Six Facts about Family-Sustaining Cost Growth

Costs have risen for families in every U.S. county since 2021. In this post, we break down six facts about where the cost of living for the typical family has grown the fastest nationally and the key expenses driving that growth.

Fact 1: Almost every U.S. county has seen family-sustaining costs—the amount needed to support two working adults and two children—grow by 2% or more each year since 2021. Cost growth is especially pronounced in Montana and New Jersey: every one of Montana’s 56 counties ranks in the top third nationally, while every New Jersey county grew faster than the national median of 4.5% a year. 

Fact 2: The counties with the fastest family-sustaining cost growth are scattered across the West, Midwest, and Northeast, and generally represent communities surrounding the nation's most prominent cities or the cores of smaller metros. Hudson County, New Jersey—the county with the fastest cost growth among those with at least 100,000 people—is home to Jersey City, a secondary urban center within the New York metro. In fact, five of the Top 20 counties sit within the greater New York region, and two more are in the Philadelphia metro area.

Other counties—like those in Idaho and Montana—represent the cores of smaller metros that have seen recent population growth. Ada County anchors Boise, Idaho, a notable destination for remote workers during the pandemic, and a city that continues to see fast population growth today. Montana's Gallatin and Flathead counties are home to Bozeman and Kalispell, both of which have experienced a population boom since 2020.

Fact 3: Childcare is the fastest-growing cost in most Top 20 counties, while housing and health care are drivers in three counties. Housing costs are climbing fastest in Flathead and Gallatin County, Montana, and Ada County, Idaho. Meanwhile, health care is pushing family expenses up in Anchorage Municipality, Alaska; Santa Cruz County, California; and Monmouth County, New Jersey. Everywhere else, childcare is the single fastest-growing expense.

Fact 4: In the nation’s most populous counties, family-sustaining costs are growing at a more modest pace. The Seattle metro’s King County leads the group with 6.6% annual growth, well below the 7.5% average among the 20 counties with the steepest increases. Cost growth in seven of the 20 most populous counties—including Los Angeles County, California; Cook County, Illinois; Dallas County, Texas; and Middlesex County, Massachusetts—falls below the national median of 4.5% a year.

Fact 5: In contrast to the Top 20 counties with the fastest cost growth, health care is driving up family-sustaining budgets in more than half (11) of the 20 most populous U.S. counties. Housing accounts for the remaining nine, while childcare—the dominant driver among the Top 20 counties—doesn’t appear at all. This difference likely reflects childcare market depth: rural and smaller counties have far less childcare supply to begin with, meaning county-wide costs are driven by a handful of providers, while large counties with deeper markets are more insulated from price volatility.

Health care's dominance is also geographically concentrated. Of the 20 most populous counties, eight sit in the Pacific or New England divisions—two regions where health care premiums have risen significantly since 2021. 

Fact 6: Family-sustaining cost growth has slowed since 2023, but costs have yet to come down. The median U.S. county saw family-sustaining costs grow 7.7% each year between 2021 and 2023, compared to just 2.3% from 2023 to 2026. Families are paying more than ever, on top of a cost base that locked in at a significantly higher level after the initial pandemic-era jump.

Additionally, every Census division saw costs keep climbing through 2026 albeit at a slower pace. However, cooling was uneven: the Mountain division cooled the most, dropping from 9% annual growth to under 3% since 2023. In contrast, the Middle Atlantic—New Jersey, New York, and Pennsylvania—barely slowed at all, with cost growth at 4% both in both time periods. As a result, the Middle Atlantic is now among the regions furthest from its 2021 starting point with few signs of reprieve.

Today, the outer suburbs, mid-size counties, and smaller metros that were once considered affordable are now absorbing the fastest cost growth, largely driven by childcare. In contrast, the nation's most populous and expensive metros are seeing costs rise more modestly, and for entirely different reasons: health care costs concentrated in a handful of states, and housing markets with less room left to run. Ultimately, the cost of living, the specific trade-offs families face to make ends meet, and the implications for frontline workforce stability remain a deeply local story.

Methodological Note: References to annual cost growth in this article reflects compound annual growth rates (CAGRs), which express total change over a period of time as a constant yearly rate. CAGRs smooth out year-to-year volatility and reflect the rate at which costs would have needed to grow each year to reach their 2026 level.