To score the states for quality of life, we use hard data on factors like crime rates, air quality and healthcare. We also consider the cost and availability of childcare, inclusiveness of state laws, and reproductive rights. Some states offer exemplary quality of life. But these ten states do not make the grade.

Starting at worst:

  • 1- Tennessee
  • 2- Texas
  • 3- Indiana
  • 4- Louisiana
  • 5- Georgia
  • 6- Utah
  • 7- Missouri
  • 8- Alabama
  • 9- Oklahoma
  • 10- Arkansas
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(#2) Texas

While Texas continues to lead the nation in attracting workers, those workers are finding a broad array of challenges when they get there. The Lone Star State has America’s highest rate of people without health insurance at 16.7%, according to the United Health Foundation, more than twice the national average. More than 17% of Texas adults said they had to forgo a doctor visit that they needed in the past year because of the cost. Even those who do have health insurance can have trouble finding a doctor. The state finishes dead last in primary care physicians per capita.

In May, Republican Gov. Greg Abbott announced $56 million in federal grants to rural hospitals. “We will deliver state-of-the-art treatment for everyone who calls Texas home,” the governor said in a statement. Some 31 million people call Texas home, so the grants amount to about $1.80 apiece, or about $350,000 for each of the state’s nearly 160 rural hospitals.

2026 Quality of Life score: 78 out of 290 points (Top States grade: F)

Strengths: Childcare, Air Quality

Weaknesses: Health, Crime, Inclusiveness, Worker Protections, Reproductive Rights