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39. Floyd County, Kentucky
> Poverty rate: 30.7%
> Adults with a bachelor’s degree: 11.3%
> Life expectancy at birth: 71.0 years
> Total population: 36,456
> Largest place in county: Prestonsburg
Floyd County, located in eastern Kentucky, is one of the worst places to live in the United States. Coal extraction has long been an economic pillar in the county, and as U.S. energy production has shifted away from coal, places in eastern Kentucky and other parts of Appalachia have suffered economically. In Floyd County, 30.7% of the population live below the poverty line, and most households earn less than $33,000 annually.
As coal mining was a way many could earn a living without a college education, relatively few in Floyd County have the education necessary for many high paying jobs more common today. Just 11.3% of the local 25 and older population have a bachelor’s degree, about one-third the comparable share of adults nationwide.
38. Brooks County, Texas
> Poverty rate: 41.4%
> Adults with a bachelor’s degree: 15.7%
> Life expectancy at birth: 77.1 years
> Total population: 7,141
> Largest place in county: Falfurrias
Brooks County, located in southern Texas, is the only county in the state to rank among the worst places to live in the United States. The county’s poverty rate of 41.4% is more than three times higher than the national poverty rate and among the 10 highest of all U.S. counties and county equivalents. Widespread poverty is due in part to a lack of economic opportunity. The unemployment rate in the county stands at 11.9%.
In recent years, Brooks County has been a popular crossing point for illegal migrants from Central America. Temperatures in the county regularly exceed 100 degrees Fahrenheit, making the journey especially dangerous for migrants, who often resort to breaking and entering and burglary out of necessity. The area is also used by drug traffickers from south of the border.

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37. Claiborne County, Mississippi
> Poverty rate: 41.0%
> Adults with a bachelor’s degree: 24.0%
> Life expectancy at birth: 72.1 years
> Total population: 9,089
> Largest place in county: Port Gibson
Claiborne County, located in southwestern Mississippi, is one of several counties in the state to rank among the worst places to live nationwide. In Claiborne, quality of life is undermined by widespread poverty. The local poverty rate stands at 41%, more than triple the national poverty rate and among the 10 highest of all counties and county equivalents in the United States.
The local poverty rate would likely decline if the job market improved. As of January 2021, 13.5% of the area’s labor force were unemployed. Even before the COVID-19 pandemic, the local 2019 unemployment rate stood at 10.7%, well above the comparable 3.7% national rate.
36. Coahoma County, Mississippi
> Poverty rate: 34.8%
> Adults with a bachelor’s degree: 16.5%
> Life expectancy at birth: 71.2 years
> Total population: 23,255
> Largest place in county: Clarksdale
Coahoma County, located in Mississippi’s Delta region, is one of the worst places to live in the country largely because of widespread poverty. Over a third of the area’s 23,300 residents live below the poverty line, and nearly 18% of households earn less than $10,000 a year, about three times the 6% share of all U.S. households living on so little.
Limited job availability partially explains the widespread poverty in Coahoma County. As of January 2021, 11.0% of the area’s labor force were unemployed. Even before the COVID-19 pandemic, the local 2019 unemployment rate stood at 7.7%, well above the comparable 3.7% national rate.

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35. Menominee County, Wisconsin
> Poverty rate: 35.3%
> Adults with a bachelor’s degree: 17.9%
> Life expectancy at birth: 70.6 years
> Total population: 4,558
> Largest place in county: Keshena
Many of the counties with some of the worst socioeconomic conditions and public health outcomes in the United States are located on Native American reservations, and Menominee County, Wisconsin, which shares a boundary with the Menominee Indian Reservation, is one of them. At 70.6 years, average life expectancy at birth in the county is over eight years below the national average.
The county’s low life expectancy is likely due to several behavioral and economic factors. Smoking is the leading cause of preventable death in the United States, and obesity is a risk factor for many potentially life threatening diseases and conditions — and adults in Menominee County are far more likely than most Americans to smoke or be obese. Poverty can also make it difficult to access health care and maintain healthy lifestyles, and over one-third of the 4,600 people in the county live below the poverty line.
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