A Ranking of the Toughest Places to Live in the U.S.

It’s not a neighborhood in the traditional sense, but Skid Row demands inclusion. More than 4,000 unhoused people live in this 50-block area of downtown Los Angeles. Tents line the sidewalks. Human suffering is visible, constant, and largely unaddressed.

Despite being blocks from skyscrapers, basic sanitation and safety are luxuries. Services exist—shelters, outreach, clinics—but rarely enough. The city’s response oscillates between neglect and force. Still, there’s a community amid the chaos: rules, leaders, mutual care.