Special Report

The Worst Counties To Live In

Source: Bill Eichelberger / Flickr

30. Apache County, Arizona
> Poverty rate: 35.5%
> Adults with a bachelor’s degree: 12.3%
> Life expectancy at birth: 72.9 years
> Total population: 71,511
> Largest place in county: Chinle

Apache County, Arizona, is located in the northeast corner of the state and covers much of the Navajo Nation. Like many counties with large Native American populations, economic opportunity is scarce in Apache County. More than one-third of the population live below the poverty line, more than one in every 10 members of the labor force are unemployed, and more than one in every five households earn less than $10,000 a year.

Such limited economic opportunity and widespread poverty can take a public health toll. In Apache County, life expectancy at birth is only about 73 years — six years shy of the national average.

Source: Jerrye & Roy Klotz, MD / Wikimedia Commons

29. Leflore County, Mississippi
> Poverty rate: 36.8%
> Adults with a bachelor’s degree: 18.5%
> Life expectancy at birth: 70.5 years
> Total population: 29,222
> Largest place in county: Greenwood

Leflore County, Mississippi, is located in the state’s Delta region. Its ranking as one of the worst places to live in the United States is due in large part to relatively poor health outcomes. Life expectancy at birth in the county is just 70.5 years, nearly nine years below the national average. This is partially the result of certain unhealthy behaviors. Adult county residents are far more likely to smoke and be obese, and far less likely to exercise, than they typical American adult.

Many residents are also severely limited in their ability to afford adequate medical care and healthy lifestyles. Leflore County’s poverty rate of 36.8% is among the 20 highest of all U.S. counties and county equivalents.

Source: Aaron Vowels / Flickr

28. Letcher County, Kentucky
> Poverty rate: 33.6%
> Adults with a bachelor’s degree: 12.1%
> Life expectancy at birth: 71.3 years
> Total population: 22,295
> Largest place in county: Jenkins

Letcher County, Kentucky, is one of several counties in the state’s eastern coalfield region to rank among the worst places to live in the United States. As is the case in other nearby counties, many in Letcher County are unable to make ends meet. Over a third of the population live below the poverty line, and 17.4% of area households earn less than $10,000 a year, each among the highest shares of any U.S county.

Incomes tend to rise with educational attainment, and in Letcher County, only 12.1% of adults have a bachelor’s degree and 75.7% have a high school diploma, well below the comparable national shares of 32.1% and 88.0%, respectively. Job opportunities are limited as well in the area, as the local unemployment rate stood at 8.2% as of January 2021.

Source: BriYYZ / Flickr

27. McKinley County, New Mexico
> Poverty rate: 34.8%
> Adults with a bachelor’s degree: 11.4%
> Life expectancy at birth: 72.2 years
> Total population: 72,438
> Largest place in county: Gallup

McKinley County, New Mexico, is located in the northwestern part of the state and covers parts of the Navajo and Zuni Indian Reservations. Native Americans are among the most disenfranchised groups in the United States, and the poor economic and public health conditions common in many Native American populations are prevalent in McKinley County as well.

The January 2021 unemployment rate in the county is 12% — well above the comparable 6.8% national rate. Additionally, nearly 35% of the local population live below the poverty line, compared to 13.4% of Americans nationwide. Perhaps the most telling disparity in McKinley County, however, is life expectancy at birth, which, at just 72.2 years, is nearly seven years less than the national average.

26. Wilkinson County, Mississippi
> Poverty rate: 34.7%
> Adults with a bachelor’s degree: 13.7%
> Life expectancy at birth: 70.8 years
> Total population: 8,875
> Largest place in county: Centreville

Wilkinson County, Mississippi, is one of the worst places to live in the United States, largely because of the relatively poor health outcomes in the area. Life expectancy at birth in the county, located in southwestern corner of the state, is just 70.8 years, over eight years less than the national average. Adult county residents are far more likely to smoke and be obese, and far less likely to exercise, than they typical American adult.

Widespread poverty, resulting in part from a weak job market, also contributes to low quality of life in the area. Over a third of all county residents live below the poverty line, and 13.9% of the local labor force are unemployed, each among the highest shares of any U.S. county or county equivalent.