Special Report

The Best (and Worst) States to Grow Old

In West Virginia, 17.8% of the population is 65 or older, the third highest percentage nationwide. Looking at state residents of all ages, West Virginia is also the fourth oldest states in the country, with a median age of 42 years.

Seniors living in West Virginia are among the most likely to have retirement income — 55% of elderly households receive retirement income from pensions, 401 (k) plans, and other sources, the fifth highest share nationwide. However, these incomes are not especially high. The median income among elderly households of $32,219 is the second lowest in the country after Mississippi. Economic measures are closely tied to health outcomes, and the low incomes in West Virginia may contribute to more chronic illness and disability, especially among the elderly. Of the noninstitutionalized 65 and over population, 44.3% are disabled, the second highest share of all states.

47. Alabama
> Pct. of pop. age 65 and up:
15.4% (17th highest)
> 65 and over poverty rate: 11.2% (6th highest)
> 65 and over bachelor attainment: 19.0% (5th lowest)
> Life expectancy at birth: 75.2 years (2nd lowest)

Poor socioeconomic measures are closely tied to health outcomes. In Alabama, where 11.2% of elderly residents live in poverty. Poor health among Alabama’s elderly population likely contributes to the state’s life expectancy of just 75 years, the second lowest in the country. Educational attainment, both as a factor in economic prosperity and in self care, contributes substantially to personal well-being and independence among the elderly. But in Alabama, fewer than one in five people 65 and older have at least a bachelor’s degree, the fifth lowest college attainment rate in the nation.

48. Tennessee
> Pct. of pop. age 65 and up:
15.1% (24th highest)
> 65 and over poverty rate: 10.1% (13th highest)
> 65 and over bachelor attainment: 20.0% (8th lowest)
> Life expectancy at birth: 76.1 years (8th lowest)

Looking at financial and social measures as well as health systems and health outcomes of elderly Americans, Tennessee is one of the worst places to grow old in the country to grow old. The median annual income for homes with elderly heads of household is $34,224 in Tennessee, among the lowest in the country. While government subsidies can help poor families make ends meet, the level of assistance is likely insufficient for a number of Tennessee families. Of all elderly households in the state, 11.5% rely on food stamps, one of the highest percentages nationwide. Yet, nearly 12% of seniors in the state struggle to afford adequately nutritious meals, the second highest level of food insecurity among seniors nationwide.

49. Nevada
> Pct. of pop. age 65 and up:
14.1% (13th lowest)
> 65 and over poverty rate: 8.3% (22nd lowest)
> 65 and over bachelor attainment: 23.6% (22nd lowest)
> Life expectancy at birth: 77.9 years (17th lowest)

Like in a number of states where life tends to be more difficult for elderly residents, violence in Nevada may contribute to higher stress levels and disproportionately impact the elderly. Researchers have found that for older individuals — especially those living in poverty — even the perception of poor neighborhood safety can damage health in old age. Nevada’s violent crime rate of 636 incidents per 100,000 people in a single year is the worst in the nation after only Alaska. The median income among Nevada’s older households and the poverty rate of 65 and older residents, at $40,482 and 8.3%, are each better than the corresponding national averages and exceptionally strong compared with the worst states in which to grow old.

Still, Nevada’s elderly seem to be struggling financially in other ways. More than 58% of elderly renters pay more than 30% of their income for housing, for example, the sixth highest percentage. Also, more than one in 10 seniors in the state struggle to afford food, one of the highest levels of food insecurity. When basic necessities such as housing, food, and out-of-pocket medical expenses are considered, Nevada’s supplemental poverty rate is actually the second highest in the country.

50. Mississippi
> Pct. of pop. age 65 and up:
14.3% (17th lowest)
> 65 and over poverty rate: 13.2% (the highest)
> 65 and over bachelor attainment: 19.1% (6th lowest)
> Life expectancy at birth: 74.5 years (the lowest)

Mississippi — and its population overall — often ranks last in many social and economic measures, the state’s elderly population also reports some of the nation’s worst outcomes compared to older Americans in other states. More than one in four residents 65 and older did not graduate from high school, the second highest such proportion in the country. The low level of education among Mississippi’s elderly residents partially explains the similarly low incomes. A typical household in the state headed by an elderly resident earns $30,254 annually, the lowest in the country. Additionally, the elderly poverty rate of 13.2% in the state is the highest compared to poverty rates of seniors living elsewhere. Older Americans are among the most vulnerable to chronic diseases and disabilities, and this is especially the case in Mississippi. Of noninstitutionalized residents 65 and over, 44.5% have a disability, the highest percentage nationwide. Relatively poor health among elderly Mississippians likely partially explains the state’s low life expectancy at birth, which at less than 75 years is the lowest of all states.

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