Every year since 2006, CNBC has conducted a study ranking American states from best to worst for business by measuring various categories, including one that compares the 50 states on their overall livability based on factors like crime rate, attractions, air quality, health care and legal protections against discrimination. 

The quality of life category accounts for 300 of the 2,500 total points the study uses to compile America’s Top States for Business. So here you have it, America’s worst states to live in based on quality of life:

10. Kentucky

With its location in the center of tobacco country, it’s no real surprise that more than a quarter of adults are regular cigarette smokers. The state also boasts the highest rate of cancer deaths in the nation and one of the highest rates of heart failure. However, the Bluegrass state has at least one thing to brag about – the lack of violent crimes with this southern state coming in with the lowest violent-crime rate.

9. New Mexico (tie)

A newcomer to the bottom 10, New Mexico is home to Doña Ana County which sits on the Mexican border and has shown the worst measured air quality over the past three years.  The pollution is so high that the air is dangerous to breath for longer than two weeks in a year. Also, the state has the highest violent-crime rates in the country. But, with the rich native culture and striking scenery, New Mexico is a beautiful state that is not lacking in things to see and do.

9. Tennessee (tie)

Tennessee’s big problem? Crime. Last year, the state reported 84,000 simple assault cases and 490 murder cases making it one of the most violent in the nation. Memphis is the fourth most dangerous cities in the country, according to Forbes, with only Detroit, St. Louis and Oakland surpassing it and Birmingham, Alabama coming in fifth. Tennessee also has high rates of cancer and diabetes, making it one of the least healthy states. Despite all that, Tennessee still made it in the overall top 10 for businesses, ranking high in business friendliness, economy and infrastructure. Plus, with Graceland, Dollywood, and just about everything in Nashville, the attractions are abundant. And apparently the Tennessee air is very clean.

7. Mississippi

Given it’s history with race relations, it’s no real surprise that Mississippi has a problem with inclusion. The state is one of only 5 with no laws protecting non-disabled people against discrimination. And, with one of the highest rates of obesity in the country, it’s population is also among the most sedentary. But thankfully all those discriminating, lazy obese people abide by the law and have not tainted the air quality. (Mississippi has both low crime rate and not much pollution.)

6. Indiana 

Thanks to the Religious Freedom Restoration Act, the Hoosier State still has some work to do to establish basic protections from discrimination based on sexual orientation, marital status and gender identity. With the state’s history as a steelmaking giant, Indiana has made great strides in improving air quality. And the cost of living is quite low.

5. Missouri

Violent crimes have been rising in Missouri for the past few years and race relations in the state have been a well-broadcasted issue. Much like Indiana, she state is missing comprehensive protections against discrimination based on sexual orientation, gender identity and marital status. The public health funding also isn’t great, with the state near the bottom of that category too. The good news is the Show Me State rose a few spots from last year when it was rated the second-to-worst state to live in! 

4. Arkansas

With high rates of crime, unattainable health care and low reports of physical activity, Arkansas could use some help across a few different planes. However, despite boasting the lowest number of dentists per person of any state, Arkansas is moving in the right direction, rising four spots after being named the worst state of living in 2016. Thank god for good air quality!

3. Oklahoma

Health problems in Oklahoma are a-plenty, with one of the highest rates of premature death in the country. Infant mortality rates are among the worst in the nation, as are reported mental health issues and tobacco use. Furthermore, Oklahoma is one of the five states with the lowest health insurance coverage. The state is also lacking in attractions, leaving Oklahoma in the same exact spot as it was last year. At least our Oakies are breaking in that good Oklahoma air, or else they’d have some real problems…

2. Louisiana

With all of Louisiana’s decadent, delicious and crave-worthy dishes, it shouldn’t be a shock that Louisiana came in first as America’s fattest state. The state is also notoriously dangerous, with the highest murder rate in the country. Last year alone New Orleans clocked in with 175 murders and as of today, the city has already seen 100. But if there’s any city not lacking in things to see and do, it’s New Orleans.

1. Alabama 

Remember how Mississippi doesn’t have any laws on protecting non-disabled people against discrimination? Well Alabama doesn’t either, making it one of the least inclusive states in America. Coming in third-highest rate of premature deaths, Alabama is also one of the least healthy states. Once again, thank goodness that high-quality air.