Bledsoe County, Tennessee
4× the national median of residents with medical debt in collections.
Main Findings
Bledsoe County, Tennessee ranks 1,019th most distressed in the United States on the County Distress Index. The driver: 14% of residents with a credit file carry medical debt in collections — more than double the national median of 4%.
- 1,019th of 3,144 counties on the County Distress Index — Elevated zone, 44th in Tennessee.
- 14% of residents with a credit file carry medical debt in collections (U.S. median 4%). Medical debt in collections at the 95th percentile nationally.
- Bankruptcy filing rate at 232 — national median 126, ranked at the 82nd percentile.
- Disability rate at 24% — national median 16%, ranked at the 95th percentile.
- Business formation rate at 5.5 — national median 10.0, ranked at the 95th percentile.
Unemployment is 3%, near the national median of 4%, while medical debt in collections runs at the 95th percentile. Jobs exist; wages don't close the gap.
Neighbors span three CDI zones. The 29-point drop to Cumberland County marks where the Tennessee distress corridor ends.
"Bledsoe County is where distress lives in the margins. A county where most households are running out of runway, even as the headline numbers stay quiet."
"Elevated-zone counties are the largest block in the index. Most Americans live in counties scoring 55–70 — middle-class households doing the math every month."
Reporter's Notes
Two data points in the indicator table worth a follow-up call.
Bledsoe County's credit card delinquency indicator is at the 10th percentile — while every other indicator in the Consumer Credit Distress domain sits at or above the 60th percentile. The gap stands out against medical debt in collections and uninsured rate. Worth a call to Urban Institute or a local credit counselor in Pikeville.
28% of children under 18 in Bledsoe County live below the federal poverty line, versus 18% nationally. When a county's adult poverty rate is accompanied by a materially higher child poverty rate, the gap typically reflects single-parent household concentration or limited access to workforce-participation supports (childcare, transportation). Worth a call to the local school district's free-and-reduced-lunch coordinator or a regional United Way affiliate.
The Indicators Behind Bledsoe County's CDI Score
Every number traces to a public source. Bledsoe County's value shown alongside TN's median and the U.S. median. Full CSV available for download.
| Indicator | Bledsoe | TN median | U.S. median | Pctile | Source |
|---|---|---|---|---|---|
| Consumer Credit Distress — domain score 65 · Rank 1,027 of 3,144 | |||||
| Debt in collections Share of residents with a credit file who have debt in collections | 29% | 28% | 23% | 70th | Urban Institute (2024) |
| Medical debt in collections Share of residents with a credit file who have medical debt in collections | 14% | 8% | 4% | 95th | Urban Institute (2024) |
| Auto loan delinquency Share of auto loan accounts 60+ days past due | 8% | 6% | 5% | 80th | Urban Institute (2024) |
| Credit card delinquency Share of credit card accounts 60+ days past due | 3% | 6% | 5% | 10th | Urban Institute (2024) |
| Uninsured rate Share of residents without health insurance coverage | 18% | 10% | 8% | 93rd | Census ACS 5-yr (2023) |
| Subprime credit share Share of residents with a credit score below 660 | 26% | 26% | 23% | 60th | Urban Institute (2024) |
| Housing Cost Burden — domain score 30 · Rank 2,390 of 3,144 | |||||
| Rent burden (30%+) Share of renter households paying 30%+ of income on rent | 26% | 35% | 38% | 13th | Census ACS 5-yr (2023) |
| Severe rent burden (50%+) Share of renter households paying 50%+ of income on rent | 18% | 17% | 18% | 53rd | Census ACS 5-yr (2023) |
| Owner housing burden Share of owner households paying 30%+ of income on housing | 19% | 22% | 24% | 14th | Census ACS 5-yr (2023) |
| Homeownership rate Share of occupied housing units that are owner-occupied | 79% | 75% | 74% | 23rd | Census ACS 5-yr (2023) |
| Structural Poverty — domain score 75 · Rank 556 of 3,144 | |||||
| Unemployment Share of labor force unemployed | 3% | 4% | 4% | 14th | BLS LAUS (Dec 2025) |
| Poverty rate Share of population below the federal poverty line | 22% | 16% | 14% | 90th | Census SAIPE (2023) |
| Household income relative to state Median household income as share of state median | 0.88× | 1.00× | 1.00× | 79th | Census SAIPE (2023) |
| Child poverty rate Share of children under 18 below the federal poverty line | 28% | 21% | 18% | 87th | Census SAIPE (2023) |
| Disability rate Share of residents reporting a disability | 24% | 19% | 16% | 95th | Census ACS 5-yr (2023) |
| Transfer-income dependency Share of personal income from government transfers | 32% | 30% | 27% | 75th | BEA Regional Personal Income (2023) |
| Legal Distress — domain score 82 · Rank 555 of 3,144 | |||||
| Bankruptcy filing rate Personal bankruptcy filings per 100,000 residents | 232 | 216 | 126 | 82nd | US Courts F-5A (2025) |
| Economic Vitality — domain score 58 · Rank 1,096 of 3,144 | |||||
| Wage-to-rent ratio Ratio of average weekly wage to fair-market rent | 4.2× | 4.1× | 4.0× | 40th | BLS QCEW × HUD FMR (2024) |
| Rent-to-income ratio Fair Market Rent (2BR) as share of median household income | 23% | 22% | 21% | 68th | HUD FMR × Census ACS (2024) |
| Business formation rate New business applications per 1,000 residents | 5.5 | 8.1 | 10.0 | 95th | Census Business Formation Statistics (2024) |
| House price change (yoy) House price index year-over-year change | 4% | 4% | 4% | 46th | FHFA HPI (2024) |
Five-Domain Breakdown
The CDI is a PCA-weighted composite of five statistically derived factors. Weights are proportional to each factor's share of explained variance across 3,144 counties.
Methodology
The County Distress Index is a 0–100 composite score of household financial distress, computed for all 3,144 U.S. counties. A score of 50 represents the national county median; higher scores indicate greater distress. The index is built from 21 indicators grouped into five statistically derived factors via principal component analysis (PCA); factor weights are proportional to each factor's share of explained variance (shown in the Five-Domain Breakdown above).
Data sources include the Urban Institute Debt in America (Equifax consumer credit panel), U.S. Census Bureau (American Community Survey 5-year, Small Area Income and Poverty Estimates, Business Formation Statistics), Bureau of Labor Statistics (Local Area Unemployment Statistics, Quarterly Census of Employment and Wages), U.S. Courts Administrative Office (F-5A bankruptcy filings), and HUD Fair Market Rents. Data vintages range from 2023 to 2025 depending on source; full indicator-level vintage detail is in the methodology document.
For Press & Research
Everything you need to cite Bledsoe County data — in under 60 seconds.
Draft wire copy 155-word AP-style article — use freely with attribution
PIKEVILLE, Tenn. — Bledsoe County ranks 1,019th among the nation's most financially distressed counties, according to the County Distress Index released this month by American Default Research.
The composite score of 59 out of 100 places Bledsoe in the "Elevated" zone. Among 3,144 U.S. counties scored, 1,018 counties rank more distressed. Within Tennessee, Bledsoe ranks 44th of 95 counties.
The index, which draws on 21 indicators from the U.S. Census Bureau, Bureau of Labor Statistics, Urban Institute and federal court filings, identifies consumer credit distress as the primary driver in Bledsoe. 14% of residents with a credit file carry medical debt in collections — more than double the national median of 4%.
"Bledsoe County is where distress lives in the margins. A county where most households are running out of runway, even as the headline numbers stay quiet," said Ross Kilburn, founder of American Default Research.
Full methodology and county-by-county data are available at americandefault.org/methodology/cdi.
Frequently Asked Questions
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