Special Report

All 50 States Ranked From Worst to Best for a Healthy Retirement

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50. Alaska
> Population: 731,545
> Pct. of population 65+: 12.4% — 2nd lowest
> Disability, 65+: 45.2% — 16th highest
> Older adults who don’t exercise: 25.4% — 5th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 13.7% — the highest
> Flu vaccine in the past year, 65+: 49.0% — 9th lowest
> Primary care physicians: 91 per 100,000 — 6th most
> Avg. retirement income: $43,642 — the highest

Alaska ranks as the worst state for a healthy retirement. With retirees often searching for a warm place to spend their golden years, Alaska is not a retirement destination. Just 12.4% of state residents are 65 and older, the second lowest share of any U.S. state.

Many Alaskans live in remote locations, making access to regular medical care a challenge. Both older men and older women are less likely to be up to date with some clinical preventive services, such as cholesterol screenings, colonoscopies, and mammograms. This may also be due to the financial struggles many older people in Alaska face, as 8.1% of state households with residents age 65 and older rely on public assistance income. This is the highest share of any state and more than four times higher the nationwide rate of 1.8%.

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49. New Mexico
> Population: 2,096,829
> Pct. of population 65+: 18.0% — 12th highest
> Disability, 65+: 44.2% — 20th highest
> Older adults who don’t exercise: 29.6% — 15th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 11.9% — 2nd highest
> Flu vaccine in the past year, 65+: 53.2% — 22nd lowest
> Primary care physicians: 75 per 100,000 — 22nd fewest
> Avg. retirement income: $31,487 — 15th highest

Older New Mexico residents are among the least likely to receive screening deemed essential by the CDC as well as be up-to-date on their vaccinations. For example, 63.0% of older women have received a mammogram within the last two years, the lowest share in the U.S. Also, 32.5% of older adults have not received regular screenings for colorectal cancer between 2008 and 2018, the second highest share of all states.

Income and health are often closely linked. About 13.5% of state residents 65 and over live below the poverty level, the highest share nationwide. For households 65 and older, 11.1% receive SNAP benefits, the seventh highest hare in the U.S.

48. Louisiana
> Population: 4,648,794
> Pct. of population 65+: 16.0% — 11th lowest
> Disability, 65+: 49.0% — 8th highest
> Older adults who don’t exercise: 38.9% — 5th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.3% — 23rd highest
> Flu vaccine in the past year, 65+: 45.7% — 4th lowest
> Primary care physicians: 67 per 100,000 — 14th fewest
> Avg. retirement income: $27,605 — 24th lowest

Older Louisiana residents are more likely to struggle with certain health problems than older Americans in the majority of states. Some 49.0% of the 65 and older population in the state has a disability, the eighth highest share of all states. Having a disability may have a negative effect on a person’s mental health. About 8.9% of older Louisianans report experiencing frequent mental distress, one of the highest shares nationwide.

Older residents in the state are more likely than older residents of all but two states to incur injuries from falling. About 12.8% of the 65 and older population in Louisiana received an injury from falling in the last year, the third largest share of all states. Nationwide, 10.2% of older Americans were injured due to a fall.

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47. Texas
> Population: 28,995,881
> Pct. of population 65+: 12.9% — 3rd lowest
> Disability, 65+: 49.9% — 6th highest
> Older adults who don’t exercise: 36.0% — 12th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.2% — 11th lowest
> Flu vaccine in the past year, 65+: 45.2% — 2nd lowest
> Primary care physicians: 61 per 100,000 — 4th fewest
> Avg. retirement income: $30,444 — 19th highest

Older residents in Texas are among the least likely in the country to receive their recommended preventive care. Only 30.9% of older men and 31.3% of older women are up-to-date on the CDC’s recommended set of clinical preventive services, the lowest and second lowest shares in the country, respectively. In addition, only 70.8% of all older adults received regular tests for colorectal cancer, well below the national average of 76.3%.

Several health outcomes contribute to Texas’ low ranking on this list. Older Texas residents were injured more from falls than older Americans in any other state. Some 13.2% of older residents in the state sustained an injury from a fall in 2018, the highest share nationwide. Those age 65 and older in Texas are more likely to be obese than older people in the rest of the country. About 35.6% of those 65 and older in the state are obese, the highest share among all states. Obesity predisposes to disability and decreased physical functioning.

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46. West Virginia
> Population: 1,792,147
> Pct. of population 65+: 20.5% — 3rd highest
> Disability, 65+: 61.1% — the highest
> Older adults who don’t exercise: 37.9% — 7th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 11.7% — 3rd highest
> Flu vaccine in the past year, 65+: 63.5% — 4th highest
> Primary care physicians: 78 per 100,000 — 22nd most
> Avg. retirement income: $22,242 — 2nd lowest

West Virginia ranks as one of the worst states for a healthy retirement for a number of reasons. More than 60% of state residents 65 and older have a disability, by far the highest share of any state. For context, 44% of Americans 65 and older report having a disability.

West Virginia older adults have some of the worst health indicators of any state. More than half of residents 65 and older have lost more than five teeth due to decay or gum disease, one of just two states where this is the case. Older residents often do not feel well, reporting an average of 7.3 physically unhealthy days per month, much more than in any other state.