This Is the Worst County to Live In

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.

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.

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.

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.

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.