A new report says that poor mental health can have as strong an impact on life expectancy as diabetes, smoking and even a lack of physical activity.These new findings are part of the Healthiest Communities rankings by U.S. News & World Report in collaboration with the Aetna Foundation.The rankings examined almost 3,000 different communities across 81 different health-related spectrums, like nutrition, housing and education, CNBC reports. According to Aetna Foundation President Garth Graham, the link between people’s perception of their own mental health and life expectancy being almost as strong as the link between smoking and diabetes and life expectancy was surprising.“I at first wanted us to double check,” said Graham, according to CNBC. In 2018, the link between mental health and life expectancy was not as apparent as it was in 2019, Graham says.“We often think about health as the four hours we spend in a doctor’s office a year, but health is about so much more than that,” Graham said.Of the top communities in the Mental Health subcategory, the report states, 16 of the top 100 were in Nebraska. Nebraska sees 26 deaths related to suicide, alcohol-related disease and drug overdoses per 100,000. The only state with fewer deaths per 100,000 is New York, at 25. Of the nearly 3,000 communities involved in the report, Douglas County, Colorado was reported the healthiest community in the country. Colorado as a whole performed well, with seven communities making the top 20 results. In those seven communities, CNBC reports, nearly all adults reported exercising, which has been known to improve mental health. Nancy VanDeMark of Mental Health Colorado says that the connection between mental health and life expectancy makes sense, since last year’s CDC data pointed to increased opioid overdoses and suicides—also referred to as “deaths of despair”—negatively affecting life expectancy. VanDeMark adds that it is vital for people to be screened for mental health issues, just as they are for physical health. “We have a screening site on our website so people can go in and complete a number of screenings to see if they’re high risk for some sort of mental health or substance use concern,” said VanDeMark. Colorado resident Kristin Gibowicz says that monitoring her mental health is something she keeps at the forefront of her life. “Just getting out, breathing fresh air and slowing your mind down a little bit, putting your phone down disconnecting,” Gibowicz said. Also worth noting is that among the top communities in the Mental Health subcategory specifically, the report states 16 of the top 100 were in Nebraska.Nebraska sees 26 deaths related to suicide, alcohol-related disease and drug overdoses per 100,000. The only state with fewer deaths per 100,000 is New York, at 25.In addition to Douglas County in Colorado, other communities in the top 10 overall include Los Alamos County, New Mexico; Falls Church, Virginia; Loudoun County, Virginia; Broomfield County, Colorado; Teton County, Wyoming; Hamilton County, Indiana; Carver County, Minnesota; Delaware County, Ohio; and Howard County, Maryland.