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Whether it stems from receiving an unexpected bill or struggling with your workload, stress is often perceived as a personal matter.

But stress levels can also be shaped by more systemic factors such as poverty, crime, and childcare costs. For the most stressed cities in the US, poverty and high levels of violent crime consistently show up as contributing factors.

A recent study by WalletHub ranked 182 US cities based on four areas of stress: work, financial, family, and health and safety. The study evaluated the 150 most populated US cities, plus at least two of the most populated cities in each state.

WalletHub evaluated the four areas using 39 metrics. Each metric was graded on a 100-point scale, with 100 representing the highest level of stress, and the results were then combined to determine each city’s overall score.

For work stress, metrics included unemployment rate, average weekly work hours, job security, and traffic congestion.

Financial stress was evaluated with metrics such as median annual household income, share of households behind on bills, and the poverty rate. Family stress included factors such as separation and divorce rates, and childcare costs.

Health and safety stress included the share of adults who could not see a doctor because of cost, hate-crime incidents per capita, and the number of mass shootings.

Data for the ranking was compiled from federal agencies, such as the Bureau of Labor Statistics, as well as non-profits and research organizations.

The scores were then ranked from highest to lowest, with 100 being the highest level of stress.

Here’s a list of the 20 most stressed cities in the US.

20. San Antonio


River walk in San Antonio city downtown skyline, cityscape of Texas, USA at sunset.

The San Antonio River Walk.

f11photo/Getty Images/iStockphoto

Total Score (out of 100): 51.37

Work Stress Rank: 67

Financial Stress Rank: 48

Family Stress Rank: 17

Health & Safety Stress Rank: 17

19. Indianapolis


Homes and buildings in Indianapolis, Indiana.

Indianapolis, Indiana.

Nicholas Klein/Getty Images

Total Score: 51.84

Work Stress Rank: 84

Financial Stress Rank: 14

Family Stress Rank: 42

Health & Safety Stress Rank: 34

18. Cincinnati


Children are playing in the fountain at the Smale Riverfront Park with downtown Cincinnati in the backdrop.

The Smale Riverfront Park in downtown Cincinnati.

alexeys/Getty Images

Total Score: 52.00

Work Stress Rank: 25

Financial Stress Rank: 24

Family Stress Rank: 36

Health & Safety Stress Rank: 40

17. Columbus, Georgia


Columbus, Georgia's skyline is visible with trees on either side.

Columbus, Georgia’s skyline.

SeanPavonePhoto/Getty Images/iStockphoto

Total Score: 52.27

Work Stress Rank: 109

Financial Stress Rank: 5

Family Stress Rank: 34

Health & Safety Stress Rank: 52

16. Montgomery, Alabama


Aerial view of Montgomery, Alabama's downtown skyline with riverfront parkland, roads, buildings, and boats under a bright blue sky.

Montgomery is Alabama’s capital city.

Kruck20/Getty Images

Total Score: 52.59

Work Stress Rank: 108

Financial Stress Rank: 12

Family Stress Rank: 45

Health & Safety Stress Rank: 18

15. Baton Rouge, Louisiana


Aerial view of the Louisiana State Capitol complex with formal gardens, surrounding lakes, and the Mississippi River in Baton Rouge.

The State Capitol Park in Baton Rouge is by the Mississippi River.

felixmizioznikov/Getty Images

Total Score: 52.95

Work Stress Rank: 52

Financial Stress Rank: 23

Family Stress Rank: 25

Health & Safety Stress Rank: 20

14. New Orleans


The LaBrance House with iron balconies, hanging plants, and pedestrians on a sunny street in New Orleans.

The historical LaBrance House in New Orleans’ French Quarter.

Delpixart/Getty Images

Total Score: 53.89

Work Stress Rank: 71

Financial Stress Rank: 10

Family Stress Rank: 41

Health & Safety Stress Rank: 24

13. Houston


Downtown Houston skyline rises behind a green park with walking paths at sunset.

The Buffalo Bayou Park in Houston.

Nantiya Rattanatum/Getty Images

Total Score: 54.18

Work Stress Rank: 11

Financial Stress Rank: 56

Family Stress Rank: 15

Health & Safety Stress Rank: 8

12. Toledo, Ohio


Downtown Toledo skyline overlooks a riverfront park, roads, bridges, and waterways beneath a cloudy sky.

The Maumee River runs through Toledo.

Jacob Boomsma/Getty Images

Work Stress Rank: 74

Financial Stress Rank: 15

Family Stress Rank: 11

Health & Safety Stress Rank: 23

11. Birmingham, Alabama


Downtown Birmingham skyline at dusk viewed from above, with an ornate stone gargoyle in the foreground.

The downtown cityscape of Birmingham, Alabama.

Sean Pavone/Getty Images

Total Score: 54.42

Work Stress Rank: 119

Financial Stress Rank: 20

Family Stress Rank: 4

Health & Safety Stress Rank: 11

10. St. Louis


Gateway Arch rises over downtown St. Louis skyline with park lawns and the Old Courthouse visible below.

St Louis’ city center framed by the Gateway Arch monument.

Wirestock/Getty Images

Total Score: 54.60

Work Stress Rank: 24

Financial Stress Rank: 8

Family Stress Rank: 67

Health & Safety Stress Rank: 13

9. Akron, Ohio


Downtown Akron skyline at sunset with illuminated twin church towers, office buildings, trees, streets, and parking lots.

The downtown skyline of Akron, Ohio.

Sean Pavone/Getty Images/iStockphoto

Total Score: 55.14

Work Stress Rank: 35

Financial Stress Rank: 18

Family Stress Rank: 9

Health & Safety Stress Rank: 22

8. Jackson, Mississippi


Mississippi State Capitol stands amid trees and downtown Jackson buildings at sunset.

The Jackson cityscape at dusk.

SeanPavonePhoto/Getty Images/iStockphoto

Total Score: 56.03

Work Stress Rank: 39

Financial Stress Rank: 6

Family Stress Rank: 37

Health & Safety Stress Rank: 10

7. Philadelphia


Philadelphia City Hall and the Benjamin Franklin Parkway are seen at dusk with autumn trees and illuminated streetlights.

The Benjamin Franklin Parkway leads to Philadelphia City Hall.

Sean Pavone/Getty Images

Total Score: 56.61

Work Stress Rank: 5

Financial Stress Rank: 9

Family Stress Rank: 33

Health & Safety Stress Rank: 26

6. Gulfport, Mississippi


Palm trees frame brick storefronts with a white water tower marked "Gulfport" against a clear blue sky.

A water tower in Gulfport, which is a port city.

Rex_Wholster/Getty Images/iStockphoto

Total Score: 56.90

Work Stress Rank: 156

Financial Stress Rank: 17

Family Stress Rank: 1

Health & Safety Stress Rank: 7

5. Shreveport, Louisiana


Rust-colored truss bridge crosses a river in front of the downtown Shreveport skyline under a clear blue sky.

The downtown Shreveport skyline can be seen from the Shreveport Railroad Bridge South.

McFarlandPhoto/Getty Images/iStockphoto

Total Score: 57.75

Work Stress Rank: 99

Financial Stress Rank: 4

Family Stress Rank: 8

Health & Safety Stress Rank: 3

4. Memphis, Tennessee


Neon signs illuminate a brick-lined Beale Street in Memphis at dusk with cafes, blues clubs, and storefronts.

Blues clubs on Memphis’ historic Beale Street.

Sean Pavone/Getty Images

Total Score: 59.24

Work Stress Rank: 63

Financial Stress Rank: 7

Family Stress Rank: 5

Health & Safety Stress Rank: 1

3. Cleveland


Cleveland skyline and bridges reflect on the Cuyahoga River amid colorful autumn trees.

The Cleveland skyline is visible from the Cuyahoga River.

Sean Pavone/Getty Images

Total Score: 59.35

Work Stress Rank: 111

Financial Stress Rank: 1

Family Stress Rank: 6

Health & Safety Stress Rank: 4

With low median household income, the second-highest poverty rate, and the highest separation and divorce rate among the cities analyzed, Cleveland has the third-most stressed residents in the US, WalletHub reported.

2. Baltimore


Baltimore’s Washington Monument rises above Mount Vernon Place at dusk with illuminated streets and historic buildings nearby.

The Washington Monument in Baltimore.

Sean Pavone/Getty Images

Total Score: 59.73

Work Stress Rank: 1

Financial Stress Rank: 2

Family Stress Rank: 18

Health & Safety Stress Rank: 31

Baltimore came in second. Contributing factors include expensive rent — the average annual rent for a two-bedroom apartment is nearly 38% of the city’s median household income — and one of the highest violent crime rates among the cities analyzed, WalletHub reported.

1. Detroit


Aerial view of downtown Detroit skyline beside the Detroit River under a blue sky with scattered clouds.

The downtown Detroit skyline.

Vadym Terelyuk/Getty Images

Total Score: 62.78

Work Stress Rank: 14

Financial Stress Rank: 3

Family Stress Rank: 2

Health & Safety Stress Rank: 2

Detroit topped the ranking as the most stressed city in the US. This is partly attributed to it having the highest unemployment rate (10.4%) and poverty rate (32.7%) among cities in the study, as well as one of the highest violent crime rates.



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