Tennessee ranks last for quality of life in CNBC’s 2026 state rankings, with Texas, Indiana and Louisiana also among the lowest-scoring states.
Where people live can shape their access to health care, affordable childcare, safe neighborhoods and workplace protections. In 2026, a new ranking from CNBC has highlighted significant differences in these conditions across the United States, placing Tennessee at the bottom of its quality-of-life assessment.
The ranking comes from CNBC’s annual America’s Top States for Business study, which evaluates states using data on factors that influence livability and economic competitiveness. The quality-of-life category considers crime rates, health care access, environmental conditions, childcare availability and affordability, worker protections, inclusiveness and reproductive rights.
According to CNBC’s 2026 state rankings and methodology, quality of life accounts for 290 possible points, or 11.6% of a state’s overall business competitiveness score. The assessment is intended to help explain how livability factors influence a state’s ability to attract and retain workers.
The 10 lowest-scoring states in the quality-of-life category face different challenges, ranging from limited access to medical care and childcare to crime rates and gaps in worker protections.
10. Arkansas
Score: 103 out of 290 | Grade: D-minus
Arkansas remains among the lowest-ranked states for quality of life despite improving its overall position in CNBC’s broader assessment.
Food insecurity is a major concern. The study highlights the difficulties some households face in consistently obtaining enough food, alongside concerns about violent crime and limited protections against discrimination.
These issues illustrate how financial hardship, public safety and access to legal protections can affect residents’ everyday lives. Even when a state improves in some economic measures, persistent challenges in these areas can weigh on its quality-of-life score.
9. Oklahoma
Score: 103 out of 290 | Grade: D-minus
Oklahoma received the same quality-of-life score as Arkansas, reflecting concerns that extend beyond household finances.
The state’s abortion restrictions are among the factors considered in the ranking, as reproductive rights can influence where workers choose to live. Minimum-wage policy is another concern. Oklahoma’s minimum wage is $7.25 an hour, and state law restricts local governments from establishing their own minimum wages.
For workers earning at the lowest end of the pay scale, the relationship between wages and household expenses can make it difficult to cover essential costs. Those pressures contribute to broader questions about affordability and economic security.
8. Alabama
Score: 99 out of 290 | Grade: D-minus
Alabama faces significant challenges in access to mental health care and workplace protections.
A shortage of mental health providers can make it harder for residents to find timely treatment, particularly in communities where medical services are already limited. The source data cited in the ranking also point to a substantial share of Alabama residents reporting a history of depressive disorders.
Worker protections are another weakness. The state performs poorly on benchmarks tracked by Oxfam America, which evaluates policies affecting workers, including wages and employment protections.
Together, these factors raise concerns about access to care and the protections available to people in the workforce.
7. Missouri
Score: 98 out of 290 | Grade: D-minus
Public safety is a major factor affecting Missouri’s quality-of-life ranking.
The figures cited in the source material put the state’s violent-crime rate at 462 offenses per 100,000 residents in 2024. Firearm deaths are also a concern, placing Missouri among the states with high rates of gun-related fatalities.
In response to crime concerns, Missouri lawmakers approved a broad crime bill that the governor signed in June 2026. The law was intended to address public safety issues, although its long-term effects will depend on implementation and subsequent outcomes.
Crime statistics are only one part of the assessment, but they can influence residents’ sense of security and a community’s overall livability.
6. Utah
Score: 95 out of 290 | Grade: F
Utah’s natural scenery and outdoor recreation opportunities do not eliminate challenges involving health care access, air quality and affordability.
The state ranks near the bottom for primary care providers per capita, making access to routine medical services an important concern. Ozone pollution is another factor affecting its environmental assessment.
Utah’s $7.25 minimum wage also falls well short of what many families need to cover household expenses. Childcare availability presents an additional challenge, with the source material citing 513 licensed childcare centers for a population of approximately 3.5 million.
For working parents, limited childcare options can affect employment decisions, household budgets and the ability to balance work with family responsibilities.
5. Georgia
Score: 89 out of 290 | Grade: F
Georgia’s ranking reflects concerns about inclusiveness and legal protections against discrimination.
The state has faced criticism over the scope of its protections for LGBTQ+ residents and the absence of a comprehensive statewide public-accommodation law protecting people from discrimination on grounds beyond disability.
In April 2026, Gov. Brian Kemp signed a religious-freedom bill. Supporters described the measure as a protection for religious liberty, while critics raised concerns that it could create opportunities for discrimination.
The debate highlights the competing views surrounding religious freedom and civil rights protections. Under CNBC’s assessment, state laws affecting inclusiveness are one of several factors that influence quality of life.
4. Louisiana
Score: 89 out of 290 | Grade: F
Louisiana faces challenges involving crime, firearm deaths, reproductive rights and state employment policies.
The state has one of the nation’s highest violent-crime rates and a high rate of firearm-related deaths, according to the data cited in the ranking. These public safety concerns contribute to its low score.
Louisiana’s abortion restrictions and changes to state employment policies have also drawn attention. Gov. Jeff Landry has supported removing affirmative-action provisions from the state civil service code in favor of hiring based on merit, a move that has prompted debate over how public-sector employment policies should address equal opportunity.
The combination of public safety concerns and disagreements over civil rights and employment protections helps explain Louisiana’s position near the bottom of the list.
3. Indiana
Score: 82 out of 290 | Grade: F
Indiana ranks poorly for childcare availability, making it difficult for some families to find affordable care while maintaining employment.
The source material cites 779 licensed childcare facilities serving a population of nearly 7 million. It also estimates that childcare costs consume about 15% of a typical two-earner household’s income.
When childcare is expensive or difficult to find, parents may have to reduce working hours, turn down job opportunities or rely on informal arrangements. These pressures can affect both family finances and employers seeking reliable workers.
Indiana also faces concerns about air quality and access to health care. Its comparatively stronger performance on some crime measures does little to offset those weaknesses in the overall quality-of-life assessment.
2. Texas
Score: 78 out of 290 | Grade: F
Texas continues to attract workers and businesses, but access to affordable health care remains a major concern.
The ranking cites an uninsured rate of 16.7%, placing Texas at the top of the nation for the share of residents without health insurance. That figure is more than double the national average, according to the source material.
Access to primary care is another weakness. Even residents with insurance can face difficulties finding a nearby provider or obtaining timely appointments.
In May 2026, Gov. Greg Abbott announced $56 million in grants for rural hospitals. The funding was intended to support health care services in rural communities, where facilities can face financial and operational pressures.
However, rural hospital funding addresses only part of the broader challenge. Insurance coverage, provider availability and the affordability of medical services remain important factors in Texas’ quality-of-life score.
1. Tennessee
Score: 64 out of 290 | Grade: F
Tennessee ranks last in CNBC’s 2026 quality-of-life assessment, receiving 64 out of a possible 290 points.
The state’s position reflects a combination of concerns involving public safety, inclusiveness and worker protections. CNBC’s assessment points to Tennessee laws affecting LGBTQ+ residents, including restrictions involving bathroom access and limits on local governments adopting their own anti-discrimination rules.
Gov. Bill Lee also signed a resolution designating June 2026 as “Nuclear Family Month,” a move that coincided with Pride Month and prompted debate over the state’s approach to family policy and LGBTQ+ inclusion.
Crime is another concern. The source material identifies Tennessee as having one of the nation’s highest violent-crime rates and the third-highest drug-death rate.
These factors contributed to Tennessee’s low score, placing it behind Texas and Indiana in the 2026 assessment.
What the 2026 Rankings Mean for Residents
CNBC’s list highlights how quality of life can differ significantly across the United States. The lowest-ranked states face different combinations of challenges, including limited health care access, high childcare costs, crime, affordability pressures and disagreements over civil rights protections.
The findings also demonstrate why a strong economy or growing population does not necessarily translate into better living conditions for every resident. Job opportunities matter, but so do access to medical care, the cost of raising a family and the ability to live and work in a safe environment.
The rankings should be understood within their methodology. CNBC’s study measures quality of life as one category within a broader assessment of state business competitiveness, rather than as a complete measure of every resident’s experience.
For people considering a move, the results can serve as a starting point for comparing states. Individual circumstances—including income, health care needs, family responsibilities, housing costs and local conditions—can make a substantial difference in deciding where to live.
