KY's 49th Rank in Well-Being Entirely Due to Embracing the Decomposing Corpse of Coal

From Gallup:

North Dakota residents had the highest well-being in the nation in 2013, according to the Gallup-Healthways Well-Being Index. South Dakota trailed its northern neighbor in second place, with its highest score in six years of measurement. Hawaii held the top spot for the previous four years, but fell slightly last year. West Virginia and Kentucky had the two lowest well-being scores, for the fifth year in a row.

Let's see: what do those two states have in common?  Something harmful to economic growth, public health and social advancement. What could it be?