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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.

Holmes County, located in central Mississippi, ranks as the worst county to live in in the state. Mississippi is the poorest state in the country, with a 20.3% poverty rate -- and Holmes County is the poorest county in the state, with a 42.4% poverty rate, more than double the rate across Mississippi.

Poverty can have a negative impact on health outcomes, including life expectancy, as poorer Americans often struggle to afford health care and healthy lifestyle choices. Partially as a result, life expectancy at birth in Holmes County is just 70.6 years, well below the 74.9 year average life expectancy statewide and 79.2 year average nationwide.

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.

PlacePoverty rate (%)Adults with a bachelor's degree (%)Life expectancy at birth (years)
Alabama: Wilcox County30.112.570.8
Alaska: Bethel Census Area28.311.971.6
Arizona: Apache County35.512.373.1
Arkansas: Phillips County34.513.871.1
California: Tulare County23.814.678.7
Colorado: Otero County23.718.674.0
Connecticut: Windham County11.424.378.5
Delaware: Kent County13.523.777.8
Florida: Hamilton County29.97.976.2
Georgia: Ben Hill County29.611.273.0
Hawaii: Hawaii County15.629.480.6
Idaho: Shoshone County19.411.575.5
Illinois: Saline County21.119.273.4
Indiana: Fayette County19.013.373.0
Iowa: Appanoose County17.716.377.1
Kansas: Wyandotte County19.218.175.8
Kentucky: Leslie County38.08.770.4
Louisiana: Madison Parish36.412.872.0
Maine: Somerset County20.416.576.5
Maryland: Somerset County21.714.475.5
Massachusetts: Hampden County16.427.178.2
Michigan: Clare County22.712.674.9
Minnesota: Wadena County14.313.876.1
Mississippi: Holmes County42.410.270.6
Missouri: Pemiscot County27.412.771.5
Montana: Roosevelt County28.317.467.7
Nebraska: Dakota County16.213.079.1
Nevada: Nye County16.410.774.2
New Hampshire: Coos County12.518.277.3
New Jersey: Cumberland County16.515.675.3
New Mexico: McKinley County34.811.471.9
New York: Bronx County28.020.180.9
North Carolina: Robeson County27.713.772.8
North Dakota: Rolette County27.119.672.3
Ohio: Scioto County22.615.772.0
Oklahoma: Okfuskee County26.311.669.6
Oregon: Malheur County21.813.778.1
Pennsylvania: Fayette County17.317.375.2
Rhode Island: Providence County15.229.079.4
South Carolina: Dillon County32.611.172.9
South Dakota: Todd County55.515.667.4
Tennessee: Cocke County23.511.671.5
Texas: Zavala County33.810.976.0
Utah: San Juan County25.018.376.4
Vermont: Orleans County13.121.578.5
Virginia: Buchanan County28.411.874.0
Washington: Adams County25.614.380.2
West Virginia: McDowell County33.25.469.0
Wisconsin: Juneau County15.113.778.2
Wyoming: Big Horn County12.719.076.1

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