Special Report

This is the Worst County to Live in Virginia

Life expectancy fell by 1.5 years in the United States in 2020. The decline, driven by the COVID-19 pandemic and the opioid crisis, represents the most pronounced regression in public health in the United States since World War II.

While the most recent dip in life expectancy in the U.S. is alarming, there are many parts of the country where poor health outcomes and other socioeconomic hardships have long been the norm.

Using an index of three measures — life expectancy at birth, bachelor’s degree attainment, and poverty rate — 24/7 Wall St. identified the worst counties to live in in every state.

There are 133 counties and independent cities in Virginia, and of them, Buchanan County, located in the western part of the state along the West Virginia and Kentucky borders, ranks as the worst place to live. County residents are nearly three times as likely to live below the poverty line as the typical Virginia resident, and life expectancy at birth in the county is 74 years — over half a decade less than the average across the state.

Like many U.S. counties lagging in key socioeconomic indicators, Buchanan County’s population is shrinking. Over the last five years, the number of people living there fell by 8.0%, even as Virginia’s population expanded by 3.3%.

Data on bachelor’s degree attainment and poverty are from the 2019 U.S. Census Bureau’s American Community Survey and are five-year estimates. Data on average life expectancy at birth came from the 2021 County Health Rankings, a joint program of the Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute, and are based on mortality data from the years 2017 to 2019. Supplemental data on population and income are from the ACS, and unemployment rates are seasonally adjusted for May 2021 and are from the Bureau of Labor Statistics. This is the worst county to live in every state.

Place Poverty rate (%) Adults with a bachelor’s degree (%) Life expectancy at birth (years)
Alabama: Wilcox County 30.1 12.5 70.8
Alaska: Bethel Census Area 28.3 11.9 71.6
Arizona: Apache County 35.5 12.3 73.1
Arkansas: Phillips County 34.5 13.8 71.1
California: Tulare County 23.8 14.6 78.7
Colorado: Otero County 23.7 18.6 74.0
Connecticut: Windham County 11.4 24.3 78.5
Delaware: Kent County 13.5 23.7 77.8
Florida: Hamilton County 29.9 7.9 76.2
Georgia: Ben Hill County 29.6 11.2 73.0
Hawaii: Hawaii County 15.6 29.4 80.6
Idaho: Shoshone County 19.4 11.5 75.5
Illinois: Saline County 21.1 19.2 73.4
Indiana: Fayette County 19.0 13.3 73.0
Iowa: Appanoose County 17.7 16.3 77.1
Kansas: Wyandotte County 19.2 18.1 75.8
Kentucky: Leslie County 38.0 8.7 70.4
Louisiana: Madison Parish 36.4 12.8 72.0
Maine: Somerset County 20.4 16.5 76.5
Maryland: Somerset County 21.7 14.4 75.5
Massachusetts: Hampden County 16.4 27.1 78.2
Michigan: Clare County 22.7 12.6 74.9
Minnesota: Wadena County 14.3 13.8 76.1
Mississippi: Holmes County 42.4 10.2 70.6
Missouri: Pemiscot County 27.4 12.7 71.5
Montana: Roosevelt County 28.3 17.4 67.7
Nebraska: Dakota County 16.2 13.0 79.1
Nevada: Nye County 16.4 10.7 74.2
New Hampshire: Coos County 12.5 18.2 77.3
New Jersey: Cumberland County 16.5 15.6 75.3
New Mexico: McKinley County 34.8 11.4 71.9
New York: Bronx County 28.0 20.1 80.9
North Carolina: Robeson County 27.7 13.7 72.8
North Dakota: Rolette County 27.1 19.6 72.3
Ohio: Scioto County 22.6 15.7 72.0
Oklahoma: Okfuskee County 26.3 11.6 69.6
Oregon: Malheur County 21.8 13.7 78.1
Pennsylvania: Fayette County 17.3 17.3 75.2
Rhode Island: Providence County 15.2 29.0 79.4
South Carolina: Dillon County 32.6 11.1 72.9
South Dakota: Todd County 55.5 15.6 67.4
Tennessee: Cocke County 23.5 11.6 71.5
Texas: Zavala County 33.8 10.9 76.0
Utah: San Juan County 25.0 18.3 76.4
Vermont: Orleans County 13.1 21.5 78.5
Virginia: Buchanan County 28.4 11.8 74.0
Washington: Adams County 25.6 14.3 80.2
West Virginia: McDowell County 33.2 5.4 69.0
Wisconsin: Juneau County 15.1 13.7 78.2
Wyoming: Big Horn County 12.7 19.0 76.1