ocean waves - don't move; don't move; don't move - we moved.

When we arrived in our new city, I wheeled my beach cruiser into the garage and parked it next to my inline skates. I missed my best friend, my book club, my favorite coffeehouse. I wrinkled my nose at the heavy colonial decor and longed for stucco. My area code, now 301 instead of 310, caused confusion among the California-based clients with whom I still worked, but mostly those two transposed numbers summed up how I felt: Rearranged.

Susan Miller, who moved 14 times in 25 years while her husband was in the prime of his hotel corporate management career, founded the faith-based nonprofit Just Moved Ministry to help people cope with letting go of an old place and starting over in a new one. I took Miller's class at a church in McLean, Virginia even though, by then, I'd been around six years.

"Cherish, don't cling," the leader said, speaking to the danger of clutching to the past. The next day, I looked around. Could I learn to love this city? The Washington Monument stuck straight up in the air and taunted me like a middle finger.

My outlook finally changed when Ron took me to Los Angeles for my birthday. One morning I met a friend for coffee at Shutters on the Beach. She told me she was divorcing. The tension in her marriage had torn it apart.

As the plane approached Reagan National on the flight home, I wondered: Maybe loving Washington didn't mean I had to wear Nats swag, become a political junkie or even stop pining for the mountains, sun and sea. Despite the links among geography, health and happiness, maybe the most important components were attitude and a willingness to adapt.

To love a city is to care for the people who live there. Ron loves Washington, and I love Ron. Real love means letting go of my own preferences to honor his. For years I'd been unable to embrace D.C. and its people because my hands were tied. In that moment on the plane from Los Angeles, I knew what to do: I laid down my rope.

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