36. Choctaw County, Oklahoma
> 5-yr. population change: -0.9%
> Nov. unemployment rate: 5.5%
> Poverty rate: 28.5%
> Life expectancy at birth: 73.3 years
Choctaw County, located on Oklahoma’s southern border with Texas, is the worst county to live in the state. A long-term decline in population is often a good indicator of a county that is a less-than-ideal place to live, and Choctaw’s population count dropped 1% in the past five years alone.
Choctaw ranks among the worst in the state in measures like poverty, income, educational attainment. Such factors have been shown to correlate with worse quality of life, as well as worth health outcomes. Life expectancy in the county is 73 years, more than five years less than the national average.
37. Malheur County, Oregon
> 5-yr. population change: -2.6%
> Nov. unemployment rate: 3.9%
> Poverty rate: 24.8%
> Life expectancy at birth: 78.4 years
Malheur County is the second largest county in Oregon by geographic size and one of the most sparsely populated. Barely 30,000 people live in the county, which covers close to 10,000 square miles. Most of Malheur has a population density of less than 1 person per square mile. People living in rural areas do not necessarily face more difficult living conditions, and there are many positives to residing outside a city. But on the whole, Americans living in rural areas are more likely to struggle financially. This is the case in Malheur, where 1 person in 4 lives in poverty, by far the largest share of any county in the state.
38. Philadelphia County, Pennsylvania
> 5-yr. population change: +3.0%
> Nov. unemployment rate: 5.7%
> Poverty rate: 25.9%
> Life expectancy at birth: 75.5 years
Philadelphia County shares its borders with the city of Philadelphia, the largest city in Pennsylvania and the fifth largest city in the country. While Philadelphia is home to some prestigious universities and 26.3% of its adults have a bachelor’s degree — one of the larger shares of any county the state — the county also struggles with high unemployment, widespread poverty, and poor health outcomes. Philadelphia’s unemployment rate is 5.7%, the fourth highest of any county in Pennsylvania. An estimated 25.9% of the county’s population lives in poverty, far higher than the state’s poverty rate of 13.3% and the highest for any county in Pennsylvania. Life expectancy in Philadelphia is just 75.5 years, more than three years lower than the state and national averages.
39. Providence County, Rhode Island
> 5-yr. population change: +0.6%
> Nov. unemployment rate: 4.6%
> Poverty rate: 17.2%
> Life expectancy at birth: 79.3 years
Unlike most counties on this list, Providence County contains a major urban area — the city of Providence. The most populous county in Rhode Island, Providence County is home to more than half of the state’s population.
Economic outcomes among area residents vary considerably. Though Providence County’s median household income of $50,637 is higher than that of most counties on this list and only about $5,000 lower than the national median, a disproportionately large share of the county’s population lives in poverty. The county’s 17.2% poverty rate is by far the highest among counties in the state and well above the U.S. rate of 15.1%.
40. Dillon County, South Carolina
> 5-yr. population change: -1.5%
> Nov. unemployment rate: 5.5%
> Poverty rate: 30.6%
> Life expectancy at birth: 73.1 years
Dillon County’s residents not only face some of the greatest challenges among people in South Carolina. They are also among the nation’s poorest residents. With a poverty rate of 30.6%, it is one of a small number of American counties with a poverty rate that’s more than double the nation’s rate of 15.1%. It is one of a small number of counties in the state where less than 10% of the adult population has a bachelor’s degree as compared with the nation’s bachelor’s degree-attainment rate of 30.3%. Like many extremely poor counties with low counts of adults with a college education, Dillon residents are more likely to face health issues that meaningfully shorten their lives. Life expectancy in the county is just 73 years, which is six years less than the national average.