The Worst Counties to Live In

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The U.S. population reached 316.5 million in 2015, an increase of 12.5 million from five years ago. In some areas of the country, however, the population declined substantially over that time. These counties have suffered from decades-long economic decline and job losses, and today struggle with severe unemployment, poverty, and public health issues.

To determine the worst counties to live in, 24/7 Wall St. developed an index based on three social measures — educational attainment, poverty rate, and life expectancy — and ranked counties based on their well-being. Most of the lowest ranked counties — reporting the lowest educational attainment, highest poverty, and lowest life expectancy — are in the rural South, concentrated within the Mississippi Delta and Eastern Kentucky Coalfield regions.

Once a dominant power in U.S. manufacturing, the Mississippi Delta has endured a steep economic decline for most of the 20th century. The populations of many counties in the Mississippi Delta peaked in 1940 or earlier. The declines in these counties’ populations was largely due to job losses, the result of the mechanization in the agriculture and manufacturing industries. Of the 25 counties on this list, six are in the Mississippi Delta region.

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A similar decline took place in a region known as the Eastern Kentucky Coalfield. The regional economy has its roots in coal mining and remains heavily dependent on the industry today. Many towns in eastern Kentucky were first established and built by mining companies. However, due to inexpensive natural gas, stricter federal regulations, and the evolution of renewable energy sources, the Kentucky coal industry has been in steep decline over the last several decades. Of the 25 worst counties to live in, eight are in the Eastern Kentucky Coalfield region.

Many of these counties, unable to establish new industries, remain economically stagnant. In hope of attracting new companies and industries, places such as Quitman County, Mississippi, and McCreary County, Kentucky have built speculative industrial parks and corporate buildings. However, they lack the talent pools that wealthier, more-educated counties often have to offer. In the average county in the Eastern Kentucky Coalfield region, just 13.1% of adults have at least a bachelor’s degree, far less than the 29.8% national college attainment rate.

Unable to improve their economies, joblessness is rampant in the majority of counties on this list. Unemployment is higher than it is nationwide in each of these counties, and in nine counties on this list, the unemployment rate more than doubles the 4.6% national rate.

The available jobs in many of these counties are often low paying. The median annual household income in nearly every county on this list is less than half the $53,889 the typical American household earns a year. High unemployment and low incomes mean that disproportionately large shares of residents regularly face serious financial hardship. In every county on this list, the share of the population living in poverty is more than double the 15.5% national poverty rate. In Oglala Lakota County, South Dakota, more than half of the population lives below the poverty line.

The relationship between income and overall health is complicated and not completely understood. However, below a certain income level, people can become seriously limited in their ability to afford healthy options related to diet, health care, and lifestyle. According to a more than decade-long study conducted by the American Medical Association, higher income is associated with greater longevity in general. Likely due in part to widespread poverty in the counties on this list, average life expectancy at birth in the vast majority of these counties is at least five years shorter than the 78.9 year national average life expectancy.

To identify the worst counties in which to live, 24/7 Wall St. devised an index composed of three socioeconomic measures — poverty rate, the percentage of adults who have at least a bachelor’s degree, and life expectancy at birth — and ranked counties based on the index. The selection of these three measures was inspired by the United Nations’ Human Development Index. Poverty, uninsured, and bachelor attainment rates came from the U.S. Census Bureau’s 2015 American Community Survey. Population data also came from the ACS. Life expectancies at birth are from the Institute for Health Metrics and Evaluation, a health research center affiliated with the University of Washington, and are for 2013. Unemployment rates are from the Bureau of Labor Statistics and are for November 2016, the most recent available month of data.

These are the 25 worst counties to live in.