Special Report

The Best and Worst States for a Healthy Retirement

Source: Susanne Neumann / iStock via Getty Images

20. South Carolina
> Population: 5,148,714
> Pct. of population 65+: 18.2% — 11th highest
> Disability, 65+: 43.9% — 22nd highest
> Older adults who don’t exercise: 33.8% — 17th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 6.9% — 5th lowest
> Flu vaccine in the past year, 65+: 58.4% — 13th highest
> Primary care physicians: 67 per 100,000 — 13th fewest
> Avg. retirement income: $28,450 — 25th highest

South Carolina has some of the highest shares of residents 65 and older who are up to date on their screenings and vaccinations, but the state also has higher shares of older adults reporting unhealthy behaviors. The state has some of the lowest shares of older residents who eat enough fruits and vegetables every day and who are likely to exercise regularly.

Mental health is just as important as physical health when it comes to living a long healthy life, and about 15.7% of South Carolina’s residents 65 and older have struggled or currently struggle with depression, compared to 14.4% of older Americans who have depression nationwide.

Source: peeterv / iStock Unreleased via Getty Images

19. Kansas
> Population: 2,913,314
> Pct. of population 65+: 16.4% — 20th lowest
> Disability, 65+: 42.5% — 23rd lowest
> Older adults who don’t exercise: 31.2% — 25th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.0% — 7th lowest
> Flu vaccine in the past year, 65+: 56.3% — 21st highest
> Primary care physicians: 77 per 100,000 — 23rd most
> Avg. retirement income: $24,301 — 5th lowest

Getting the flu at an older age can be life-threatening, and in Kansas, about 56.3% of 65 and older residents got their flu shot in 2018, above the national share of 54.0%. Older Kansas residents are also slightly less likely to smoke and lead a sedentary lifestyle than older Americans nationwide. About 8.3% of adults 65 and over smoke often if not every day, below the comparable national smoking rate of 8.9%. And 31.2% of older residents do not exercise, compared to 32.3% of Americans 65 and older across the U.S.

Kansas residents 65 and older are less likely to struggle with mental health than those of the age group nationwide. About 7.3% of older adults in the state reported experiencing frequent mental distress in 2018, compared to 7.9% of older adults in the U.S. as a whole.

Source: gregobagel / iStock via Getty Images

18. Rhode Island
> Population: 1,059,361
> Pct. of population 65+: 17.7% — 15th highest
> Disability, 65+: 40.2% — 13th lowest
> Older adults who don’t exercise: 35.5% — 14th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.6% — 14th lowest
> Flu vaccine in the past year, 65+: 51.1% — 14th lowest
> Primary care physicians: 97 per 100,000 — 4th most
> Avg. retirement income: $28,854 — 22nd highest

Rhode Island ranks higher than most other states as a healthy retirement destination in large part because state older residents are more likely to receive certain preventive health screenings than older Americans overall. The state has the highest share in the country of 65 and older residents who have gotten a cholesterol screening in the past five years, at 98.4%.

Rhode Island ranks fifth in the country for testing its older population for colorectal cancer by a stool test, sigmoidoscopy, or colonoscopy, with 79.2% of 65 and older residents having been tested compared to 76.3% of all older Americans. The state also ranks 10th in mammography screening, having tested 76.8% of 65 and older women in the last two years.

Source: Mark Lucey / iStock Editorial via Getty Images

17. Nebraska
> Population: 1,934,408
> Pct. of population 65+: 16.1% — 15th lowest
> Disability, 65+: 40.0% — 10th lowest
> Older adults who don’t exercise: 31.5% — 24th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.5% — 18th highest
> Flu vaccine in the past year, 65+: 57.9% — 17th highest
> Primary care physicians: 75 per 100,000 — 23rd fewest
> Avg. retirement income: $24,647 — 6th lowest

Retirement-age residents in Nebraska are proactive about receiving preventive care. Both older men and older women are more likely to be up to date with their core clinical preventive services than older adults in most other states. Nebraska residents 65 and older are also more likely to get their flu shot. Some 57.9% received their vaccination in 2018, more than 54.0% nationwide. Older adults in Nebraska are also less likely to struggle with mental health than their peers across the county.

However, older adults in the state are not healthy by all measures. They are more likely to be obese with nearly one in three 65 and over residents considered obese, the 11th highest rate among all states.

Source: Kirkikis / iStock Editorial via Getty Images

16. Virginia
> Population: 8,535,519
> Pct. of population 65+: 15.9% — 10th lowest
> Disability, 65+: 41.0% — 16th lowest
> Older adults who don’t exercise: 30.3% — 17th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.8% — 13th highest
> Flu vaccine in the past year, 65+: 58.9% — 12th highest
> Primary care physicians: 76 per 100,000 — 25th fewest
> Avg. retirement income: $36,695 — 4th highest

Wealthier individuals are more likely to make regular doctor visits and receive preventive care, and older Virginia residents tend to be relatively financially secure. The state has one of the lowest shares of the 65 and older population living below the poverty line. In addition, the average retirement income among households 65 and older is $36,695 a year, the fourth highest and well above the comparable $30,512 average income nationwide.

Older residents of the state are much more likely to receive preventive screenings than older adults in most other states. For example, 43.4% of older men and 46.2% of older women in Virginia are up to date on recommended clinical preventive services, the 12th and fourth highest shares nationwide, respectively.