Naples, Florida, remains the city in the United States with the highest levels of well-being, according to a survey released Tuesday. It is the second year in a row that the metropolitan area, which also includes Immokalee and Marco Island, has been voted as the best to live by the survey conducted by Gallup and Healthways. Barnstable Town, Massachusetts, and the Santa Cruz-Watsonville region on the California coast, came in second and third, respectively.

The results were compiled based on more than 350,000 interviews with U.S. adults across all 50 states between the start of 2016 and the end of 2016. Each score is based on five factors – purpose, social, financial, community and physical – to judge, according to the survey’s authors, “important aspects of how people feel about and experience their daily lives.”

The top five metro areas, which were rounded out by urban Honolulu and Charlottesville, Virginia, have all featured on previous top 10 lists of well-being. Florida, California and Virginia are represented twice in the top 10 for 2015-2016.

North Port-Sarasota-Bradenton in Florida and San Luis Obispo-Paso Robles-Arroyo Grande in California were tied for sixth spot. Two newcomers to the list, Lynchburg, Virginia and Hilton Head Island-Bluffton-Beaufort, South Carolina, were tied for eighth, with Boulder, Colorado rounding out the top 10.

As a general trend, areas on the East and West coast had the highest scores with the lowest being found in the South and Midwest.

At the bottom of the list of 189 communities was the Fort Smith region in Arkansas near the Oklahoma border, which moved down one spot from the previous year. The Hickory-Lenoir-Morganton area in North Carolina and the Huntington-Ashland area shared by residents in West Virginia, Kentucky and Ohio have also been ranked among the lowest for well-being since 2008, as has Chico, California, and Flint, Michigan.

In a separate study released last month, Hawaii was found to be the state with the highest well-being index score, followed by Alaska, South Dakota, Maine and Colorado. West Virginia, Kentucky, Oklahoma, Indiana and Arkansas took the bottom five spots.