Most people know not catching enough zzz’s and skimping out on veggies affects our health. But according to a new study, where we live also predicts a vital component of well-being: the heart.

Researchers compared the risk for heart problems by examining specific markers that indicate swelling of the arteries. Over 26,000 healthy women participated, and results showed people in certain regions of the U.S. were at greater risk for cardiovascular disease (CVD). Women living in southern and Appalachian states were at greatest risk for developing CVD, while Iowa, Massachusetts, and New York presented moderately low risk.

But scientists are still unsure why CVD varies state-by-state. Researchers often point to lifestyle and clinical risk factors for heart problems, but even after controlling for measures like smoking status, exercise patterns, and caloric intake, variation among states remained.

Researchers suggest environment and economics may be important factors. Exposure to particulate matter in the air could increase the risk for elevated inflammation of the arteries. And studies have shown rural and impoverished areas tend to have higher mortality rates. Just remember, heart health isn’t determined only by our address. A healthful diet and plenty of exercise can help keep the heart healthy, too!