The 20 US cities where people are the most stressed

Poverty is a contributing factor to stress. Tiago_Fernandez/Getty Images 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 The San Antonio River Walk. f11photo/Getty Images/iStockphoto Total Score (out of 100): 51.37Work Stress Rank: 67Financial Stress Rank: 48Family Stress Rank: 17Health & Safety Stress Rank: 17 19. Indianapolis Indianapolis, Indiana. Nicholas Klein/Getty Images Total Score: 51.84Work Stress Rank: 84Financial Stress Rank: 14Family Stress Rank: 42Health & Safety Stress Rank: 34 18. Cincinnati The Smale Riverfront Park in downtown Cincinnati. alexeys/Getty Images Total Score: 52.00Work Stress Rank: 25Financial Stress Rank: 24Family Stress Rank: 36Health & Safety Stress Rank: 40 17. Columbus, Georgia Columbus, Georgia's skyline. SeanPavonePhoto/Getty Images/iStockphoto Total Score: 52.27Work Stress Rank: 109Financial Stress Rank: 5Family Stress Rank: 34Health & Safety Stress Rank: 52 16. Montgomery, Alabama Montgomery is Alabama's capital city. Kruck20/Getty Images Total Score: 52.59Work Stress Rank: 108Financial Stress Rank: 12Family Stress Rank: 45Health & Safety Stress Rank: 18 15. Baton Rouge, Louisiana The State Capitol Park in Baton Rouge is by the Mississippi River. felixmizioznikov/Getty Images Total Score: 52.95Work Stress Rank: 52Financial Stress Rank: 23Family Stress Rank: 25Health & Safety Stress Rank: 20 14. New Orleans The historical LaBrance House in New Orleans' French Quarter. Delpixart/Getty Images Total Score: 53.89Work Stress Rank: 71Financial Stress Rank: 10Family Stress Rank: 41Health & Safety Stress Rank: 24 13. Houston The Buffalo Bayou Park in Houston. Nantiya Rattanatum/Getty Images Total Score: 54.18Work Stress Rank: 11Financial Stress Rank: 56Family Stress Rank: 15Health & Safety Stress Rank: 8 12. Toledo, Ohio The Maumee River runs through Toledo. Jacob Boomsma/Getty Images Work Stress Rank: 74Financial Stress Rank: 15Family Stress Rank: 11Health & Safety Stress Rank: 23 11. Birmingham, Alabama The downtown cityscape of Birmingham, Alabama. Sean Pavone/Getty Images Total Score: 54.42Work Stress Rank: 119Financial Stress Rank: 20Family Stress Rank: 4Health & Safety Stress Rank: 11 10. St. Louis St Louis' city center framed by the Gateway Arch monument. Wirestock/Getty Images Total Score: 54.60Work Stress Rank: 24Financial Stress Rank: 8Family Stress Rank: 67Health & Safety Stress Rank: 13 9. Akron, Ohio The downtown skyline of Akron, Ohio. Sean Pavone/Getty Images/iStockphoto Total Score: 55.14Work Stress Rank: 35Financial Stress Rank: 18Family Stress Rank: 9Health & Safety Stress Rank: 22 8. Jackson, Mississippi The Jackson cityscape at dusk. SeanPavonePhoto/Getty Images/iStockphoto Total Score: 56.03Work Stress Rank: 39Financial Stress Rank: 6Family Stress Rank: 37Health & Safety Stress Rank: 10 7. Philadelphia The Benjamin Franklin Parkway leads to Philadelphia City Hall. Sean Pavone/Getty Images Total Score: 56.61Work Stress Rank: 5Financial Stress Rank: 9Family Stress Rank: 33Health & Safety Stress Rank: 26 6. Gulfport, Mississippi A water tower in Gulfport, which is a port city. Rex_Wholster/Getty Images/iStockphoto Total Score: 56.90Work Stress Rank: 156Financial Stress Rank: 17Family Stress Rank: 1Health & Safety Stress Rank: 7 5. Shreveport, Louisiana The downtown Shreveport skyline can be seen from the Shreveport Railroad Bridge South. McFarlandPhoto/Getty Images/iStockphoto Total Score: 57.75Work Stress Rank: 99Financial Stress Rank: 4Family Stress Rank: 8Health & Safety Stress Rank: 3 4. Memphis, Tennessee Blues clubs on Memphis' historic Beale Street. Sean Pavone/Getty Images Total Score: 59.24Work Stress Rank: 63Financial Stress Rank: 7Family Stress Rank: 5Health & Safety Stress Rank: 1 3. Cleveland The Cleveland skyline is visible from the Cuyahoga River. Sean Pavone/Getty Images Total Score: 59.35Work Stress Rank: 111Financial Stress Rank: 1Family Stress Rank: 6Health & Safety Stress Rank: 4With 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 The Washington Monument in Baltimore. Sean Pavone/Getty Images Total Score: 59.73Work Stress Rank: 1Financial Stress Rank: 2Family Stress Rank: 18Health & Safety Stress Rank: 31Baltimore 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 The downtown Detroit skyline. Vadym Terelyuk/Getty Images Total Score: 62.78Work Stress Rank: 14Financial Stress Rank: 3Family Stress Rank: 2Health & Safety Stress Rank: 2Detroit 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. Read next Roya is a reporter on Business Insider's Editorial Partnerships team. She is based in London. Before joining Business Insider, she worked as a reporter at financial newswire Alliance News and was an intern at The Wall Street Journal. Roya graduated from City St George's, University of London with an MA in International Journalism. You can contact her via email at rshahidi@businessinsider.com. Mental Health