These are the 10 worst U.S. states for quality of life

The job market may have cooled a bit, but there are still far more job openings nationwide than there are people available to fill them. That means qualified workers are still a precious commodity.

So, companies seeking to attract great employees like to set up shop in states that offer a great quality of life. While some states are more than happy to oblige, these are not those states. They are America’s worst states to live and work in. 

Each year, CNBC’s America’s Top States for Business study considers quality of life among ten categories of competitiveness used to rank the states. Under this year’s methodology, the Quality of Life category counts for 13% of a state’s overall score. 

We score each state on multiple livability factors including crime rates, health care, air quality and child care. We also consider worker protections, and legal safeguards against discrimination of all kinds. And, we look at personal freedom including reproductive rights. 

In these ten states, the welcome mat has more than a few holes in it. 

Because everyone has their own opinion about the weather, we don’t include it in our Quality of Life rankings. That means Arizona reaches the bottom tier without even considering the sweltering heat. We do, however, consider air quality, and the state’s rising temperatures are contributing to some of the worst ozone pollution in the nation, according to the American Lung Association. 

In May, Democratic Gov. Katie Hobbs signed a repeal of the near-total abortion ban passed in 1864, before Arizona was a state. But that still left the state with a 15-week ban. And a quirk in the state constitution could allow the 1864 ban to go back into effect, if only briefly, this fall. 

2024 Quality of Life Score: 119 out of 325 Points (Top States Grade: D-)

Strengths: Crime, Voting Rights, Worker Protections

Weaknesses: Air Quality, Reproductive Rights, Health Care  

Quality child care is sparse in the Sunflower State, with just 825 licensed child-care centers in a state of 2.9 million people, according to Child Care Aware of America. Kansas also has some of the most expensive child care in the nation. A married couple earning a median income can expect to spend nearly 14% of it on child care. 

Louisiana is America’s least healthy state, according to the United Health Foundation, with the fourth-highest rate of premature deaths. More than 40% of Louisianans are obese. However, the state is a leader in child care, with more than 1,800 licensed facilities in a state of 4.5 million people, according to the Louisiana Department of Education.

In 2020, as the Covid-19 pandemic raged, Missouri became one of the last states to give in and allow early and mail voting. But it remains one of the most burdensome states to vote in, according to elections researcher Michael Pomante, who has published a Cost of Voting Index since 2018. Missouri is one of only 10 states requiring a qualified excuse to vote by mail. Missouri also has America’s sixth-highest crime rate, with more than 30,000 offenses reported in 2022.

The Tennessee Bureau of Investigation reports that violent crime in the Volunteer State is declining, including a nearly 9% drop in the murder rate in 2022. But it is still among the most violent states in the nation, according to FBI crime statistics. 

The Human Rights Campaign alleges Tennessee lawmakers unleashed “a tsunami of discriminatory legislation” in 2024, including a law signed by Republican Gov. Bill Lee in April that forbids the state social services department from seeking to place LGBTQ+ foster children in supportive homes. Another law clears the way for the state to abolish its independent human rights commission, folding it into the partisan Attorney General’s office. 

2024 Quality of Life Score: 96 out of 325 points (Top States Grade: F)

Strengths: Child Care, Air Quality

Weaknesses: Crime, Inclusiveness, Health Care

The Natural State is dangerous, with the second-highest violent crime rate in the nation after New Mexico. Anti-discrimination provisions in the state’s public accommodation law are weak, according to the National Conference of State Legislatures, with no protections against discrimination based on age, veteran or military status, pregnancy, sexual orientation or marital status. However, the state is a leader in affordable child care. A married, median income couple can expect to pay just 9% of their income on child care. The state of about three million people has nearly 1,800 licensed child-care facilities. 

Oklahoma’s abortion ban, triggered by the Supreme Court’s 2022 Dobbs decision, is among the most restrictive in the nation, according to the Guttmacher Institute. It prohibits abortions at any stage of pregnancy, except in cases of rape or incest, or if the procedure is necessary to save the life of the mother. Oklahomans have the nation’s third-highest obesity rate and the third-lowest rate of physical exercise. That helps make the Sooner State among America’s least healthy. 

2024 Quality of Life Score: 85 out of 325 points (Top States Grade: F)

Strength: Air Quality

Weaknesses: Reproductive Rights, Health, Worker Protections, Voting Rights 

Alabama is one of only three states that do not allow early voting, according to The Center for Election Innovation and Research (the others are Mississippi and New Hampshire). And this year, the state passed significant new restrictions on absentee voting. 

Indiana is the worst state for access to child care, with just 772 licensed facilities in a state of nearly seven million people. The low supply versus demand makes child care expensive in the Hoosier State. A married couple can expect to spend nearly 13% of a median income on child care.

Take something as basic as health care. Texas ranks near the bottom in primary care providers per 100,000 residents at 182, according to the United Health Foundation. According to The Commonwealth Fund, Texas leads the nation — by far — in residents without health insurance, and a staggering 19% of all people with a credit score in Texas have medical debt that has gone to collections.

Might Texas’ restrictive policies trigger a backlash? There are some anecdotal accounts of people leaving the state over its abortion ban and its anti-LGBTQ+ laws. But for now, statistically speaking, people keep pouring into the state with America’s worst quality of life. 

2024 Quality of Life Score: 75 out of 325 points (Top States Grade: F)

Strength: Air Quality

Weaknesses: Reproductive Rights, Health Care, Voting Rights, Inclusiveness, Worker Protections

Correction: Alabama is one of only three states that do not allow early voting. Delaware recently reinstated early voting. Elections researcher Michael Pomante has published a Cost of Voting Index since 2018 separate from his work for the States United Democracy Center. An earlier version of this article misstated these facts.