The COVID-19 pandemic profoundly affected Americans throughout 2020 by disrupting work and education, wreaking havoc on the economy, and putting a strain on personal relationships. The health crisis has exacerbated factors that people had normally pointed to as major stress sources.

About 64% of people in the U.S. say that money is a significant source of stress in their life, and just over half say they have experienced negative financial impacts due to the pandemic, according to a November 2020 Stress in America survey by the American Psychological Association.

Another common cause of stress, which is in many ways also related to money, is work. About one in two employed Americans say their job adds stress to their lives.

To identify the most stressed city in every state, 24/7 Tempo created an index that measures the likelihood that money and work will cause stress among residents of U.S. metropolitan areas. Our index included several money- and work-related factors, including unemployment, poverty, income, and commuting time among others.

Some of the cities on our list are among the most desirable cities for young Americans. But these cities have long commutes and steep housing costs, making it necessary for people to work long hours so they can stay in those cities.

Only nine of the most stressed out cities in every state have a median household income that is higher than the statewide median household income and a poverty rate that is lower than the statewide figure.

While everyone experiences some stress – and some short-lived stress can improve cognitive performance — too much stress can have many negative effects on health. Elevated levels of stress can be a sign of health problems – here are 25 symptoms people always ignore but never should.

Click here to see the most stressed out city in every state

To identify the most stressed city in every state, 24/7 Tempo created an index of data measuring the two most common sources of stress — money and work — in each state’s metropolitan areas. 

To capture money-related stress inputs we reviewed poverty rates, housing affordability, and food insecurity. For work-related stress inputs we included average weekly work hours, average daily commute times in hours, and annual unemployment rates. 

With the exception of food insecurity and unemployment rates, which came from the United States Department of Agriculture and the Bureau of Labor Statistics, respectively, all data used in the index came from the U.S. Census Bureau’s 2019 American Community Survey. 

The incidence of violent crime in each area came from the Federal Bureau of Investigation’s 2019 Uniform Crime Report. All data are for the most recent periods available.