These are America’s 10 worst states for quality of life in 2024

Health, Fitness & Food

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. 

10. Arizona 

Members of Arizona for Abortion Access, the ballot initiative to enshrine abortion rights in the Arizona State Constitution, hold a press conference and protest condemning Arizona House Republicans and the 1864 abortion ban during a recess from a legislative session at the Arizona House of Representatives on April 17, 2024 in Phoenix, Arizona. 
Rebecca Noble | Getty Images

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. 

The Grand Canyon State also has growing gaps in health care, with fewer than two staffed hospital beds per 1,000 people, according to the American Hospital 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  

9. Kansas 

Thomas Barwick | Digitalvision | Getty Images

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. 

Oh, and don’t let the idyllic prairie fool you: Kansans reported more than 11,000 violent crimes in 2022, the most recent figure available from the FBI. The crime rate has recently begun to decline after nearly a decade on the rise, but Kansas is still more violent than the nation as a whole. 

2024 Quality of Life Score: 113 out of 325 Points (Top States Grade: F)

Strengths: Health Care, Reproductive Rights

Weaknesses: Child Care, Crime, Worker Protections

8. Louisiana

Police officers work at the scene of a shooting that occured during the Krewe of Bacchus parade in New Orleans, February 19, 2023. 
Chandan Khanna | AFP | Getty Images

People in the Pelican State pride themselves on being made of stern stuff. That’s probably a good thing in a state with the fourth-highest violent crime rate in the nation, according to FBI statistics, including more than 300 murders in 2022.

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.

2024 Quality of Life Score: 100 out of 325 points (Top States Grade: F)

Strength: Child Care

Weaknesses: Crime, Health, Reproductive Rights

7. Missouri

St. Louis County Prosecutor Wesley Bell listens to a concerned voter after casting his ballot on November 3, 2020 outside the St. Louis County Board of Elections in St. Ann, Missouri.
Michael B. Thomas | Getty Images

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 of the States United Democracy Center. 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.

 2024 Quality of Life Score: 98 out of 325 points (Top States Grade: F)

Strength: Air Quality

Weaknesses: Voting Rights, Crime, Reproductive Rights

6. Tennessee 

Educators and various organizations from across the state of Tennessee march to the Amazon headquarters in downtown Nashville in protest of Governor Bill Lee’s school voucher program on March 12, 2024 in Nashville, Tennessee. 
Seth Herald  | Getty Images

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

5. Arkansas

Kali9 | E+ | Getty Images

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. 

2024 Quality of Life Score: 93 out of 325 points (Top States Grade: F)

Strength: Child Care

Weaknesses: Inclusiveness, Crime, Voting Rights 

4. Oklahoma 

Dr. Franz Theard consults a woman seeking abortion from Oklahoma in his clinic, Womens Reproductive Clinic, a provider of abortions in Santa Teresa, New Mexico on May 7, 2022. Paul Ratje/The Washington Post via Getty Images
Paul Ratje | The Washington Post | Getty Images

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 

3. Alabama 

Voters enter a polling location to cast their ballots in the state’s primary on March 5, 2024 in Oxford, Alabama. 15 States and one U.S. 
Elijah Nouvelage | Getty Images

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. 

Oxfam America ranked the Yellowhammer State dead last for wage policies. The state minimum wage of $7.25 per hour covers less than 20% of the cost of living for a family of four. Alabama is one of only five states with no public accommodation law barring discrimination against non-disabled people. 

2024 Quality of Life Score: 83 out of 325 points (Top States Grade: F)

Strength: Child Care

Weaknesses: Voting Rights, Inclusiveness, Worker Protections 

2. Indiana 

Solstock | E+ | Getty Images

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.

Indiana has joined a parade of states passing laws targeting the LGBTQ+ population, including a ban on gender-affirming care for minors, and barring teachers from discussing human sexuality from pre-kindergarten through third grade. 

2024 Quality of Life Score: 78 out of 325 points (Top States Grade: F)

Strength: Crime

Weaknesses: Child Care, Reproductive Rights, Inclusiveness, Voting Rights 

1. Texas 

Darwin Varela is carried into the Fort Duncan Regional Medical Center after suffering from dehydration on July 18, 2023 in Eagle Pass, Texas. 
Brandon Bell | Getty Images

Yes, we know. People are moving to the Lone Star State in droves. Some 220,000 educated workers moved there in 2022 alone, according to the Census Bureau. So how could we possibly score Texas at the bottom for Quality of Life? The fact is that people move to a state for any number of reasons. The ones arriving in Texas are encountering some serious livability issues, based on the data. 

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.

Those new Texans are also finding few protections in the law. Texas is another state with no public accommodation law barring discrimination against non-disabled people; it has passed a barrage of laws targeting the LGBTQ+ community; and its abortion ban is the strictest in the nation. Also, if any of those new Texas residents lose their jobs, state unemployment benefits cover less than 10% of the average cost of living, according to Oxfam America. 

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. An earlier version of this article misstated that fact.

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