According to the World Health Organization (WHO), quality of life measures seek to understand how individuals perceive their position in society and the level to which they can obtain their needs, meet their goals and address their concerns. A population's well-being is determined by material conditions, like housing and income, and immaterial considerations, such as health, education, and security. Measuring quality of life across large populations helps researchers and policymakers better understand how well programs and governments serve their citizens.
While the United States ranks 20th globally in quality of life metrics, programs and policies make for vastly different experiences across states. Each year, U.S. News and World Reports releases its Best State Rankings to show how states perform on metrics that impact the quality of life. The states ranked the worst to live in are those that provide the worst quality of life for their people.
The Best State Rankings utilize public data and extensive surveying to determine the quality of life and effectiveness of governance across the 50 states. The study includes an analysis of 71 metrics across eight categories to determine their ranking.
The categories included are:
Many of these metrics are intertwined and influence one another. For example, states with lower economic opportunity may have less money to invest in education or healthcare. Perhaps for this reason, improvements in these states are slow. Every member of the worst ten states in the U.S. & World News rankings has been in the bottom ten since 2017.
U.S. & World News ranks Kentucky as the tenth worst state to live in in 2022. While the state outperforms the nation in crime, infrastructure, and opportunity metrics, its fiscal instability and healthcare concerns overshadow some of those strengths.
The state has one of the lowest levels of fiscal stability, due in part to the state's 1.8 billion dollar shortfall in 2021. Wallethub also ranks Kentucky among the states with the highest levels of poverty.
Kentucky also falls behind the nation in several health metrics, including low levels of childhood immunizations and high levels of preventable hospitalization. However, according to America’s Health Rankings, much of the state's healthcare concerns have to do with the habits of its people. Kentucky ranks last in the nation for exercise and fruit and vegetable consumption while maintaining the country’s second-highest rate of smoking and sleep deprivation.
South Carolina is the ninth-worst state to live in, according to U.S. & World News, mainly due to rates of crime and shortcomings in education.
The state has one of the highest levels of violent crime, with the nation’s fifth-highest homicide rate and a juvenile incarceration rate 10% higher than the national average. The murder and aggravated assault rates have been on a steady climb since 2016, despite a significant decrease in the 20 years prior.
South Carolina’s schools trail behind the nation in K-12 performance measures and high school graduation rates (81% to 85%). According to Quality Counts, the poverty gap in South Carolina is one of the worst in the nation. This metric measures the difference in the quality of education between poor and wealthy students. Given that South Carolina has one of the nation's highest poverty levels, the poverty gap affects many of the state's students.
U.S. & World News ranks Oklahoma the eighth-worst state for living, a rank it has maintained since 2018 due to healthcare concerns and crime rates.
Residents of Oklahoma have some of the nation's lowest rates of healthcare access. A fifth of individuals aged 19 to 64 in the state do not have insurance, while 14.6% of individuals reported avoiding healthcare due to cost. The state also has some of the country's highest rates of non-medical drug use and the second-lowest rate of exercise and vegetable consumption.
Oklahoma has the 16th highest murder rate in the country and has seen a rise in violent crimes. The state also has the nation's second-highest incarceration rate, with 639 out of every 100,000 people behind bars.
Arkansas is the seventh-worst state in the U.S. & World News ranking, primarily due to healthcare concerns and crime rates.
Arkansas' access to healthcare, specifically dental care, is ranked among the worst in the country. Residents have the lowest rate of dentist visits and 12.9% report avoiding health care due to cost. The state also has the nation's second-highest rates of tobacco use and cardiovascular disease.
Arkansas has the fourth-highest incarceration rate, with 586 of every 100,000 people imprisoned. The state also has the fourth-highest incidence of violent crime. High rates of poverty and economic hardship coupled with low levels of educational attainment may contribute to the high crime rates seen in the state.
U.S. & World News ranks Alaska as the sixth-worst state in the nation to live in, slightly worse than in previous years.
Alaska’s economy is 50th in the nation, falling from the 46th spot in the 2019 rankings. The Covid-19 pandemic hurt the state's heavy reliance on oil and tourism. According to the Alaskan Department of Labor, Alaska’s economy trails behind the nation in job growth, unemployment rate, and wage growth, though the state did outpace the nation in job growth in the fourth quarter of 2021.
The National Institute of Justice defines violent crimes involving murder, rape, sexual assault, robbery, or aggravated assault. Despite falling in line with the nation's average homicide rate, Alaska leads the nation in violent crime rates.
Alabama ranks as the fifth-worst state in the nation, according to the U.S. & World News report, primarily due to education and healthcare concerns.
The state has seen some improvement in its education system since 2019 when it ranked 50th in the nation. Education Weekly’s Quality Counts analysis gave the state a D+, citing low levels of student performance and adult outcomes. While the state made improvements in early-childhood education, overall progress is happening at a slower rate than the nation overall.
Healthcare in Alabama trails most of the nation due to low levels of access. America’s Health Rankings ranks the state 49th for overall health outcomes, citing the lowest level of access to providers in the country. Rates of depression, obesity, diabetes, and chronic kidney disease are some of the highest in the country.
The state’s infrastructure is the worst in the nation. Nearly a third of West Virginia’s roads are in poor condition. Infrastructurereportcard.org gives West Virginia a grade of D, signifying that the state systems are at risk, with many elements reaching the end of their service life.
New Mexico ranks 48th in the nation, or third-worst, according to the U.S. & World News report. The state has fallen in the bottom five states every year since 2017, mainly due to concerns about education and opportunity.
New Mexico’s education system ranks last in the nation, and EdWeek Research Center ranked the state's public schools the worst in the country. by the EdWeek Research Center. The state's fourth-grade reading levels are the lowest in the country. Only 75% of New Mexican students graduate from high school, significantly lower than the national average of 85.8%.
Opportunity metrics are low in the state, with a poverty rate of 17%. Furthermore, 26% of children live at or below the poverty line, which is the country's highest level of childhood poverty.
Mississippi ranks second-worst state in the U.S. & World News report, a spot it has mostly maintained since the 2017 report, with just a brief move to the 48th spot in 2019. The state maintains its low ranking due to low performance across many metrics.
Mississippi ranks last in terms of healthcare due to low levels of access and outcomes. Nearly a fifth of residents have no health insurance. Fourteen percent of residents claim to have avoided seeking medical care due to cost concerns. Mississippi also has the highest rate of obesity in the nation, with 38.7% being obese. The state also leads the nation in infant mortality, cesarean delivery, preterm birth, and low birth weight.
America's Health Rankings rank Mississippi the worst in the Economic Hardship Index. Nearly nineteen percent of Mississippi's residents live at or below the poverty line. The per capita income for the state is $25,300, the lowest in the nation. Levels of unemployment and food insecurity are also the worst in the country.
U.S. & World News ranks Louisiana the worst state in the nation, as it has every year since 2017. Low performance across all metrics, especially crime and education concerns.
Both crime and criminal justice are concerns in Louisiana. The state ranks first in the nation for homicide, with 15.8 murders for every 100,000 people, far outpacing the runner-up, Missouri, with 11.8 homicides per 100,000. It also has the nation's highest incarceration rate, with 680 incarcerated individuals for every 100,000 residents.
Opportunity and education in Louisiana are also among the worst in the nation. The state has the highest level of poverty, at 19%, and among the highest levels of food insecurity. School spending is the lowest in the nation, as are performance measures on 4th and 8th-grade reading and math.
The U.S. & World News Best State Rankings synthesize a wealth of information to provide a snapshot of how well states are meeting the needs of their people. The nation's poorest-performing states tend to be concentrated in the South, suggesting there may be some cultural influences that may play a role in the decisions made by policymakers and government officials.
While the worst states in the country are pretty well the same year to year, the top ten states are quite dynamic, with the top spots frequently changing. Head here to see the best states to live in in 2022.