The poorest county in each state

Thomas C. Frohlich | 24/7 Wall St.

Show Caption Hide Caption The poorest county in each state Doug McIntyre of 24/7 Wall St. takes a national look at areas struggling the most financially.

In each state, there was at least one county with a median annual household income more than $7,000 lower than the state's median income. Virginia and Maryland had counties with median incomes over $35,000 lower than that of the state. 24/7 Wall St. reviewed the poorest county in each state based on data from the Census Bureau's American Community Survey.

The population of 24 of these poorest counties was predominantly rural. Eight had 100% rural populations. However, in some states, the poorest counties were largely urban. For example, the poorest counties in New York and Pennsylvania had 100% urban populations as of 2010.

In many of these counties, residents struggled with low educational attainment and limited job opportunities. In the five years through 2013, the percentage of adults who had attained at least a bachelor's degree was below the comparable national figure of 28.8% in 45 of the 50 counties. There were exceptions. In Washington and Wyoming's poorest counties, nearly half of the adult residents had attained at least a bachelor's degree.

While some of the counties had decent job markets, the unemployment rate of 36 of the poorest counties was above the national rate of 7.4% in 2013. Notably, nearly one in five workers in Apache County, Ariz., was unemployed.

To identify the poorest counties in each state, 24/7 Wall St. reviewed five-year estimated median annual household incomes from 2009 through 2013 from the U.S. Census Bureau's American Community Survey (ACS). Five-year estimated educational attainment rates also came from the Census Bureau. Annual unemployment rates are for 2013 and came from the Bureau of Labor Statistics. Figures on the percentage of populations that are classified as urban or rural are from the Census Bureau's 2010 decennial census.

These are the poorest counties in each state.

1. Sumter County, Alabama

> County median household income, 2009-2013: $22,186

> State median household income, 2009-2013: $43,253

> Poverty rate, 2009-2013: 38.0%

> Unemployment, 2013: 9.9%

Alabama had a median annual household income of $43,253 over the five years through 2013, one of the lowest in the nation. A typical Sumter County households earned barely more than half of that figure, with a median annual household income of $22,186 between 2009 and 2013. Sumter County also had one of the nation's highest poverty rates. Between 2009 and 2013, 38% of residents lived in poverty, versus the comparable national poverty rate of 15.4%.

2. Bethel Census Area, Alaska

> County median household income, 2009-2013: $51,689

> State median household income, 2009-2013: $70,760

> Poverty rate, 2009-2013: 22.8%

> Unemployment, 2013: 15.4%

A typical household in Bethel — the poorest part of Alaska — earned nearly $52,000 annually between 2009 and 2013. While this figure was over $19,000 lower than the state's median household income, Bethel households did not earn much less than a typical American household. Bethel's unemployment rate, on the other hand, was quite high, at 15.4% in 2013.

3. Apache County, Arizona

> County median household income, 2009-2013: $31,476

> State median household income, 2009-2013: $49,774

> Poverty rate, 2009-2013: 36.2%

> Unemployment, 2013: 19.8%

Residents of Arizona's poorest county clearly struggled with poverty over the five years through 2013. Apache County's poverty rate of more than 36% was more than double the national rate of 15.4% and one of the highest among states' poorest counties. Apache also had one of the highest unemployment rates in 2013, at nearly 20%.

4. Lee County, Arkansas

> County median household income, 2009-2013: $25,034

> State median household income, 2009-2013: $40,768

> Poverty rate, 2009-2013: 31.5%

> Unemployment, 2013: 11.2%

During the five years through 2013, Arkansas had a median annual household income of less than $41,000, lower than in every state except for Mississippi. A typical household in Lee County, the state's poorest, earned nearly $16,000 less than the statewide figure. As in other poor counties, Lee residents had relatively low educational attainment rates. Just 7.1% of adults had completed at least a bachelor's degree between 2009 and 2013, and 70.1% had finished at least high school, some of the lower rates among the 50 counties reviewed.

5. Lake County, California

> County median household income, 2009-2013: $36,548

> State median household income, 2009-2013: $61,094

> Poverty rate, 2009-2013: 25.0%

> Unemployment, 2013: 11.9%

As in many low-income areas, California's Lake County had a relatively high poverty rate. The county's poverty rate between 2009 and 2013 was 25%, versus a national rate of 15.4%. More than 35% of children were estimated to be living in poverty over that period as well, considerably higher than the national rate of 21.3%.

6. Otero County, Colorado

> County median household income, 2009-2013: $33,848

> State median household income, 2009-2013: $58,433

> Poverty rate, 2009-2013: 25.2%

> Unemployment, 2013: 8.8%

As in many other low-income areas, many children in Ortero County were considered poor — 42.4% lived in poverty during the five years through 2013, nearly double the comparable national rate. Residents were also far less likely than most Americans to have completed college. While 28.8% of Americans had at least a bachelor's degree during the five years through 2013, only 15.5% of Otero residents had such a degree. The contrast is even more stark when compared to Colorado residents, who tend to be among the nation's most educated.

7. Windham County, Connecticut

> County median household income, 2009-2013: $59,333

> State median household income, 2009-2013: $69,461

> Poverty rate, 2009-2013: 11.4%

> Unemployment, 2013: 8.7%

People living in the poorest county in Connecticut still had higher incomes than most American households. While Windham County residents earned much less than the majority of Connecticut residents between 2009 and 2013, a typical household in Windham earned nearly $60,000 annually over that period, well above the national median. Residents also benefited from high health insurance coverage rates, and low poverty rates. Less than 9% went without health insurance between 2009 and 2013, and 11.4% lived in poverty. Children also were much less likely to live in poverty than most in America. While more than one in five American children lived in poverty during the five year period through 2013, less than 15% did in Windham County.

8. Sussex County, Delaware

> County median household income, 2009-2013: $52,710

> State median household income, 2009-2013: $59,878

> Poverty rate, 2009-2013: 13.4%

> Unemployment, 2013: 6.7%

Income is relatively well-distributed in Delaware. A typical household in Sussex — Delaware's poorest county — earned just $7,168 less than the state's median annual household income between 2009 and 2013. The county's poverty rate was also a relatively low 13.4% between 2009 and 2013, versus the comparable national figure of 15.4%. Similarly, the county's unemployment rate of 6.7% in 2013 was lower than the national rate of 7.4% that year.

9. Putnam County, Florida

> County median household income, 2009-2013: $32,497

> State median household income, 2009-2013: $46,956

> Poverty rate, 2009-2013: 26.4%

> Unemployment, 2013: 9.4%

Putnam County residents are the poorest in Florida. Last year, 9.4% of the county's workforce was unemployed, versus a national unemployment rate of 7.4%. As in the poorest counties in most states, Putnam residents had relatively low educational attainment rates. Just 11.4% of adults had at least a bachelor's degree during the five years through 2013, a fraction of the comparable national figure.

10. Telfair County, Georgia

> County median household income, 2009-2013: $26,634

> State median household income, 2009-2013: $49,179

> Poverty rate, 2009-2013: 30.5%

> Unemployment, 2013: 15.6%

Telfair County is the poorest in Georgia as well as poorer than all but nine of the other poorest counties reviewed. Over the five years through 2013, a typical household in Telfair County earned $26,634, nearly half the national five-year median household income of $53,046. The low incomes may be partly due to the area's weak job market. Telfair's unemployment rate was 15.6% in 2013, nearly the highest rate reviewed, and considerably higher than the national rate of 7.4% that year.

11. Hawaii County, Hawaii

> County median household income, 2009-2013: $51,250

> State median household income, 2009-2013: $67,402

> Poverty rate, 2009-2013: 18.3%

> Unemployment, 2013: 6.8%

With a median annual household income of $51,250 between 2009 and 2013, people living in Hawaii's poorest county were not especially poor when compared to the rest of the nation. However, this figure may be somewhat misleading because of the state's remarkably high cost of living. At any rate, county residents were well-educated, and the area's job market was relatively strong. Ninety-one percent of county adults had at least a high school diploma over the five years through 2013, versus 86% nationally. Also, 6.8% of labor force participants were unemployed in 2013, versus the national unemployment rate of 7.4%.

12. Madison County, Idaho

> County median household income, 2009-2013: $32,059

> State median household income, 2009-2013: $46,767

> Poverty rate, 2009-2013: 35.8%

> Unemployment, 2013: 4.6%

With a median household income of $32,059 between 2009 and 2013, Madison is Idaho's poorest county. Despite the low incomes, residents had relatively high educational attainment rates. Nearly 95% of adults had attained at least a high school diploma, and nearly 34% had completed at least a bachelor's degree during the five years through 2013. Both figures were among the highest reviewed. However, low incomes likely made it difficult for residents to own their homes. Less than half of housing units in Madison were owned by their occupants, one of the lower homeownership rates.

13. Jackson County, Illinois

> County median household income, 2009-2013: $33,479

> State median household income, 2009-2013: $56,797

> Poverty rate, 2009-2013: 30.4%

> Unemployment, 2013: 7.9%

With a median annual household income of just $33,479 over the five years through 2013 — $23,318 less than the statewide figure — Jackson was Illinois's poorest county. Despite the low incomes, area residents were well-educated. More than 35% of Jackson County adults had at least a bachelor's degree over that period, one of the higher rates reviewed.

14. Fayette County, Indiana

> County median household income, 2009-2013: $37,391

> State median household income, 2009-2013: $48,248

> Poverty rate, 2009-2013: 23.0%

> Unemployment, 2013: 10.3%

Less than 9% of Fayette County adults had completed at least a bachelor's degree in the five years through 2013, a fraction of the national rate of 28.8%. The poor college attainment rate may have exacerbated the area's poverty rate, as residents may have also found it more difficult to find a job without a higher education. Nearly one in three children lived in poverty between 2009 and 2013, and more than one in 10 labor force participants were unemployed, both well above the respective national rates.

15. Appanoose County, Iowa

> County median household income, 2009-2013: $39,208

> State median household income, 2009-2013: $51,843

> Poverty rate, 2009-2013: 15.2%

> Unemployment, 2013: 6.4%

A typical Appanoose household earned less than $40,000 annually between 2009 and 2013, less than in any other county in Iowa. By contrast, the state's median annual household income over that period was $51,843, slightly lower than the national figure. While area residents had relatively low incomes, Appanoose's 2013 unemployment rate of 6.4% was lower than the national rate of 7.4%.

16. Crawford County, Kansas

> County median household income, 2009-2013: $37,378

> State median household income, 2009-2013: $51,332

> Poverty rate, 2009-2013: 20.6%

> Unemployment, 2013: 5.6%

Between 2009 and 2013, more than one in five Crawford County residents lived in poverty, versus the national figure of 15.4%. The area's unemployment rate, on the other hand, was relatively low, at 5.6%. While residents living in the poorest counties of other states tended to have relatively poor educational attainment rates, 90.2% of Crawford adults had completed at least high school over the five year period through 2013.

17. McCreary County, Kentucky

> County median household income, 2009-2013: $20,972

> State median household income, 2009-2013: $43,036

> Poverty rate, 2009-2013: 30.3%

> Unemployment, 2013: 13.5%

During the five years prior to 2013, McCreary County households had a median annual income of less than $21,000, the lowest county-level income in Kentucky — and in the nation. The low area incomes were likely due in part to poor educational attainment rates. Less than 70% of adults had at least a high school diploma during the five years through 2013, and just 7.3% had at least a bachelor's degree. For context, 86% of adults nationwide had at least a high school while 28.8% had at least a bachelor's degree. McCreary County's job market was also relatively weak, as 13.5% of the workforce was unemployed last year, versus the national rate of 7.4%.

18. Madison Parish, Louisiana

> County median household income, 2009-2013: $25,498

> State median household income, 2009-2013: $44,874

> Poverty rate, 2009-2013: 40.3%

> Unemployment, 2013: 9.7%

Less than three-quarters of Madison Parish residents had completed at least high school, one of the lowest rates reviewed. While nearly 30% of Americans had at least a bachelor's degree, that rate was just 11.2% in Madison Parish. Poor educational attainment rates likely explain in part the low incomes in the area. Over the five years through 2013, a typical Madison household made just $25,498, the lowest in the state and the eighth lowest compared to other poor counties in each of the states. The area's poverty rate was also especially high — greater than 40% over the five years through 2013. The rate for children was far worse, at 59.2% over that period.

19. Piscataquis County, Maine

> County median household income, 2009-2013: $36,646

> State median household income, 2009-2013: $48,453

> Poverty rate, 2009-2013: 18.5%

> Unemployment, 2013: 9.6%

A typical household in Piscatuquis County, Maine earned $36,646 annually between 2009 and 2013, the lowest in the state, and considerably lower than the comparable national figure of $53,046. As in the poorest counties in many other states, the job market in Piscatuquis was relatively weak. Ten percent of workforce participants were unemployed in 2013, versus the national unemployment rate of 7.4% that year.

20. Somerset County, Maryland

> County median household income, 2009-2013: $38,447

> State median household income, 2009-2013: $73,538

> Poverty rate, 2009-2013: 23.4%

> Unemployment, 2013: 9.9%

During the five years through 2013, Maryland households had a median annual income of $73,538, the highest of any state. While wealthy states tend to have wealthier localities across the board, Somserset County, the poorest in Maryland was still relatively poor. A typical household earned less than $38,500 between 2009 and 2013, more than $35,000 less than the comparable state figure. Poor educational attainment among county residents may be partially the reason for the low incomes — 14.2% of area adults had at least a bachelor's degree during the five years through 2013, less than half the comparable national rate of 28.8%.

21. Berkshire County, Massachusetts

> County median household income, 2009-2013: $48,450

> State median household income, 2009-2013: $66,866

> Poverty rate, 2009-2013: 12.8%

> Unemployment, 2013: 7.1%

Massachusetts residents are some of the nation's wealthiest. Between 2009 and 2013, the state's poorest county had a median annual household income of $48,450, not especially poor compared to other counties reviewed. As in the rest of the state, Berkshire County residents benefited from exceptionally high health insurance coverage. Just 3.3% of residents did not have health insurance over the five years through 2013, one of the best rates nationwide.

22. Lake County, Michigan

> County median household income, 2009-2013: $29,379

> State median household income, 2009-2013: $48,411

> Poverty rate, 2009-2013: 27.9%

> Unemployment, 2013: 13.1%

Lake County, Michigan's unemployment rate of nearly 12% in 2013 — well above the national rate of 7.4% — may have contributed to the area's low incomes. A typical household earned $29,379 annually over the five years through 2013, the lowest in the state and considerably lower than the national figure of $53,046. Low college attainment rates may also explain in part the low incomes. Just 8.4% of area adults had attained at least a bachelor's degree during the five years through 2013, one of the lowest figures reviewed.

23. Wadena County, Minnesota

> County median household income, 2009-2013: $36,928

> State median household income, 2009-2013: $59,836

> Poverty rate, 2009-2013: 16.9%

> Unemployment, 2013: 7.1%

While Wadena County households had far lower incomes than Minnesotans as a whole between 2009 and 2013, county residents had relatively good health coverage. Just 9.2% of residents did not have health insurance over the five years through 2013, a national uninsured rate of nearly 15%. The county's unemployment rate was also slightly lower than the national rate of 7.4% in 2013.

24. Holmes County, Mississippi

> County median household income, 2009-2013: $22,325

> State median household income, 2009-2013: $39,031

> Poverty rate, 2009-2013: 43.5%

> Unemployment, 2013: 16.5%

Mississippi had the lowest median annual household income of any state over the five years through 2013, at just $39,031 — no other state had a median income of less than $40,000. A typical household in Mississippi's poorest county, Holmes, earned just $22,325 annually over that period. Area residents also suffered from high poverty rates. More than 43% of Holmes residents and 62.4% of children lived in poverty between 2009 and 2013, both among the highest rates reviewed.

25. Oregon County, Missouri

> County median household income, 2009-2013: $27,743

> State median household income, 2009-2013: $47,380

> Poverty rate, 2009-2013: 27.7%

> Unemployment, 2013: 6.6%

A less-educated population tends to earn lower incomes, and Oregon County, Missouri is no exception. Less than one in 10 area residents had at least a bachelor's degree during the five years through 2013, barely one-third of the national figure. Despite the low incomes, residents were more likely to own their homes than in many other poor counties. More than 76% of housing units were owned by their occupants, versus the national homeownership rate of less than 65%.

26. Sanders County, Montana

> County median household income, 2009-2013: $32,881

> State median household income, 2009-2013: $46,230

> Poverty rate, 2009-2013: 22.0%

> Unemployment, 2013: 12.6%

As in the poorest counties in a majority of states, the job market in Sanders County was relatively weak. In 2013, nearly 13% of the workforce was unemployed, versus the national unemployment rate of 7.4%. In addition, more than one-third of children were estimated to be living in poverty between 2009 and 2013, versus 21.3% of children across the U.S. during that time.

27. Red Willow County, Nebraska

> County median household income, 2009-2013: $42,345

> State median household income, 2009-2013: $51,672

> Poverty rate, 2009-2013: 12.7%

> Unemployment, 2013: 3.1%

Households located in Red Willow County had an annual median income of $42,345 over the five years prior to 2013, the lowest in Nebraska, and $10,000 lower than the comparable state figure. While incomes were relatively low, residents were much better off than residents of the poorest counties in most other states. The unemployment rate, for example, was just 3.1% in 2013, the lowest among the poorest counties for each state. Additionally, less than 13% of people lived in poverty between 2009 and 2013, versus the national figure of 15.4%.

28. Nye County, Nevada

> County median household income, 2009-2013: $39,876

> State median household income, 2009-2013: $52,800

> Poverty rate, 2009-2013: 18

> Unemployment, 2013: 11.9%

As in the poorest counties in many other states, the population of Nye County dropped slightly between the middles of 2012 and 2013. Nye's 2013 unemployment rate of nearly 12% may have encouraged many residents to relocate from the area. The relatively poor job market may also explain in part the low area incomes. A typical Nye household earned less than $40,000 between 2009 and 2013, nearly $13,000 less than the statewide median household income over that time.

29. Coos County, New Hampshire

> County median household income, 2009-2013: $41,985

> State median household income, 2009-2013: $64,916

> Poverty rate, 2009-2013: 13.4%

> Unemployment, 2013: 6.4%

As in other wealthy states, residents living in the poorest county in New Hampshire were not especially burdened financially. A typical household earned less than $42,000 annually over the five years through 2013, considerably less than the national figure of $53,046. However, the poverty rate was 13.4%, and the unemployment rate was 6.4%, both lower than the national rates of 15.4% and 7.4%, respectively.

30. Cumberland County, New Jersey

> County median household income, 2009-2013: $50,750

> State median household income, 2009-2013: $71,629

> Poverty rate, 2009-2013: 17.5%

> Unemployment, 2013: 12.2%

Over the five years through 2013, a typical New Jersey household earned $71,629 annually, the second-highest median household income of any state. Typical Cumberland County households earned $50,750 annually over that period, nearly $21,000 less than the statewide figure, but not remarkably lower than the national median. Despite the moderately high incomes, Cumberland residents had lower educational attainment rates compared to most Americans.

31. Sierra County, New Mexico

> County median household income, 2009-2013: $27,430

> State median household income, 2009-2013: $44,927

> Poverty rate, 2009-2013: 22.6%

> Unemployment, 2013: 6.2%

Like in most of New Mexico, Sierra County residents earned relatively little compared to most Americans. County households had a median annual income of $27,430 between 2009 and 2013, nearly half the national income of $53,046. However, the county's job market, as measured by unemployment, was relatively strong. Just 6.2% of the area's workforce was unemployed in 2013, lower than the national rate.

32. Bronx County, New York

> County median household income, 2009-2013: $34,388

> State median household income, 2009-2013: $58,003

> Poverty rate, 2009-2013: 29.8%

> Unemployment, 2013: 11.8%

Less than 70% of adults living in the Bronx had attained at least a high school diploma, one of the lowest attainment rates in the country. Poor education among residents likely contributed to the area's low incomes. Low incomes, in turn, made it exceedingly difficult for residents to afford owning their homes. Less than one in five housing units in the Bronx were occupied by the homeowner, versus close to two-thirds of housing units across the nation.

33. Scotland County, North Carolina

> County median household income, 2009-2013: $29,592

> State median household income, 2009-2013: $46,334

> Poverty rate, 2009-2013: 32.3%

> Unemployment, 2013: 14.6%

A typical household in Scotland County earned an annual income of less than $30,000 over the five years through 2013, substantially lower than the state and national median household incomes. The county's job market was particularly weak, with an unemployment rate of 14.6%, nearly double the national rate in 2013. Additionally, as in most of the poorest counties in each state, Scotland residents had low college attainment rates. While nearly 29% of Americans had at least a bachelor's degree during the five years through 2013, just over 14% of Scotland residents had such a degree.

34. Rolette County, North Dakota

> County median household income, 2009-2013: $31,336

> State median household income, 2009-2013: $53,741

> Poverty rate, 2009-2013: 36.0%

> Unemployment, 2013: 12.9%

More than 34% of Rolette County residents did not have health insurance during the five years through 2013, versus 14.9% nationwide. The low coverage rate was likely the result of the low incomes and weak job market. Nearly 13% of the workforce was unemployed in 2013, versus the national unemployment rate of 7.4%.

35. Athens County, Ohio

> County median household income, 2009-2013: $33,823

> State median household income, 2009-2013: $48,308

> Poverty rate, 2009-2013: 31.7%

> Unemployment, 2013: 8.4%

Nearly 32% of Athens County residents lived in poverty over the five years through 2013, more than double the national figure of 15.4%. While children are almost always more likely to live in poverty than adults in the United States, this was not the case in Athens County, where nearly 29% of children lived in poverty. However, this rate was much higher than the comparable national rate of 21.3%. County households had such low incomes that owning a home was also out of reach for many area residents. Over the five years through 2013, less than 57% of housing units were owned by occupants, versus the national homeownership rate of 64.9%.

36. Pushmataha County, Oklahoma

> County median household income, 2009-2013: $29,897

> State median household income, 2009-2013: $45,339

> Poverty rate, 2009-2013: 26.5%

> Unemployment, 2013: 7.6%

Pushmataha County households had a median annual income of less than $30,000 between 2009 and 2013, the poorest in Oklahoma. Perhaps due in part to the low incomes, residents also had relatively low health insurance coverage rates. More than 27% did not have health care insurance over the five years through 2013, versus the comparable national figure of 14.9%.

37. Malheur County, Oregon

> County median household income, 2009-2013: $35,578

> State median household income, 2009-2013: $50,229

> Poverty rate, 2009-2013: 27.4%

> Unemployment, 2013: 8.7%

As in the poorest counties in other states, low incomes among Malheur County residents can be partly attributed to low educational attainment rates. Just 13.1% of adults in the region had at least a bachelor's degree during the five years through 2013, versus the national figure of nearly 29%. Poverty was also prevalent in the area. Between 2009 and 2013, 27.4% of Malheur residents lived below the poverty line.

38. Philadelphia County, Pennsylvania

> County median household income, 2009-2013: $37,192

> State median household income, 2009-2013: $52,548

> Poverty rate, 2009-2013: 26.5%

> Unemployment, 2013: 10.0%

While most of the poorest counties in each state tend to have relatively small populations, Philadelphia is one of several exceptions. Often, living expenses in urban areas can be higher, making Philadelphia's low incomes more of a financial burden than in other states' poorest counties. Also, just 53.3% of housing units in the county were owned by their occupants. Nearly 65% of U.S. housing units, by contrast, were owned by occupants. Poverty was also a problem in the area, as 26.5% of residents lived below the poverty line during the five years through 2013.

39. Providence County, Rhode Island

> County median household income, 2009-2013: $49,297

> State median household income, 2009-2013: $56,361

> Poverty rate, 2009-2013: 17.1%

> Unemployment, 2013: 10.2%

Providence County residents, the poorest in Rhode Island, were not especially poor compared with the rest of the state. A typical household in the area earned more than $49,000 annually between 2009 and 2013, just $7,064 less than the comparable median household income for the state. One reason for the small disparity between the county and its overall state may be the relatively small size of Rhode Island. The state is divided into just five counties.

40. Allendale County, South Carolina

> County median household income, 2009-2013: $25,252

> State median household income, 2009-2013: $44,779

> Poverty rate, 2009-2013: 36.0%

> Unemployment, 2013: 14.0%

Allendale County's 2013 unemployment rate of 14% was among the higher rates nationwide and considerably higher than the national rate of 7.4%. The area's relatively weak job market may help explain the remarkably low incomes among residents. Between 2009 and 2013, the median annual household income in Allendale was just $25,252, less than half the national figure of $53,046.

41. Shannon County, South Dakota

> County median household income, 2009-2013: $25,648

> State median household income, 2009-2013: $49,495

> Poverty rate, 2009-2013: 53.2%

> Unemployment, 2013: 12.9%

As in other especially poor areas, Shannon County's job market was relatively weak. The area's unemployment rate of 12.9% in 2013 may partly explain low incomes. Shannon County residents also struggled with poverty. More than 53% of the area's population lived below the poverty line over the five years through 2013, by far the highest such rate of any of the 50 countries reviewed. Children, who tend to be disproportionately impacted by poverty, were even more likely to live in poverty. More than 60% of children in the area lived in poverty between 2009 and 2013. Nearly 41% of adults did not have health insurance over the five-year period through 2013, the worst rate among all counties reviewed.

42. Grundy County, Tennessee

> County median household income, 2009-2013: $26,814

> State median household income, 2009-2013: $44,298

> Poverty rate, 2009-2013: 29.7%

> Unemployment, 2013: 9.5%

A typical household in Grundy County earned less than $27,000 annually between 2009 and 2013. This was especially poor even in Tennessee, where statewide incomes tended to be among the lowest in the nation. Low educational attainment rates partly explain the relatively low incomes. Only 10% of Grundy adults had at least a bachelor's degree, and just 70.5% had completed at least high school, both among the lower rates reviewed.

43. Starr County, Texas

> County median household income, 2009-2013: $24,927

> State median household income, 2009-2013: $51,900

> Poverty rate, 2009-2013: 39.2%

> Unemployment, 2013: 15.4%

With a median annual household income of less than $25,000 between 2009 and 2013 — less than half the comparable state figure — Starr County was one of the poorest in the nation. Low incomes were likely related to a range of economic factors in the area: Nearly 40% of residents did not have health insurance during the five years through 2013; a majority of children were estimated to be living in poverty over that period; and 15.4% of the workforce was unemployed in 2013. All of these figures were among the nation's worst. In addition, just 45% of adults had finished at least high school, and 8.6% had at least a bachelor's degree, both among the lowest rates nationwide.

44. San Juan County, Utah

> County median household income, 2009-2013: $40,492

> State median household income, 2009-2013: $58,821

> Poverty rate, 2009-2013: 27.1%

> Unemployment, 2013: 9.3%

While San Juan County households earned far less than most Americans, they were among the most likely to own their own homes. More than 81% of county housing units were owned by their occupants, one of the highest homeownership rates nationwide. Low incomes still likely had a negative impact on residents. For example, more than 27% of residents went without health insurance during the five years through 2013, versus just under 15% nationwide.

45. Orleans County, Vermont

> County median household income, 2009-2013: $41,953

> State median household income, 2009-2013: $54,267

> Poverty rate, 2009-2013: 15.4%

> Unemployment, 2013: 6.2%

Vermont households had a median income of $54,267 between 2009 and 2013, slightly higher than the comparable national figure. But a typical household in Orleans County — the state's poorest — earned much less, with a median annual income of nearly $42,000. While the poorest counties in many other states, less than 10% of Orleans residents did not have health insurance between 2009 and 2013, which was also better than the national figure of nearly 15%. The county's 2013 unemployment rate of 6.2% was also lower than the national rate.

46. Martinsville, Virginia

> County median household income, 2009-2013: $28,116

> State median household income, 2009-2013: $63,907

> Poverty rate, 2009-2013: 27.2%

> Unemployment, 2013: 12.1%

Residents in poor counties — even the poorest counties – in relatively wealthy states tend to have higher incomes compared to the poorest counties in less well-off states. Virginia, however, appears to be the exception to this pattern. In Martinsville, the poorest area in Virginia, a typical household earned $28,116 annually between 2009 and 2013, nearly $36,000 less than the statewide figure.

47. Whitman County, Washington

> County median household income, 2009-2013: $36,257

> State median household income, 2009-2013: $59,478

> Poverty rate, 2009-2013: 32.6%

> Unemployment, 2013: 6.2%

While Washington residents earned nearly $60,000 annually between 2009 and 2013, a typical Whitman County household earned over $23,000 less. Despite the low incomes, however, residents were exceptionally well educated. Nearly half of adults in the county had attained at least a bachelor's degree during the five years through 2013, one of the highest rates. The region also had a extremely strong high school attainment rate, with 96.2% of adults having completed at least high school.

48. McDowell County, West Virginia

> County median household income, 2009-2013: $22,252

> State median household income, 2009-2013: $41,043

> Poverty rate, 2009-2013: 36.3%

> Unemployment, 2013: 10.0%

Due in large part to especially low incomes in McDowell County, nearly 51% of county residents lived in poverty between 2009 and 2013, versus the comparable national rate of 15.4%. McDowell County children were also much more likely to live in poverty than children in other counties. More than 77% of county minors were estimated to have lived in poverty over that period, higher than in the vast majority of regions.

49. Ashland County, Wisconsin

> County median household income, 2009-2013: $38,550

> State median household income, 2009-2013: $52,413

> Poverty rate, 2009-2013: 18.8%

> Unemployment, 2013: 9.0%

Nearly 22% of Ashland County residents had attained at least a bachelor's degree between 2009 and 2013. While this figure was high relative to the poorest counties in other states, it was substantially lower than the national college attainment rate of nearly 29%. At any rate, households in the county were quite poor. Children are usually disproportionately affected by poverty: More than 30% of children in Ashland County lived in poverty, versus the comparable national rate of 21.3%.

50. Albany County, Wyoming

> County median household income, 2009-2013: $42,774

> State median household income, 2009-2013: $57,406

> Poverty rate, 2009-2013: 26.0%

> Unemployment, 2013: 4.0%

A typical family in Albany County earned $42,774 a year between 2009 and the 2013, the lowest median annual household income in Wyoming. While this was substantially lower than the corresponding national figure of $53,046, Albany was far wealthier than other poor regions in other states. Residents were also exceptionally well-educated. Nearly half of the area's adults had a bachelor's degree during the five years through 2013, versus less than 29% of all Americans.

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