This song provides details about Rosanne's family's life, centering on her father John's mother Carrie; the title comes from the area where her father grew up in Arkansas. Roseanne told the UK newspaper The Sun: "I began thinking about the lives of women back then like my grandmother. She picked cotton. The men picked cotton but the women picked cotton and kept charge of the kids. Her husband was not very nice."
She added: "My grandmother had a hard, hard life but she never became bitter. She was a very cheerful woman and had fortitude like I can't imagine."
Fall Out Boy's "The Kids Aren't Alright" song title is not a reference to The Offspring's 1998 single of the same name. It actually alludes to The Who's 1979 rockumentary film called The Kids Are Alright.