Respect Equality

Here are the 10 states with the poorest quality of life

States with the poorest quality of life are mainly clustered in the South.

Story at a glance


  • CNBC released its ‘America’s Top States for Business’ report, which considers quality of life in its ranking.

  • The states with the poorest quality of life in 2024 are Texas, Indiana and Alabama, according to the report.  

  • Texas’ anti-LGBTQ legislation, restrictive abortion policy and poor healthcare are all reasons it has the worst quality of life, according to the ranking.

Texas is the state with the worst quality of life, according to data from CNBC’s America’s Top States for Business report.  

As part of the study, CNBC considers states’ quality of life as one of their 10 categories of competitiveness used to rank states.  

CNBC uses multiple factors like crime rates, health care, air quality and child care when determining quality of life of each state.  

Texas came in as the state with the worst quality of life, in part, due to its poor healthcare.  

The Lone Star State has one of the lowest primary care provider-to-patient ratios in the country, with 182 primary care providers per 100,000 residents, according to the United Health Foundation.  

The state has one of the lowest primary care physician-to-patient ratios with 64.4 per 100,000, according to the Bureau of Health Workforce.  

Texas also has the highest percentage of people without health insurance. In 2022, about 22 percent of Texans did not have health insurance, according to The Commonwealth Fund. 

On top of this, 19 percent of Texas had some sort of medical debt in 2021, 6 percentage points higher than the national average and 17 points higher than the state with the lowest percentage of residents with medical debt, according to The Commonwealth Fund.

Texas has few legal protections against discrimination and worker protection policies, contributing to its low quality of life ranking.  

“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,” CNBC wrote.  

The minimum wage in Texas is $7.25 an hour—about 20 percent lower than an hourly rate that would cover the cost of living for a family of four, according to an Oxfam America report.  

And if a Texan loses their job, the state’s unemployment benefits cover 10.5 percent of the income needed to cover the cost of living.  

Here are all the states with a poor quality of life, according to the report:  

  1. Texas 
  1. Indiana 
  1. Alabama 
  1. Oklahoma 
  1. Arkansas 
  1. Tennessee 
  1. Missouri 
  1. Louisiana 
  1. Kansas 
  1. Arizona 

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