Detailed Findings & Methodology
The migration patterns of America’s older population can indicate where some of the top destinations for retirees are located. On average, the 65-plus population in the U.S. grew 1.1% over the past year from out-of-state migration. In our analysis, 24/7 Wall St. looked at the 90 counties where the 65-and-over population grew at least 1.7% from out-of-state migration in the last year and where they comprised at least 21.2% of the total county population — each 150% of the corresponding national figures.
24/7 Wall St. ranked those 90 counties with large elderly populations attracting new residents based on an index comprised of various measures related to health behaviors, health outcomes, and access to health care, such as physical activity, premature death, and the regularity of diabetes and breast cancer screening.
Regular physical exercise plays a significant role in one’s health. Routine physical exercise is important for senior citizens because as age increases, muscle mass and bone density decrease — both of which are important to maintain in order to execute daily activities independently. Nationwide, 32% of adults 65 and over engage in no leisure-time physical activity, the largest share of any age cohort and far more than the 22% inactivity rate for all adults over 20. While older populations tend to be less physically inactive, some retirement communities have far lower inactivity rates than the U.S. as a whole. In San Juan County, for example, the healthiest retirement community, just 15% of adults engage in no leisure-time activity, one of the smallest shares of any county nationwide.
Healthy behaviors can significantly reduce the likelihood of premature death. In the 500 counties with the oldest populations, approximately 7,500 years of life are lost per 100,000 residents annually to premature death before the age of 75 — far more than the national average of 6,600 potential years of life lost per 100,00 Americans. In some healthy elderly counties, however, the premature death rate is far below the U.S. average.
Having reliable access to health care is incredibly important for the elderly. One factor included in our health index is the share of diabetic Medicare patients aged 65 to 75 who received HbA1c tests in the past year. HbA1c is a test that evaluates a patient’s long-term control of his or her blood glucose concentration, and helps diabetes patients assess how well they have managed their condition in the past several months. The index also includes the share of female Medicare enrollees aged 65 to 67 who received a mammography screening in the past two years. Breast cancer is the most common type of cancer among U.S. women, and regular screenings can reduce the likelihood of mortality, especially among older women.
The healthiest retirement communities are often relatively wealthy. The average annual retirement income ranges from $63,000 per household in the wealthiest county to just $8,000 a year in the county with the lowest retirement earnings, and can be the difference between affording healthy food, physical instruction and therapy, and quality medical care. In 20 of the 25 healthiest retirement communities, the average annual household retirement income is greater than the $24,337 national average.
Many of the healthiest retirement communities also have well-educated senior populations. Americans with a college education often have more comfortable working conditions throughout their lifetime, which can have a major effect on longevity. Educated Americans are also more likely to retain cognitive ability and memory into old age, factors which can drastically affect one’s health. In 17 of 22 retirement communities on this list with education data, the share of the 65-plus population with a bachelor’s degree is greater than the 24.1% national share.
To identify the healthiest communities for retirement, 24/7 Wall St. constructed an index consisting of various health outcomes and health behaviors for counties with significant retirement populations. Data on the share of the population with diabetes in 2013 came from the Centers for Disease Control and Prevention and was included in the index with full weight. Data on the number primary care physicians, dentists, and mental health providers per 100,000 residents came from County Health Rankings & Roadmaps, a Robert Wood Johnson Foundation and University of Wisconsin Population Health Institute joint program, and were each given a one-third weighting in the index. Data on the number of social associations per 10,000 people, annual preventable hospitalizations per 1,000 Medicare enrollees, years of potential life lost per 100,000 residents annually, smoking rate, obesity rate, share of the population with access to opportunities for physical activity, share of diabetic Medicare patients aged 65 to 75 who received HbA1c tests in the past year, share of the female Medicare enrollees aged 65 to 67 who received a mammography screening in the past two years, and the share of residents who are physically inactive also came from County Health Rankings & Roadmaps and were included in the index and given a full weighting. Social associations per 10,000 residents and the share of the population with access to physical activity locations were given one-half weights, and the inactivity rate was given double weight. All data is from the most recent period available.
Only counties in which the share of the population aged 65 and older and the share of 65-year and older population that moved to the county from a different state in the past year were larger than 150% of the national values were considered. Data on the share of the population aged 65 and older and the share of the 65 and over population that moved to the county from a different state over the past year came from the U.S. Census Bureau’s American Community Survey and are 5-year averages for the period 2011 to 2015.