Special Report

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

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45. Kentucky
> Population: 4,467,673
> Pct. of population 65+: 16.9% — 24th lowest
> Disability, 65+: 56.8% — 3rd highest
> Older adults who don’t exercise: 45.6% — the highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.9% — 21st lowest
> Flu vaccine in the past year, 65+: 59.4% — 10th highest
> Primary care physicians: 66 per 100,000 — 8th fewest
> Avg. retirement income: $26,310 — 15th lowest

The 65 and older population in Kentucky reports some of the least healthy behaviors among this population in any state. The smoking rate among older Kentucky adults of 13.1% is the second highest nationwide, and 45.6% of 65 and older residents do not exercise on a regular basis, the highest share of all states. Both of these unhealthy behaviors likely contribute to state older adults reporting feeling physically unhealthy for more than six days a month, more than all but two other states.

Mental health is just as significant as physical health and can greatly affect daily routine. In Kentucky, 19.4% of older residents have been diagnosed with depression, the third highest share in the U.S.

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44. Nevada
> Population: 3,080,156
> Pct. of population 65+: 16.2% — 17th lowest
> Disability, 65+: 48.5% — 11th highest
> Older adults who don’t exercise: 32.9% — 19th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.1% — 23rd lowest
> Flu vaccine in the past year, 65+: 59.5% — 9th highest
> Primary care physicians: 57 per 100,000 — 2nd fewest
> Avg. retirement income: $34,913 — 7th highest

Nevada residents age 65 and older are among the least likely to eat a healthy diet in the country. Just 28.5% reported eating the recommended daily amount of fruit, and 7.5% said they ate the recommended amount of vegetables — both figures well below the nationwide rates of 34.5% and 13.2%, respectively.

State residents may also struggle to find medical care, as there are just 56.6 primary care physicians per 100,000 Nevada residents — the second lowest concentration among all states, and well below the national concentration of 75.5 per 100,000. Just 70.1% of Nevada residents 65 and older have had a colorectal cancer screening, such as a home stool test, sigmoidoscopy, or colonoscopy in the past decade, a lower share than all but two other states.

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43. Mississippi
> Population: 2,976,149
> Pct. of population 65+: 16.4% — 19th lowest
> Disability, 65+: 58.6% — 2nd highest
> Older adults who don’t exercise: 40.6% — 4th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.4% — 13th lowest
> Flu vaccine in the past year, 65+: 60.0% — 6th highest
> Primary care physicians: 53 per 100,000 — the fewest
> Avg. retirement income: $24,987 — 8th lowest

Mississippi ranks as one of the worst states for a healthy retirement, as state residents age 65 and older tend to struggle with their health as well as their finances. The state has the second highest share of 65 and older residents who live in poverty at 13.2%. And the average income for households with retirement income is less than $25,000, compared to $30,512 for the average American household with retirement income.

Lower-income areas tend to have worse health outcomes, and Mississippi is no exception. State residents 65 and older report an average of 6.6 physically unhealthy days per month, more than a full day over the U.S. average. Mississippi has the second lowest life expectancy of all 50 states, at 74.9 years. The U.S. life expectancy is 78.7.

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42. Arkansas
> Population: 3,017,804
> Pct. of population 65+: 17.4% — 22nd highest
> Disability, 65+: 49.8% — 7th highest
> Older adults who don’t exercise: 41.3% — 2nd highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.8% — 18th lowest
> Flu vaccine in the past year, 65+: 47.6% — 6th lowest
> Primary care physicians: 67 per 100,000 — 12th fewest
> Avg. retirement income: $25,635 — 13th lowest

Arkansas ranks as one of the worst states for a healthy retirement mostly because of the relatively poor physical health of the 65 and older population. Residents of this age group report an average of 6.4 physically unhealthy days per month, the fourth highest average nationwide. Nearly one in two older residents have a disability, one of the highest shares in the U.S.

Leading a healthy lifestyle typically requires regular doctor visits and getting necessary screenings and other preventive care. Only 35.3% of men 65 and older and 33.1% of women 65 and older in Arkansas are up to date on recommended clinical preventive services, the seventh and third lowest shares nationwide, respectively.

41. Tennessee
> Population: 6,829,174
> Pct. of population 65+: 16.7% — 22nd lowest
> Disability, 65+: 52.4% — 5th highest
> Older adults who don’t exercise: 41.1% — 3rd highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.1% — 8th lowest
> Flu vaccine in the past year, 65+: 48.1% — 7th lowest
> Primary care physicians: 72 per 100,000 — 18th fewest
> Avg. retirement income: $25,111 — 9th lowest

According to the CDC, nearly one in five deaths in the United States, or 1,300 deaths every day, are caused by smoking cigarettes, and in Tennessee, 13.1% of residents 65 and older smoke often or every day, the second highest share of any state. Smoking can hinder a person’s ability to exercise and be physically fit, and 41.1% of older state residents do not exercise, while 52.4% have a disability, the third and fifth highest shares in the U.S., respectively.

Poor mental health can also reduce quality of life. In Tennessee. 10.3% of 65 and older residents report frequent mental distress, and 18.6% have been diagnosed with depression at some point in their lives. Both rates are among the highest in the country.