(CBS DETROIT) — The motor city is topping another list for the second year in a row.

A study from Wallethub ranks Detroit as the most stressed out city in America.

The study compared stress caused by finances, work, family and health and safety in 182 cities, using data about everything from traffic congestion to a city’s crime rate to determine its rankings.

Detroit is followed by Cleveland, Newark, Baltimore and Philadelphia.

The report says, some stress can have positive effects, however, when it reaches an unmanageable level, it turns “chronic.” That’s when people become vulnerable to health problems and loss of productivity.

The least stressed cities on the list are Sioux Falls, South Dakota; Bismarck, North Dakota and Fremont, California.

Click here for the full list.

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