Cities With the Most Stressful Jobs

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While the COVID-19 pandemic has undoubtedly exacerbated stressful work conditions for frontline and essential workers, workers in a wide range of other occupations must also contend with stress at work on a regular basis. According to data from the Bureau of Labor Statistics and the Occupational Information Network (O*NET), nearly 8% of U.S. workers are employed in occupations requiring the highest degrees of stress tolerance.

Stress on the job can be caused by high risks, demanding customers, and tight deadlines among other factors. O*NET ranks occupations on a scale of 0 to 100 based on how much a job “requires accepting criticism and dealing calmly and effectively with high-stress situations.” With a score of 100, urologists are thought to face some of the most stressful work conditions. Many of the other higher scoring jobs, such as nurse anesthetists and physician assistants, are in the health care field as well.

While many high-stress occupations command high wages—such as those in health care, business, and law—not all do. For example, telephone operators, public safety telecommunicators, and retail sales managers are all among the most high-stress occupations, but their wages are at or slightly below the national median.

Chronic stress, whether from one’s work or personal life, has been shown to cause a range of physical effects. Long-term chronic stress can cause or contribute to the risk factors for heart disease, metabolic disorders (e.g. obesity and diabetes), and depression among other problems. Workers in stressful jobs are more at risk for these harmful conditions, but there are strategies—including exercise, getting adequate sleep, and having a strong social support network—for managing stress.

The share of workers in high-stress occupations—defined as occupations with O*NET stress scores of 90 and above—varies on a geographic basis based on local economic factors. Workers in the South and on the East Coast tend to be more concentrated in stressful occupations than workers on the West Coast. At the state level, West Virginia and Mississippi have the highest share of workers in the most high-stress occupations, with 9.4% and 9.0% of workers in these jobs respectively. With just 6.4% of workers in high-stress occupations, Utah workers are the least likely to work in stressful jobs.

To determine the U.S. metropolitan areas with the most stressful jobs, researchers at Smartest Dollar analyzed the latest data from the U.S. Bureau of Labor Statistics and O*NET. The researchers ranked metros according to the percentage of workers in the most high-stress occupations. Researchers also calculated the total number of workers in the most high-stress occupations, the median annual wage across all workers, and the median annual wage across workers in high-stress occupations. To improve relevance, only metropolitan areas with at least 100,000 people were included in the analysis.

Here are the metros with the most stressful jobs.

Large Metros With the Most Stressful Jobs

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15. St. Louis, MO-IL

Percentage of workers in the most high-stress occupations: 7.6%
Total workers in the most high-stress occupations: 98,270
Median annual wage across all workers: $42,060
Median annual wage across workers in high-stress occupations: $63,085

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14. Miami-Fort Lauderdale-West Palm Beach, FL

Percentage of workers in the most high-stress occupations: 7.6%
Total workers in the most high-stress occupations: 190,340
Median annual wage across all workers: $38,690
Median annual wage across workers in high-stress occupations: $65,902

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13. Kansas City, MO-KS

Percentage of workers in the most high-stress occupations: 7.7%
Total workers in the most high-stress occupations: 79,790
Median annual wage across all workers: $43,200
Median annual wage across workers in high-stress occupations: $62,882

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12. New York-Newark-Jersey City, NY-NJ-PA

Percentage of workers in the most high-stress occupations: 7.7%
Total workers in the most high-stress occupations: 684,020
Median annual wage across all workers: $52,020
Median annual wage across workers in high-stress occupations: $84,360

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11. Baltimore-Columbia-Towson, MD

Percentage of workers in the most high-stress occupations: 7.9%
Total workers in the most high-stress occupations: 102,340
Median annual wage across all workers: $48,470
Median annual wage across workers in high-stress occupations: $71,688

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10. Buffalo-Cheektowaga-Niagara Falls, NY

Percentage of workers in the most high-stress occupations: 8.1%
Total workers in the most high-stress occupations: 40,310
Median annual wage across all workers: $42,040
Median annual wage across workers in high-stress occupations: $71,477

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9. Providence-Warwick, RI-MA

Percentage of workers in the most high-stress occupations: 8.1%
Total workers in the most high-stress occupations: 42,940
Median annual wage across all workers: $46,000
Median annual wage across workers in high-stress occupations: $74,967

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8. Tucson, AZ

Percentage of workers in the most high-stress occupations: 8.2%
Total workers in the most high-stress occupations: 30,130
Median annual wage across all workers: $38,900
Median annual wage across workers in high-stress occupations: $58,521

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7. Philadelphia-Camden-Wilmington, PA-NJ-DE-MD

Percentage of workers in the most high-stress occupations: 8.2%
Total workers in the most high-stress occupations: 220,690
Median annual wage across all workers: $46,500
Median annual wage across workers in high-stress occupations: $72,606

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6. Rochester, NY

Percentage of workers in the most high-stress occupations: 8.3%
Total workers in the most high-stress occupations: 39,630
Median annual wage across all workers: $42,430
Median annual wage across workers in high-stress occupations: $66,228

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5. Oklahoma City, OK

Percentage of workers in the most high-stress occupations: 8.4%
Total workers in the most high-stress occupations: 51,330
Median annual wage across all workers: $39,080
Median annual wage across workers in high-stress occupations: $60,689

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4. Pittsburgh, PA

Percentage of workers in the most high-stress occupations: 8.4%
Total workers in the most high-stress occupations: 90,130
Median annual wage across all workers: $43,200
Median annual wage across workers in high-stress occupations: $66,731

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3. New Orleans-Metairie, LA

Percentage of workers in the most high-stress occupations: 8.5%
Total workers in the most high-stress occupations: 43,700
Median annual wage across all workers: $38,280
Median annual wage across workers in high-stress occupations: $60,015

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2. Cleveland-Elyria, OH

Percentage of workers in the most high-stress occupations: 8.5%
Total workers in the most high-stress occupations: 83,650
Median annual wage across all workers: $42,740
Median annual wage across workers in high-stress occupations: $68,794

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1. Birmingham-Hoover, AL

Percentage of workers in the most high-stress occupations: 9.8%
Total workers in the most high-stress occupations: 48,770
Median annual wage across all workers: $39,530
Median annual wage across workers in high-stress occupations: $56,895

Detailed Findings & Methodology

To determine the U.S. metropolitan areas with the most stressful jobs, researchers at Smartest Dollar analyzed the latest data from the U.S. Bureau of Labor Statistics’s 2020 Occupational Employment Survey and O*NET’s Occupational Stress Tolerance data. The researchers ranked metros according to the percentage of workers in the most high-stress occupations, defined as the share of workers in jobs with O*NET stress scores of 90 and above. In the event of a tie, the metro with the larger total number of workers in the most high-stress occupations was ranked higher. Researchers also calculated the median annual wage across all workers and the median annual wage across workers in high-stress occupations.

To improve relevance, only metropolitan areas with at least 100,000 people were included in the analysis. Additionally, metro areas were grouped into the following cohorts based on population size:

Small metros: 100,000-350,000
Midsize metros: 350,000-1,000,000
Large metros: more than 1,000,000