Stressed Cities And Countries – The Most And Least Stressed Places In The World

To most people living abroad is the dream – a stress-free life and a never-ending holiday. However, from finding a job to organising international health insurance, moving abroad can be a source of anxiety.

Although stress sometimes comes from your lifestyle, it can also be impacted by your environment. Following on from last year’s report, we have updated the research for 2023, ranking 66 cities and 37 countries to find the most stressful places in the world and how this compares to last year. The rankings are based on cleanliness, financial stress, LGBTQ+ safety and suicide rates.

We also compared the 50 US states to reveal which states are the most and least stressed in the country.

Where are the most stressed cities in the world?

The following cities rank as the most stressed in the world, based on factors like air pollution levels, green spaces and LGBTQ+ safety rating.

The results show that geography may have an impact on stress levels, with 9 of the top 10 cities located in Asia.

1/ Mumbai, India

Score: 6.85/10

Knocking Cairo off the top spot this year is India’s largest city, Mumbai. India’s financial capital is the busiest and largest city in the country and, based on the factors used, the world’s most stressed city.

Mumbai is home to some of the largest slum areas in the country, so it’s no surprise that 83% of the population lives in poverty, ranking fourth for the factor.

The city also has one of the lowest levels of cleanliness in the index, scoring just 24.31, dropping slightly from last year’s score of 24.38. This makes it the lowest-scoring Indian city on our list for the factor, behind Kolkata and the capital Delhi.

2/ Bangalore, India

Score: 6.80/10

Moving up seven places from last year, Bangalore is the second Indian city in the top three. Despite the city’s low cost of living, more than 80% of the population lives in poverty, a drop of 4% since last year, and 17.46% of people in the city spend more than 10% of their
household income on health costs, making living in Bangalore very stressful financially.

3/ Nairobi, Kenya

Score: 6.77/10

Taking third place is a new entry on the list, Kenya’s capital Nairobi. Home to some of the largest slum areas on the continent, 91% of the city’s residents live in poverty, topping the list for the factor. It’s also one of the most stressful cities for its LGBTQ+ community, scoring -62 for its safety rating, placing fifth just behind Tehran and Dubai.

Where are the least stressed cities in the world?

These cities are the least stressed in the world, based on factors including pollution levels, LGBTQ+ safety, cleanliness and cost of living.

The majority of the top 10 least stressed cities in the world are in Europe, with Vienna ranking highest. With the exception being Dubai in the United Arab Emirates.

1/ Vienna, Austria

Score: 2.67/10

Rising from second place last year, Vienna is the world’s least stressed city. In Austria’s capital, none of the population lives on less than US$6.50 a day, down from just 1% last year.

Alongside the non-existent poverty rate, the cost of living in Vienna is more affordable than most. A single person would spend £841 per month on living costs without rent. Despite this low cost, this is still a 27% increase since last year.

Vienna’s LGBTQ+ safety rating is 309, higher than most cities on the list and up nine points from 2022. It also has the second-highest cleanliness rating of any city at 83.75, up from third place for the factor last year.

2/ Munich, Germany

Score: 2.79/10

Taking second place this year, Munich ranks as one of the least stressed cities – the Bavarian capital has one of the lowest poverty rates, with none of its residents living on less than US$6.50 a day. The cost of living in Munich is £909 per month for a single person, rising from £750 in 2022.

Munich is the second-best city for the quality of green areas and parks, dropping from the top spot last year. It has a green area quality rating of 84.96, down from 83.38 in 2022.

The cleanliness rating of Munich shows that it’s the fourth-cleanest city on the list, up a place since 2022. The city scored 80.28, also lower than last year’s score of 82.42.

3/ Edinburgh, United Kingdom

Score: 2.98/10

A new entry on the list, Edinburgh takes its place as the third least stressed city, with an overall score of 2.98 out of 10. Ranking highly across the board, the Scottish capital scores higher than most for its LGBTQ+ safety, with a score of 342. The quality of its green spaces is also highly regarded, ranking fifth for the factor and scoring 82.26.

The most and least stressed cities in the world

The most stressed countries in the OECD

To find the most stressed countries around the world, we looked at OECD countries (Organisation for Economic Co-operation and Development; an intergovernmental organisation founded to stimulate economic progress and world trade), developed nations with high-income economies committed to improving international and domestic policy.

Each country was compared based on factors including air quality, noise pollution and health expenditure per capita.

The following countries are the most stressed in the world, according to the factors that were analysed.

1/ South Korea

Score: 8.02/10

South Korea remains the most stressed country in the OECD, scoring even higher this year, up from 6.74 out of 10 in 2022.

Mental illness in the Republic of Korea is prevalent, and while economic growth has boomed in recent decades, mental health services remain largely underfunded.

The suicide rate in South Korea is the highest out of all OECD countries, and suicide is the fourth leading cause of death in the country.

South Korea ranks in the three worst countries for LGBTQ+ safety at 92, dropping a point since last year. The country also has one of the highest air pollution index scores, thanks to the rapid industrialisation in many cities, including Seoul.

2/ United States

Score: 7.29/10

Recent studies have shown that 89% of Americans experienced burnout over the last year, so it’s no surprise the United States ranks as one of the OECD’s most stressed countries. Up from third place last year, the country ranks higher than most for noise and light pollution. The estimated cost of living is also notably high at £951.80, showing an increase of 35% since 2022.

Out of all OECD countries, the United States has the highest health expenditure per capita at £10,359, £2,355 more than last year.

The most stressed countries are from different geographical regions, including Asia, Europe and North America. Despite the United States ranking 2nd overall for stress, its neighbouring country Canada ranks 23rd overall.

Read on to find out which US states are the most stressed in the country.

3/ Belgium

Score: 7.12/10

Noise and light pollution can have a drastic effect on mental health, affecting the quality of sleep and increasing stress and anxiety. So with a noise and light pollution score of 54.93, a rise of 0.13 since last year, it’s no surprise Belgium takes third place, up from fourth in 2022.

Noise pollution is so bad in the capital Brussels that it knocks an estimated 8 months off the life expectancy of its residents.

The least stressed countries in the OECD

These are the least stressed countries in the OECD, and with the top three most relaxed cities all being in Europe, it comes as no surprise the top 10 countries are all European. With Portugal, Sweden and Estonia occupying the top three spots.

1/ Portugal

Score: 2.95/10

Rising from the middle of the ranking last year, Portugal claims the title of the least stressed country in 2023. The country ranks highly for LGBTQ+ safety, scoring 358, a slight decrease from last year’s 359. Residents aren’t stressed when it comes to their finances either, as living costs average £538, a steep rise from £451 in 2022.

2/ Sweden

Score: 3.20/10

Nordic countries often rank as some of the least stressed in the world, and Sweden is no exception, retaining its place as the second least stressed country in the OECD.

Sweden ranks among the best five countries for air pollution, with an index score of 14.89, down from 18.43 last year.

Sweden ranks as the second safest OECD country for the LGBTQ+ community – same-sex marriage has been legal since 2009 and lesbian couples have had equal access to IVF since 2005.

3/ Estonia

Score: 3.26/10

Research has linked air pollution and stress for years, with higher levels contributing to both negative physical and mental health effects, including an increased risk of depression.

It therefore comes as no surprise Estonia has climbed up from seventh place this year to the top three. The country ranks second for cleanest air with an index score of 12.13, down from 19.8 in 2022.

Estonia also has one of the highest cleanliness ratings on the list at 82.06, rising by slightly over 5% since 2022.

The most and least stressed countries in the OECD

The most stressed states in the USA

Each US state was analysed based on factors like air quality, suicide rates, LGBT population density and cost of living. Stress seems to be concentrated along geographic lines in the US, with two of the states in the top three in the Midwest region.

1/ Oklahoma

Score: 6.39/10

Rising from 15th place in 2022, The Sooner State is 2023’s most stressed state. Despite covering more than 68,000 square miles, national parks make up only 0.13% of the area of the state, making it much more difficult for residents to relax in nature.

One of the biggest contributing factors to stress in the US is air pollution, which varies considerably by state. Oklahoma ranks in the worst ten states for average air quality index, with a daily level of 46.7, a rise of 168% since 2022 and a 15-point increase on last year’s worst performer for the factor, New Mexico.

2/ Alabama and Missouri

Score: 6.21/10

Two states share second place this year, with Alabama and Missouri replacing Montana as the most stressed states in 2023 based on cleanliness, air quality, financial stress, LGBTQ+ population density and cost of living.

The Southeastern state of Alabama has one of the lowest population densities of LGBTQ+ people at only 3.1%, unchanged from last year and a lack of access to national parks, which only cover 0.14% of the state.

Greenhouse gas emissions can be a huge problem depending on several factors, like the amount of traffic or industry in an area. Unfortunately for its residents, Missouri scores highly for its CO2 emissions from large facilities, producing 67 million tonnes of CO2, 10 million more than last year.

The least stressed states in the USA

These are the least stressed states in the USA, based on factors like air quality, suicide rates, LGBT population density and cost of living.

Two states are on the coast, albeit on opposite sides of the country, and the third is the US’s only island state.

1/ Washington

Score: 3.29/10

Rising from third place last year, Washington ranks as the country’s least stressed state overall in 2023. The state has some of the cleanest air in the country, with a daily index score of 25.6, way up from last year’s 17.3.

Although Oregon has the country’s highest LGBTQ+ population density at 5.6%, its neighbour Washington isn’t far behind as the LGBTQ+ community makes up 5.2% of the population.

2/ Maine

Score: 3.35/10

Up two places from last year, Maine takes second place as the US’s most relaxed state. The coastal state known for its stunning national parks has some of the lowest industrial CO2 emissions, placing in the top five at a mere 3.5 million tonnes, increasing from 2.2 million last year.

The Pine Tree State also has more land dedicated to state parks than most areas of the country at just under 3.6%.

3/ Hawaii

Score: 3.64

With miles of sandy beaches and lush tropical scenery, it’s no wonder The Aloha State is one of the most relaxed in the US, rising from eighth place last year.

Hawaii has the most land dedicated to national parks, which take up 9.41% of the islands that make up the state, making it very easy for residents to relax in nature. It also has the cleanest air quality in the index, scoring 22.4, although this has doubled since last year.

The most and least stressed states in the US

Tips for coping with expat stress

One of the biggest changes you can make in your life is packing up and moving abroad, so it’s no wonder that stress is one of the most common expat concerns.

It isn’t easy to call another country home, especially if you’re moving away from a stable income and the foods you love.

5 tips to help you deal with stress as an expat

Here are 5 tips to help you deal with stress as an expat:

1. Remind yourself why you’re an expat

   Before you get too homesick, it is always a good idea to remind yourself why you moved away in the first place. Come up with a list of reasons, which could be anything from moving to join a spouse or partner, to the new and exciting professional opportunities that await you in your new home. Whenever you feel the stress of expat life gets too much, think of the positives this big change can bring.

2. Explore the area

   A common expat concern is homesickness – many miss walking the streets of their home city or visiting their local supermarket. Although the culture shock of moving abroad can be scary at times, your new city has landmarks, shops and sights that are just as beautiful as the ones back home.

   Try to look online for a running route, or go out of your home and choose a direction to explore. Your new favourite cafe or bookstore is out there just waiting for you to find it. Just make sure you have plenty of time for some self-care so you don’t end up exhausted and lacking the motivation for more exploration.

3. Meet new people

   It can be hard to make new friends as an expat, and while staying in touch with your loved ones can ease the pressure of homesickness, the limited social interactions could be getting you down. The best way to meet new people in an unfamiliar city is to join a club or social event. Whether you’re living in a big city like Tokyo or in a small French town, there are often language courses for expats or Facebook groups for like-minded people.

   If you find yourself struggling with a language barrier, then workout and sports groups could be the answer. Little verbal communication is needed, and you’ll pick up new words to use in everyday life.

4. Learn a new language

   The easiest way to learn a new language is to be surrounded by it at all times. And what better opportunity to learn a language than when living abroad with native speakers. Language classes are widely available and can be a great way to meet new international people in the same boat as you.

   When dealing with expat stress, it can be vital to have someone who’s in the same situation to share your worries with. If there aren’t any language classes in your area, there are plenty of resources online for learning languages. Use websites and apps to pick up words and phrases that you can use in daily life.

5. Bring some home comforts

   Despite wanting to immerse in the culture of your new home, it can be tempting to enjoy home comforts, like dishes and snacks from your home country. Sometimes other cuisines take time to adapt to, but it’s important to get enough nutrition after moving abroad, as stress can lead to poor diet choices, affecting your overall health.

   In some places, you can easily find international foods in big supermarkets. However, if you live in a more remote city with no access to home foods, you could ask friends and family at home to mail you a food package.

   Home comforts aren’t just limited to food either, you could have a special blanket or little trinkets that remind you of home too. However, you should avoid bringing too many of these with you as they could make you homesick.

Wherever you move, go with total peace of mind

At William Russell, we have nearly 30 years of helping expatriates finding best places in the world to move abroad and settle into their new lives overseas by providing world-class international health insurance. Plus, we produce lots of expert material to help you and your family adapt to life abroad.

Making the move to another country can be challenging. But no matter where you go, you can take one thing off your mind. William Russell offers international health insurance that covers you for everything from minor injuries to long hospital stays, and we can even offer medical evacuations to patients who require treatment in other countries.

Methodology

Cities

Financial stress is considered by the % of the population spending greater than 10% of the household income on health costs according to The World Health Organization, the % of the population living in poverty, and the estimated monthly cost of living for a single person.

Data on pollution, air pollution, noise and light pollution, quality of green spaces and parks, cleanliness and the estimated monthly living cost of a single person without rent were obtained from Numbeo.

Information on suicide rates per 100,000 was taken from the World Health Organisation.

LGBTQ+ safety ratings were taken from Asher Fergusson, and The World Bank was used for data on the poverty headcount ratio for each city.

We gave each location a normalised score out of ten for each factor before taking an average across all of the factors to reach our overall stress score out of ten.

Countries

The ranking is based on cleanliness, current health expenditure per capita, cost of living, LGBTQ+ safety and suicide rates. Cleanliness includes air pollution index, noise pollution, cleanliness rating and quality of green spaces rating.

Data on pollution, air pollution, noise and light pollution, quality of green spaces and parks, cleanliness and the estimated monthly living cost of a single person without rent were obtained from Numbeo.

Information on suicide rates per 100,000 was taken from the World Health Organization.

LGBTQ+ safety ratings were taken from Asher Fergusson. The current health expenditure per capita was sourced from the World Health Organization.

We gave each location a normalised score out of ten for each factor before taking an average across all of the factors to reach our overall stress score out of ten.

States

The ranking is based on cleanliness, % of land made up of by state or national parks, cost of living index, LGBTQ+ population density and suicide rates. Cleanliness includes average air quality index, CO2 emissions and the number of landfills per 1,000 sq miles.

To find the average daily air quality index, the average daily AQI across all monitoring sites in each state during 2022 was taken from the United States Environmental Protection Agency.

The % of land comprising state or national parks was sourced from PlaygroundEquipment.

The number of landfills in each state was sourced from the United States Environmental Protection Agency and the land area of each state was obtained from Wikipedia.

Information on suicide rates per 100,000 was taken from the National Center for Health Statistics.

The cost of living index for each state was sourced from the Missouri Economic Research and Information Center.

The LGBT population density in each state was sourced from the Movement Advancement Project.

The amount of CO2 gas emissions from large facilities in metric tons was sourced from the United States Environmental Protection Agency.

We gave each location a normalised score out of ten for each of these factors, before taking an average across all of the factors to reach our overall stress score out of ten.