A majority of voters casting midterm election ballots in Washington state said the country is headed in the wrong direction, according to a wide-ranging survey of the American electorate.

As voters cast ballots for U.S. Senate and members of Congress in Tuesday's elections, AP VoteCast found that one-third of Washington voters said the country is on the right track, compared with two-thirds who said the country is headed in the wrong direction.

Washington voters weighed in on high-profile ballot measures, including whether to adopt the nation's first carbon tax, and they decided to return Democratic Sen. Maria Cantwell to Washington, D.C., for a fourth term.

The hotly contested open seat in the 8th Congressional District was one of the nation's costliest congressional races, as Democrat Kim Schrier led Republican Dino Rossi in early returns. In Eastern Washington, Republican incumbent Cathy McMorris Rodgers beat Democrat Lisa Brown in the 5th District, and in southwest Washington, Republican Rep. Jaime Herrera Beutler was leading Democrat Carolyn Long.

Here's a snapshot of who voted and why in Washington, based on preliminary results from AP VoteCast, an innovative nationwide survey of about 139,000 voters and nonvoters — including 4,418 voters and 462 nonvoters in the state of Washington — conducted for The Associated Press by NORC at the University of Chicago.

TOP ISSUE: HEALTH CARE

Health care was at the forefront of voters' minds: More than one-quarter named it as the most important issue facing the nation in this year's midterm elections. About one-fifth said immigration was paramount, while the economy, the environment and gun policy were the top issues for others.

Nancy Andrews, a retired 73-year-old from Seattle who has suffered from a pulmonary embolism, said she spends about four months a year in France and has experienced emergency room care there. A four-day hospital stay there cost vastly less than a one-day stay in the U.S., she said.

"It's ridiculous to me we can't get that under control," she said.

Andrews dropped off her ballot at a drop box in North Seattle on Tuesday morning. Asked what motivated her votes, she said she wanted to oppose President Donald Trump at all turns.

"It's so important that we have some sort of moral bottom line," Andrews said.

STATE OF THE ECONOMY

Washington voters have a positive view of the nation's economic outlook — about 6 in 10 said the nation's economy is good, compared with 4 in 10 who disagreed.

Washington's unemployment rate is 4.4 percent, according to the U.S. Bureau of Labor Statistics. The national rate is 3.7 percent, a five-decade low.

TRUMP FACTOR

For about one-third of Washington voters, President Donald Trump was not a factor they considered while casting their vote. By comparison, two-thirds said he was.

In heavily Democratic Seattle, a dearth of high-profile races prompted some voters to direct their attention — and money — elsewhere, and they cited their opposition to Trump as their motivation. Andrews said she made campaign contributions for the first time in her life this year, giving to Democratic House candidates in other Washington districts.

Nina Lamble, a 33-year-old Seattle physician and mother, said she's given more campaign contributions this year than ever before — so much she's lost track. She joined a Facebook group called Physician Women for Democratic Principles, whose members she said had contributed $1.5 million to progressive candidates around the country.

Lamble said she's so frustrated with the Trump administration it was hard to even name a top concern. Protecting vulnerable people, including immigrants, and the environment were among her priorities.

"I feel like our country is falling apart," Lamble said as she dropped off her ballot at a North Seattle drop box Tuesday. "I have small children, and I feel like we're not leaving this place better than how we found it."

CONTROL OF CONGRESS

Tuesday's elections will determine control of Congress in the final two years of Trump's first term in office, and two-thirds of Washington voters said which party will hold control was very important as they considered their vote. Another 1 in 5 said it was somewhat important.