in the United States House of Representatives in the 2020 census. West Virginia is the only state where death rates exceed birth rates. During 2010–2013, about 21,000 babies per year were born in West Virginia, but over these three years West Virginia had 3,000 more deaths than births. Family Gallup-Healthways annual "State of American Well-Being" rankings reports that 1,261 concerned West Virginians rated themselves as "suffering" in categories such as Quality of Life, Physical Health, and Access to Basic Needs. Overall, West Virginia citizens rated themselves as being more miserable than people in all other states—for five years running. In addition, the Gallup Well-Being Index for 2013 ranked Charleston, the state capital, and Huntington last and next-to-last out of 189 U.S. Metropolitan Statistical Areas. The Annie E. Casey Foundation's National Index of Children's Progress ranked West Virginia 43rd in the nation for all kids, and last for white kids. The Annie E. Casey Foundation's 2013 KIDS COUNT Data Book also ranked West Virginia's education system 47th in the nation for the second straight year. Charleston, West Virginia has the worst divorce rate among 100 cities in the nation. Stephen Smith, the executive director of the West Virginia Healthy Kids and Families Coalition, said poor employment prospects are to blame: "The pressure to make a good living puts strain on a marriage, and right now it is infinitely harder to make a living here than it was 40 years ago." Health United Health Foundation's "America's Health Rankings" for 2013 found that Americans are making considerable progress in key health measures. West Virginia, however, ranked either last or second-to-last in twenty categories, including cancer, child immunization, diabetes, disabilities, drug deaths, teeth loss, low birth weight, missed work days due to health, prescription drug overdose, preventable hospitalizations, and senior clinical care. Wisconsin Population Health Institute annual "Health Rankings" for 2012 showed West Virginia spends $9,671 per capita on health care annually. El Salvador spends just $467, yet both have the same life expectancy. In 2012, according to the Census Bureau, West Virginia was the only state where death rates exceed birth rates. During 2010–2013, about 21,000 babies per year were born in West Virginia, but there were 24,000 deaths. In demographics, this is called a "net mortality society". The National Center for Health Statistics says national birth rates for teenagers are at historic lows—during 2007–2010, teen birth rates fell 17% nationally. West Virginia,