Bell County is a dry county, meaning that the sale of alcohol is prohibited. The Middlesborough Micropolitan Statistical Area includes all of Bell County.
As of the census of 2000, there were 30,060 people, 12,004 households, and 8,522 families residing in the county. The population density was 83 per square mile (32 /km). There were 13,341 housing units at an average density of 37 per square mile (14 /km). The racial makeup of the county was 96.02% White, 2.40% Black or African American, 0.25% Native American, 0.35% Asian, 0.03% Pacific Islander, 0.12% from other races, and 0.83% from two or more races. 0.65% of the population were Hispanic or Latino of any race.
There were 12,004 households out of which 31.90% had children under the age of 18 living with them, 51.00% were married couples living together, 15.70% had a female householder with no husband present, and 29.00% were non-families. 26.80% of all households were made up of individuals and 11.40% had someone living alone who was 65 years of age or older. The average household size was 2.44 and the average family size was 2.95.
The age distribution was 24.40% under the age of 18, 9.00% from 18 to 24, 28.70% from 25 to 44, 24.20% from 45 to 64, and 13.70% who were 65 years of age or older. The median age was 37 years. For every 100 females there were 91.60 males. For every 100 females age 18 and over, there were 88.00 males.
The median income for a household in the county was $19,057, and the median income for a family was $23,818. Males had a median income of $24,521 versus $19,975 for females. The per capita income for the county was $11,526. About 26.70% of families and 31.10% of the population were below the poverty line, including 42.00% of those under age 18 and 21.80% of those age 65 or over.