25. Jefferson County, Mississippi
> Poverty rate: 37.6%
> Adults with a bachelor’s degree: 15.9%
> Life expectancy at birth: 71.9 years
> Total population: 7,225
> Largest place in county: Fayette
Jefferson County, located in the southwestern section of Mississippi, is one of several counties in the state to rank among the worst places to live — largely because it is one of the poorest counties in the United States. About 38% of the county’s 7,300 residents live below the poverty line. Widespread poverty is partially the result of a lack of jobs. As of January 2021, 17.0% of the local labor force were unemployed, a higher jobless rate than in all but six other U.S. counties and county equivalents.
As is often the case in areas with low incomes and limited job opportunities, educational attainment is low in Jefferson County. Just 15.9% of area adults have a bachelor’s degree or higher, about half the national share, and 78% of local adults have a high school diploma, 10 percentage points below the national share.
24. Breathitt County, Kentucky
> Poverty rate: 34.4%
> Adults with a bachelor’s degree: 15.2%
> Life expectancy at birth: 69.7 years
> Total population: 12,977
> Largest place in county: Jackson
Breathitt County, Kentucky, is one of the worst places to live in the United States largely because of the relatively poor health outcomes in the area. The county, located in the state’s eastern coalfield region in the Appalachian Mountains, is one of only 24 counties nationwide where life expectancy at birth is less than 70 years. As is the case in much of Appalachia, Breathitt County has been severely affected by the opioid epidemic. There are nearly 31 deaths for every 100,000 people in the county due to drug overdoses annually, compared to 21 per 100,000 nationwide.
Poor health outcomes are also due to widespread financial hardship. The local poverty rate in Breathitt County stands at 34.4% — well more than double the 13.4% national poverty rate.
23. Madison Parish, Louisiana
> Poverty rate: 36.4%
> Adults with a bachelor’s degree: 12.8%
> Life expectancy at birth: 72.4 years
> Total population: 11,306
> Largest place in parish: Tallulah
Madison Parish, located in northeastern Louisiana along the Mississippi River, ranks among the worst places to live largely because of widespread poverty. Some 36.4% of the local population live below the poverty line, meaning that residents of Madison Parish are well more than twice as likely to face serious financial hardship than the typical American.
Incomes tend to rise with educational attainment, and in Madison Parish, only 12.8% of adults have a bachelor’s degree and 73.9% have a high school diploma, well below the respective national shares of 32.1% and 88.0%.
22. Clay County, Georgia
> Poverty rate: 39.5%
> Adults with a bachelor’s degree: 12.5%
> Life expectancy at birth: 74.6 years
> Total population: 2,951
> Largest place in county: Fort Gaines
Clay County is located in western Georgia along the state border with Alabama. One of the poorest parts of the country, Clay is one of only 13 counties or county equivalents nationwide where over 39% of the population live below the poverty line. Low incomes can take a toll on health outcomes as people living below the poverty line often cannot afford adequate health care and healthy lifestyles. In Clay County, life expectancy is just 74.6 years at birth, about five a half years below the national average.
Financial hardship in the area is due in part to a lack of jobs. As of January 2021, unemployment in Clay County stood at 11.5%, well above the comparable 6.8% national unemployment rate.
21. Greene County, Alabama
> Poverty rate: 38.1%
> Adults with a bachelor’s degree: 10.1%
> Life expectancy at birth: 74.8 years
> Total population: 8,324
> Largest place in county: Eutaw
Greene County, located in west-central Alabama, is the only county in the state to rank among the worst places to live in the United States. Greene County is one of the poorest counties in the country with a 38.1% poverty rate — among the 20 highest poverty rates of any U.S. county or county equivalent.
The area’s widespread poverty coupled with some pervasive unhealthy behaviors likely contribute to the low average life expectancy in the county. Nearly one-quarter of local adults are smokers and over a third are obese, each higher than the national figures of 17.1% and 29.0%, respectively. Smoking is the leading cause of preventable death in the United States, and obesity is a risk factor for a number of potentially life threatening diseases and conditions. Life expectancy birth in Greene County is just 74.8 years, over four years less than the national average.