Special Report

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

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25. Missouri
> Population: 6,137,428
> Pct. of population 65+: 17.2% — 23rd highest
> Disability, 65+: 49.0% — 8th highest
> Older adults who don’t exercise: 33.9% — 16th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.6% — 15th lowest
> Flu vaccine in the past year, 65+: 61.2% — 5th highest
> Primary care physicians: 70 per 100,000 — 16th fewest
> Avg. retirement income: $25,482 — 11th lowest

Missouri ranks right in the middle of U.S. states as a place for a healthy retirement. The state performs well on a number of key health indicators, but poorly on others. For instance, 65 and older Missouri residents are among the most likely in the country to have received preventive care with 43.4% of older men and 47.8% of older women up to date on clinical preventive services like disease screenings and immunizations. This is much higher than the national rates of 39.9% of men and 39.0% of women.

However, nearly half of Missouri’s older adults, 49.0%, report having a disability — the eighth highest share in the country and 5 percentage points higher than the comparable national rate. The state also has the 15th highest obesity rate among 65 and older adults, at 31.6%.

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24. Florida
> Population: 21,477,737
> Pct. of population 65+: 20.9% — 2nd highest
> Disability, 65+: 43.3% — 24th highest
> Older adults who don’t exercise: 31.1% — 24th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.4% — 22nd highest
> Flu vaccine in the past year, 65+: 52.8% — 19th lowest
> Primary care physicians: 73 per 100,000 — 20th fewest
> Avg. retirement income: $31,405 — 16th highest

With the second largest proportion of residents 65 and over, Florida is one of the country’s most popular retirement destinations. But the state’s older population is not among the healthiest. Older Florida residents are less likely to get a flu vaccination and less likely to regularly engage in physical activity than the typical older American. Income and health are often closely linked, and 10.7% of state residents 65 and over live below the poverty level, the sixth highest poverty rate among the age group nationwide.

The 65 and older population in Florida is ahead of most other states when it comes to receiving cancer screenings. Some 79.9% of people 65 and older receive regular tests for colorectal cancer, the fourth largest share of all states.

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23. Oregon
> Population: 4,217,737
> Pct. of population 65+: 18.2% — 10th highest
> Disability, 65+: 43.3% — 24th highest
> Older adults who don’t exercise: 26.1% — 6th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.9% — 11th highest
> Flu vaccine in the past year, 65+: 49.2% — 10th lowest
> Primary care physicians: 94 per 100,000 — 5th most
> Avg. retirement income: $30,446 — 18th highest

Older Oregon residents are among the most likely to eat healthily and exercise. Some 17.8% of 65 and over state residents eat three or more servings of vegetables a day, and 41.1% eat two or more fruits a day, the third and second highest share of all states, respectively. Older Oregon residents are the sixth most likely to report regular exercise routines. About 73.9% report regular physical activity, compared to the national average of 67.7%.

Yet that same population is among the most likely in the country to struggle with mental health. For example, just 19.2% of 65 and older adults in the state have struggled or are currently struggling with depression, the fourth highest rate in the U.S., compared to a nationwide share of 14.4%.

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22. Utah
> Population: 3,205,958
> Pct. of population 65+: 11.4% — the lowest
> Disability, 65+: 41.8% — 20th lowest
> Older adults who don’t exercise: 26.3% — 7th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 6.0% — 2nd lowest
> Flu vaccine in the past year, 65+: 52.0% — 16th lowest
> Primary care physicians: 58 per 100,000 — 3rd fewest
> Avg. retirement income: $29,406 — 21st highest

Utah ranks among the top 25 states for a healthy retirement, partially because of older residents’ healthy habits. Older residents are less likely to smoke and more likely to exercise regularly compared to most states. In fact, only 5.5% of 65 and older residents smoke, the lowest share of any state. These healthy behaviors may have contributed to the lower prevalence of older adults with disability. About 41.8% of those 65 and older Utah residents have a disability, less than the 44.0% of older adults nationwide.

While 96.2% of older state residents received regular cholesterol screenings – in line with the national rate — the frequency of other checks among Utah’s older population has room for improvement, especially among women. About 68.7% of women 65 and older have received a mammogram between 2016 and 2018, one of the lowest share in the U.S.

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21. Massachusetts
> Population: 6,892,503
> Pct. of population 65+: 17.0% — 25th highest
> Disability, 65+: 41.1% — 18th lowest
> Older adults who don’t exercise: 31.3% — 25th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.9% — 20th lowest
> Flu vaccine in the past year, 65+: 54.5% — 24th lowest
> Primary care physicians: 103 per 100,000 — 3rd most
> Avg. retirement income: $34,989 — 6th highest

Retirement-age adults in Massachusetts tend to have relatively healthy diets. Some 14.7% of older adults in the state eat three or more servings of vegetables each day, compared to 13.2% of older adults nationwide. Also, 36.7% of older adults in the state eat two or more servings of fruit daily, compared to 34.5% nationwide. Healthy eating habits may be a factor in the state’s lower than average 26.2% obesity rate among 65 and older residents, the eighth lowest share in the U.S.

Leading a healthy lifestyle typically requires regular doctor visits. There are 103 primary care physicians per 100,000 residents in Massachusetts, the third highest concentration and well above the national average of 75 per 100,000 people.