People line up to vote at the Gwinnett County Fairgrounds on October 30, 2020 in Lawrenceville, Georgia.
Justin Sullivan | Getty Images
More than a year of quarantine has reminded all of us about the importance of home. And even as the pandemic subsides, some companies are rethinking their policies on remote work.
That helps explain why states are increasingly touting their quality of life in pitches to businesses. Plus, companies that are seeking workers in a time of shortages want to be in a state where workers will want to reside. This heightened competitiveness over quality of life puts some states at a disadvantage. By the numbers, they are just not great places to live.
The definition is changing, too. We now know how important public health systems and hospital capacity can be. Inclusive states value all their citizens and protect them from discrimination. And corporate America has spoken loudly, as well as quietly behind the scenes, against restrictive voting laws.
CNBC’s America’s Top States for Business study takes all of this into account, along with basic quality of life measures like crime rates and environmental quality, in our Life, Health and Inclusion category. Based on our methodology, this category is worth 15% of a state’s total points. Some states score highly as places to live, or more specifically, as places to remote work.
If one of these ten states is your home, though — and you may beg to differ — but based on the data, these are America’s worst places to live.
10. Indiana
Zaira Hernandez, front line Healthcare worker is vaccinated with the Pfizer covid-19 vaccine by Amy Meek at IU Health Bloomington.
Jeremy Hogan | SOPA Images | LightRocket | Getty Images
The Hoosier State ranks 48th in public health funding per capita, according to the United Health Foundation, spending a paltry $55 per person in 2020. That has not been helpful in getting through the pandemic. While hospitals were generally adequate, Indiana‘s Covid-19 vaccination rates have lagged, according to data from the Centers for Disease Control. The state’s public accommodation law does not cover discrimination based on age, sexual orientation, or gender identity. In April, the state amended its already restrictive voting law to place new limits on mail voting.
2021 Life, Health and Inclusion score: 130 out of 375 points (Top States Grade: F)
Strength: Hospital resources
Weaknesses: Public health funding, voting rights, inclusiveness, air quality
9. Louisiana
Poor Cajun home in Ville Platte, Louisiana, United States.
Barry Lewis | In Pictures | Getty Images
Louisiana is America’s least healthy state, with high rates of obesity, smoking and premature death, likely aggravated by the nation’s highest poverty rate at 19%. The state also has one of the nation’s highest crime rates, and one of the lowest Covid-19 vaccination rates. According to the Center for Election Innovation and Research, Louisiana is one of a handful of states requiring an excuse to vote absentee. The state offers just seven days of early voting, according to the National Conference of State Legislatures.
2021 Life, Health and Inclusion score: 129 out of 375 points (Top States Grade: F)
Strength: Hospital resources
Weaknesses: Health, crime, Covid vaccinations, voting rights
8. Arkansas
A voter walks out of the polling location inside the Critteden County courthouse building after casting his ballot.
Andrea Morales | Getty Images
Voting in Arkansas was already no picnic. This year, the state made it even harder with legislation that the Arkansas ACLU called “the most dangerous assault on the right to vote since the Jim Crow era.” It includes sweeping new restrictions on mail and absentee voting, stricter ID requirements and prohibitions against supplying food or water to voters in line. Arkansas also suffers from a high crime rate and a low rate of Covid-19 vaccinations.
2021 Life, Health and Inclusion score: 124 out of 375 points (Top States Grade: F)
Strengths: Air quality, hospital resources
Weaknesses: Voting rights, inclusiveness, health, crime
7. Alabama
Lashondra Walter, (center), a nurse practitioner for Cahaba Medical Care gets ready to give a shot to a person in their car. She was joined by colleagues who roamed the parking lot with laptops to register people at the Linden National Guard Armory in Linden, Alabama on Friday, March 19, 2021.
Michael S. Williamson | The Washington Post | Getty Images
Alabama has the nation’s second-lowest Covid-19 vaccination rate, after Mississippi. That has led to concerns that the state could become a vector for more contagious variants of the virus. And the Yellowhammer State has serious health issues beyond Covid, with one of the nation’s highest rates of premature death, the second-highest rate of cardiovascular disease, and the third-highest rate of diabetes. According to the National Conference of State Legislatures, Alabama is one of just five states with no legal protections against discrimination for its non-disabled citizens.
2021 Life, Health and Inclusion score: 123 out of 375 points (Top States Grade: F)
Strengths: Air quality, public health funding, hospital resources
Weaknesses: Covid vaccinations, inclusiveness, health, crime
6. Georgia
Protesters gather outside of the Georgia State Capitol to protest HB 531, which would place tougher restrictions on voting in Georgia, in Atlanta, Georgia, U.S. March 4, 2021.
Dustin Chambers | Reuters
Georgia‘s sweeping new voting restrictions set the tone for similar legislation across the country — and for the business backlash that followed, with Major League Baseball pulling this year’s All-Star Game out of Atlanta. The state ranks 49th in an index of voting difficulty calculated by researchers at Northern Illinois University. Proponents of the new law note that the Peach State allows no-excuse absentee voting while President Joe Biden’s home state of Delaware does not. But the broad crackdown on supposed election fraud — despite no evidence that fraud occurred in 2020 — has drawn widespread scorn in the business world. Georgia also has no statewide protections against discrimination.
2021 Life, Health and Inclusion score: 119 out of 375 points (Top States Grade: F)
Strength: Air quality
Weaknesses: Covid vaccinations, voting rights, hospital resources
5. Tennessee
Amy Allen, the mother of an 8th grade transgender son, speaks after a Human Rights Campaign round table discussion on anti-transgender laws Friday, May 21, 2021, in Nashville, Tenn.
Mark Humphrey | AP
Tennessee lawmakers took aim at the state’s transgender population in a big way in 2021, passing a flurry of bills including a ban on transgender girls participating in girls’ sports, restrictions on the use of public bathrooms and school locker rooms, and a ban on gender-affirming care for minors. Tennessee residents also suffer poor health, a low rate of Covid-19 vaccinations, and a high crime rate.
2021 Life, Health and Inclusion score: 113 out of 375 points (Top States Grade: F)
Strength: Hospital resources
Weaknesses: Inclusiveness, crime, Covid vaccinations
3. (tie) Missouri
A Law Enforcement Officer temperature screens voters as they wait in line to cast their ballots on November 3, 2020 at the St. Louis County Board of Elections in St. Ann, Missouri.
Michael B. Thomas | Getty Images
According to the Center for Election Innovation and Research, Missouri is one of just six states that does not allow universal early voting. The state also lags in public health funding, and it has one of the nation’s highest crime rates, with burglary and aggravated assault among the most prevalent in the most recent FBI crime statistics.
2021 Life, Health and Inclusion score: 112 out of 375 points (Top States Grade: F)
Strength: Hospital resources
Weaknesses: Voting rights, crime, public health funding
3. (tie) Nevada
Touro University Nevada medical student Nikie Tong looks on as fellow student Claire Chen (R) takes a man’s temperature as he arrives at a temporary homeless shelter set up in a parking lot at Cashman Center on March 28, 2020 in Las Vegas, Nevada.
Ethan Miller | Getty Images
No state spends less on the health of its citizens than Nevada does — just $50 per person for public health. The state also ranks dead last in primary care doctors per person. Air quality in the desert is poor, and crime is high. But unlike many of the states on this list, Nevada is expanding voting rights, with Governor Steve Sisolak signing a package of legislation in June to expand mail-in voting, streamline registration, and end the state’s balky caucus system in favor of presidential primaries.
2021 Life, Health and Inclusion score: 112 out of 375 points (Top States Grade: F)
Strengths: Voting rights, inclusiveness
Weaknesses: Public health funding, hospital resources, air quality
2. Texas
Voting rights activists gather during a protest against Texas legislators who are advancing new voting restrictions in Austin, Texas, U.S., May 8, 2021.
Mikala Compton/ | Reuters
For all its strength as a place to do business, Texas keeps trying to outdo itself when it comes to laws and policies that are seen as exclusionary. It is one of the only states with no public accommodation law to protect against discrimination. Texas Democrats thwarted a bill that would have further restricted voting in a state that is already, by some measures, the hardest to vote in. That likely saved the Lone Star State from finishing at the bottom of this list, though Governor Greg Abbott and legislators are pushing ahead in a new special session to pass the legislation. Democratic lawmakers fled the state as a way to slow down the process and draw national attention, while the Texas Senate already voted in favor of the bill.
2021 Life, Health and Inclusion score: 104 out of 375 points (Top States Grade: F)
Strength: Hospital resources
Weaknesses: Inclusiveness, health, voting rights, public health funding
1. Arizona
Smog and haze obscure the Phoenix, Ariz. skyline from Piestewa Peak.
Deirdre Hamill | Arizona Republic | AP
Natural beauty is abundant in the Grand Canyon State, but so is ozone, particularly in heavily populated Maricopa County — the home to Phoenix, and to some of the worst air quality in the nation, according to the American Lung Association. Arizona is stingy when it comes to public health funding, and it has a shortage of doctors and mental health providers. Even though there is no evidence of election fraud in Arizona — and not for lack of trying to find it — state lawmakers passed new restrictions on mail voting this year.
2021 Life, Health and Inclusion score: 91 out of 375 points (Top States Grade: F)
Strength: Arizona scored poorly in all metrics
Weaknesses: Air quality, public health funding, crime, inclusiveness
