America's Healthiest States for Seniors, Ranked

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SENIOR CARE

Senior health is an acute concern everywhere, but some states are doing a far better job of addressing it. According to the Census Bureau, adults 65 and older are now more than 15 percent of the total population. By 2030, that will grow to 20 percent, putting stress on clinical and community services and not doing wonders for the nation's health overall. America's Health Rankings took a 34-point look at the health of seniors in the United States — right down to their isolation levels and suicide rate — and ranked each state by how it met those criteria. Read on to find out where your state ranks.
senior in Bayou Classic Parade in New Orleans, Louisiana
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50. LOUISIANA

Change since last year: Down three
It doesn't look good in cajun country. There's a high rate of of obesity (35.3 percent of adults aged 65 and older), a lot of seniors living in poverty (13 percent), many seniors who don't know where their next meal is coming from (23.4 percent of adults aged 60 and older), the worst nursing home quality in the country (31.6 percent of four- and five-star beds), and a high percentage of frequent mental distress (10 percent of adults aged 65 and older). The good news? There is a high number of home health care workers (154.3 workers per 1,000 adults aged 75 and older) and a low prevalence of excessive drinking (6.8 percent of adults aged 65 and older).

two girls and grandma walking by river in Mississippi
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49. MISSISSIPPI

Change since last year: Up one
The state is up one spot from the bottom, but still gets bad marks across the board. Nearly one in four Mississippi seniors don't know where their next meal is coming from, while 30 percent are obese. The state is 85 percent short of the number of geriatric physicians it needs, which is why just 65 percent of seniors get health screenings, only 30 percent are in high health, and a nationwide worst 2,435 out of every 100,000 seniors between 65 and 75 dies early. Roughly 12 percent live in poverty, 12 percent smoke, and 34 percent are physically inactive. At least Mississippi knows this: Community support has increased 10 percent, from $188 to $207 for each senior in poverty, within the last year.

senior woman with her horse
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48. KENTUCKY

Change since last year: Up one
This is one spot better than last year, but still awful. More than 12 percent of seniors in Kentucky smoke, while 36 percent are physically inactive. That takes some of the guesswork out of discerning why just 57.7 percent of Kentucky seniors are able-bodied and why 76.6 out of every 1,000 hospitalizations of seniors here are completely preventable. Oh, and 2,419 out of every 100,000 seniors between 65 and 75 die early.

senior man on ATV on Mt. Magazine, Arkansas
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47. ARKANSAS

Change since last year: Down one
That's No. 47 on the way down from 46 last year, despite having a low rate of excessive drinking (4.3 percent of those 65 and older). Only 56 percent of seniors go for dental visits, only 63 percent get health screenings, and 10 percent report high levels of mental distress. Community support decreased 10 percent in the past year, to $457 from $509 per adult aged 60 or older in poverty. In the past two years, flu vaccination coverage decreased 15 percent from 63.5 percent, to 53.9 percent of adults aged 65 and older. Most frighteningly, the suicide rate among Arkansas seniors has jumped 21 percent in the past four years.

senior farmer man with plow in background
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46. OKLAHOMA

Change since last year: Up two
Oklahoma's score is far worse than it looks. Roughly 38 percent of its seniors are inactive (the worst in the country), only 54 percent are able-bodied, just 36 percent are in high health, and 60 out of every 1,000 hospital visits is for an easily preventable condition. Just 57 percent go to the dentist regularly, while 21 percent have teeth extracted. The state has 85 percent fewer geriatric doctors than it needs, only 37 percent of its nursing homes are considered "quality," and 18 percent of seniors don't know where their next meal is coming from. As a result, 2,343 seniors out of every 100,000 between 65 and 75 die early.

senior father with son camping outside
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45. WEST VIRGINIA

Change since last year: None
Welcome to the worst dental hygiene among seniors in the United States. Just 52.5 percent of seniors here visit the dentist, while 30.4 percent get teeth extracted. Overall senior health here isn't much better: 57 percent are able-bodied, 33 percent are in high health, 32.4 percent are obese, 30.5 percent are physically inactive, 10.8 percent smoke, 18.5 percent don't know where their next meal is coming from and 9.5 percent live in poverty. About 63 percent of nursing home beds here are sub-par, 75 of every 1,000 seniors admitted to the hospital has a preventable condition, 15.7 percent are readmitted for the same condition, 16.8 percent end up in intensive care, and 24 percent die in the hospital. Unsurprisingly, the number of West Virginian seniors who die early (2,293 out of every 100,000 between ages 65 and 75) is among the largest in the country.

fly fisherman in the woods
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44. TENNESSEE

Change since last year: None
Tennessee has the most seniors who smoke (13 percent of all seniors), but the fewest meal-delivery services for seniors (just 3.5 meals per 100 adults over 60 who have trouble living independently). It has 82 percent fewer geriatric doctors than it needs, it has only 55 home health care workers for every 1,000 seniors over 75, and 59.3 of every 1,000 senior hospitalizations are for preventable conditions. It's little surprise, then, that Tennessee, ranks in the bottom fifth of the country for able-bodied seniors (62 percent), frequent mental distress (8.3 percent), seniors in high health (35 percent) and seniors who die early (2,271 out of every 100,000 between 65 and 75).

senior woman running Atlanta Peachtree Road Race
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43. GEORGIA

Change since last year: Down two
When you're already ranked below No. 40, dropping two spots in a year isn't great. A whopping 37.2 percent of seniors are physically inactive, which could explain the 6.9 percent who suffer hip fractures and 2,038 out of 100,000 who die early. Georgia isn't helping itself, either: Health screenings decreased 6 in the past year, while smoking among seniors increased 33 percent and food insecurity jumped 13 percent within the past two years.

grandchild whispering to her smiling grandfather while sitting on bench in park
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42. ALABAMA

Change since last year: Up one
Alabama's seniors have a high early death rate (2,370 deaths per 100,000 adults aged 65 to 74), a low prevalence of pain management (46.6 percent of seniors with arthritis), and not all that many health care workers (just 57.5 for every 1,000 adults age 75 and over). Yet Alabama moved up a spot from 43 last year thanks to a low prevalence of excessive drinking (just 5.5 percent of seniors), a high rate of health screenings (75.6 percent of seniors get screened), and a high rate of diabetes management (81 percent of Medicare-enrolled seniors ages 65 to 75).

senior woman shopping for Western boots
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41. TEXAS

Change since last year: Down three
How is Texas, a state with vast resources, this bad for seniors? Well, 10.5 percent of Texas seniors live in poverty and get just $229 apiece from Texas to help them cope with it. About 30 percent are obese, 32 percent are physically inactive, and 17 percent don't know where their next meal is coming from. While 93 percent have a dedicated health care provider, just 68.5 percent get regular health screenings, 61 percent are able-bodied, 37 percent are in high health, and 17 percent end up in intensive care. In the past year, flu vaccination coverage decreased 14 percent, to 57.3 percent of adults aged 65 and older, while frequent mental distress increased 32 percent, to 8.2 percent of all seniors.

Native American senior smiling
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40. NEW MEXICO

Change since last year: Down six
Why is New Mexico at No. 40 and falling? Because just 90 percent of its seniors have a dedicated health care provider and a national-low 61 percent get regular health screenings. This is largely because 11.5 percent of New Mexico seniors live in poverty, with 18 percent not sure where they'll get their next meal and the state providing them only $575 in support each year. As a result, just 60 percent are considered able-bodied, just 38 percent are in high health, and 10 percent experience frequent mental distress.

senior farmer in corn field
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39. INDIANA

Change since last year: No change
Indiana hasn't moved in the rankings, but that isn't good news. Roughly 31 percent of its seniors are obese, 11.6 percent smoke, 18.2 percent don't know where they're getting their next meal from, and just 55.2 percent get the flu vaccine. As a result, 2,065 out of every 100,000 seniors in Indiana dies early.

senior woman enjoys dance class
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38. ILLINOIS

Change since last year: Down two
Illinois is slipping in the ranks (from No. 36 in 2017) largely because of seniors themselves. While 66.2 percent of seniors in Illinois are able-bodied, 30.8 percent are obese and just 66.9 percent get health screenings. More than 16 percent end up in intensive care. But Illinois seniors' poverty has increased 8 percent in the past year and have dealt with food insecurity that has increased 22 percent within the past half-decade.

senior couple walking with pet bulldog in countryside
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37. SOUTH CAROLINA

Change since last year: Down four
South Carolina dropped four spots from 2017, but could easily have fallen further. Though 8.6 percent of seniors live in poverty, 20 percent aren't sure how they'll get their next meal. South Carolina has no answer for them, either, as it dedicates only $247 per person to helping impoverished seniors. Only 60 percent of South Carolina seniors go to the dentist regularly, which leads to 18 percent having teeth extracted. With only 76 home health care workers per 1,000 people over 75 — in a state filled with retirees — even those with more money will have a tough time staying healthy.

senior cyclist touring Katy Trail in Missouri
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36. MISSOURI

Change since last year: Up six
This ranking isn't great, but it's a six-spot improvement in the past year. Roughly 24 percent of nursing home residents receive low to no care, 57 out of every 1,000 hospital admissions is for a preventable condition, 15.5 percent of hospitalized seniors are readmitted, and 18 percent of seniors have teeth extracted. But 95 percent of seniors have a dedicated health care provider, 87 percent have prescription drug coverage, 65 percent have access to the flu vaccine, and the number of seniors in high health and with access to home health care workers has increased in recent years.

senior woman hiking in a beautiful Red Rock Canyon in Nevada
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35. NEVADA

Change since last year: Up five
Nevada's ranking has improved five spots, but most of its biggest issues are self-inflicted. Just 26 percent of Nevada seniors are obese, while only 26 percent injure themselves in falls — both among the lowest rates in the country. But Nevada has only 76 percent of the geriatric doctors it needs and dedicates just $215 to seniors in poverty. That results in just 91 percent of seniors having a dedicated health care provider, only 54 percent having access to the flu vaccine, just 68 percent getting health screenings, and 15.6 percent of all seniors admitted to the hospital going back for the same reason. Nevada seniors return the state's stinginess in kind, with a U.S.-low 16.8 percent volunteering in any capacity.

mature couple hiking along forest path together
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34. OHIO

Change since last year: Up one
Ohio's seniors are, overall, unhealthy. Roughly 30 percent are obese, 35 percent are physically inactive, only 70 percent get health screenings, 17 percent end up in intensive care, and 2,034 out of every 10,0000 between 65 and 75 die early. Only 66 percent get regular dental visits, which leads to 17 percent having teeth extracted. That said, the 89 percent of Ohio seniors who have prescription drug coverage is the highest percentage in the country.

senior woman sitting on a bench watching the sea
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33. NORTH CAROLINA

Change since last year: Down one
In some ways, North Carolina is a lot better than its ranking. Roughly 96 percent of seniors here have dedicated health providers, 87 percent have prescription drug coverage, 77 percent get health screenings, and 65 percent get the flu vaccine. But with more than 9 percent of seniors here living in poverty, the $342 a year the state spends on each of them hasn't been enough to keep 21 percent of seniors from thinking they might starve. Those who are better off, meanwhile, face a nursing-home system where only 32 percent of beds are considered "quality."

senior couple enjoying the sunset on Siesta Key Beach, Florida
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32. FLORIDA

Change since last year: Down one
Florida dropped a spot from 2017, thanks to the 8.7 percent of seniors who drink excessively, 20 percent who end up in intensive care, and the abysmal 27.9 home health care workers per 1,000 adults 75 and older. Florida is improving in a whole lot of other areas, though: Flu vaccination coverage is up 12 in the past year, the number of four- or five-star rated nursing home beds jumped 24 percent in the past two years, and preventable hospitalizations decreased 18 percent in the past five years as high health status increased 11 percent during the same span.

happy senior people in the garden
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31. ARIZONA

Change since last year: Down eight
What happened that could've caused Arizona to drop from No. 23 in last year's rankings? Well, in the past three years, Supplemental Nutrition Assistance Program reach decreased 34 percent, from 67 to 44.1 participants per 100 adults in poverty aged 60 and over. During that same time, suicides increased 15 percent, from 21.2 to 24.4 deaths per 100,000 adults aged 65 and over. Meanwhile, the past half-decade has seen Arizona's obesity rate increased 22 percent, to 25.9 percent of seniors 65 and older, while the share of seniors who don't know where their next meal is coming from jumped to 17.8 percent of adults aged 60 or older from 12.8 percent.

senior Yellowstone Park Ranger on horse
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30. WYOMING

Change since last year: Up seven
It isn't in the top half of the rankings yet, but a six-point improvement certainly helps. Roughly 8.5 percent of Wyoming seniors live in poverty, but the state spends $1,915 per person addressing their needs. That's resulted in the most home-delivered meals in the nation for seniors having trouble living independently, and just 9.1 percent of seniors dealing with food insecurity. Yet there are still big health-care issues for seniors in this state: It has less than 12 percent of the geriatric doctors it needs, only 88 percent of seniors have a dedicated health care provider, just 63 percent get health screenings, and just 62 percent of seniors here are able-bodied as a result.

happy senior couple on scooter
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29. KANSAS

Change since last year: Up two
Kansas is still in the wrong half of these rankings, but things are getting better. The bad news is that only 45 percent get the SNAP coverage they need, just 55 percent get the flu vaccine, and 6.4 percent end up hospitalized by hip fractures. Yet only 5.6 percent report frequent mental distress, while 34.6 percent volunteer for various causes. In the past year, four- or five-star rated nursing home beds increased 14 percent, while preventable hospitalizations decreased 23 percent in the past five years.

senior man and woman having conversation on porch in Montana
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28. MONTANA

Change since last year: Down one
There are some drawbacks for seniors living in Big Sky Country. The state is 89 percent short of the number of geriatric physicians it needs, ranking it worst in the country in that regard. As a result, only 89.7 percent of seniors have a dedicated health care provider, just 69 percent get regular health care screenings, and just 80 percent have prescription drug coverage. None of that is great in a state where 9 percent of seniors drink excessively and 35 percent are prone to injure themselves by falling, but more than 90 percent know where they're getting their next meal, just 24 percent are obese, and 76 percent are physically active. Seniors here do their best to keep healthy, which is why only 1,662 out of 100,000 between ages 65 and 75 die early.

senior male canoeing on a lake in Idaho
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27. IDAHO

Change since last year: Down five
Idaho dropped five spots into the bottom half of the rankings largely because it isn't keeping pace. The number of geriatric physicians it has is 88.3 percent less than it needs. As a result, just 64.4 percent of Idaho seniors get health screenings and just 53.6 percent have access to flu vaccines. Meanwhile, the environment surrounding seniors in Idaho is getting more hostile. In the past year, excessive drinking increased 13 percent, to more than 8 percent of all seniors, while early deaths have increased 11 percent within the past four years. During the past half-decade, poverty among seniors has increased 33 percent and put one in every 10 Idaho seniors below the poverty line.

senior couple smiling in the park together
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26. MICHIGAN

Change since last year: Up one
Michigan jumped a spot in the rankings, but still remains in the middle thanks to its seniors' doughy middles. Roughly 32 percent of all seniors here are obese, with 8.6 percent drinking excessively and 28 percent considered physically inactive. While 72.8 percent make regular dental visits, 87 percent have prescription drug coverage, and 96 percent have a dedicated health care provider, just 56.1 percent have access to the flu vaccine and 15 percent of those who end up in the hospital are readmitted for the same condition.

senior walking on recreational Cowboy Trail in northern Nebraska
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25. NEBRASKA

Change since last year: Down one
Nebraska falls squarely in the middle of the senior health spectrum, but it is doing its best to improve. The state spends nearly $1,050 on every senior in poverty, provides 87 percent of seniors with prescription drug coverage, and gives 63 percent of seniors access to flu vaccines. While just 68 percent of seniors here get health screenings, 65.5 percent are able-bodied, 46 percent are in high health and 35 percent volunteer in their spare time. Just don't expect much home health care, as there are only 68 workers for every 1,000 people over 75.

senior man resting during exercise
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24. VIRGINIA

Change since last year: Up one
Seniors living in Virginia love it. More than 67 percent are able-bodied, 44 percent are in high health, and only 6 percent report frequent mental distress. That doesn't mean they're feeling all that secure, however. Only 38 percent of the state's nursing-home beds are "quality" (four-star or better), just 81 percent have prescription drug coverage, 15.4 percent end up in intensive care, and 24 percent die in the hospital.

senior woman trimming flowers in her garden
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23. NEW JERSEY

Change since last year: Down three
New Jersey dropped three spots out of the top 20, but not without cause. Nearly one in every four of its seniors ends up in intensive care, largely because 36 percent of seniors are physically inactive. Despite 68 percent of New Jersey seniors being considered able-bodied, 8 percent experience frequent mental distress and just 42 percent are considered to be in high health. New Jersey ranks among the Top 10 states in the country for its number of geriatric physicians, the quality of its nursing homes, and its management of diabetes, but the fact that 26 percent of its seniors die in hospitals frustrates the state's efforts a bit.

senior man with Golden Retriever dogs in Lena Beach, Juneau, Alaska
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22. ALASKA

Change since last year: Up seven
Alaska was 29th in 2017, but jumped up in the rankings as four- or five-star rated nursing home beds increased to 64.8 percent of certified nursing home beds from 43.9 percent within the past year. Meanwhile, suicide decreased 38 percent, from 22.8 to 14.1 deaths per 100,000 adults aged 65 and over during the past four years, while dental visits among the same age group increased 7 percent, to 67 percent from 62.4 percent during that same span. Meanwhile, only 4.2 percent of Alaska seniors live in poverty, with Alaska spending a top-ranked $3,675 to help seniors in poverty find a way out of it.

two senior men in front of Mount Rushmore National Monument, South Dakota
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21. SOUTH DAKOTA

Change since last year: Down six
In a state where seniors are relatively poor, this ranking is a minor miracle. Eleven percent of South Dakota seniors live in poverty, which means few can afford home health care workers (there are only 54.5 here per every 1,000 people over 75) or hospice care (just 40 percent). Just 41 percent of seniors in poverty get SNAP benefits, while just 92 percent have dedicated health care providers. Yet South Dakota seniors manage to stay positive: Just 4.7 percent report frequent mental distress, while 36 percent volunteer their time and services.

African American senior couple embracing on rock over beach
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20. CALIFORNIA

Change since last year: Down four
It seems good relative to other states, but California actually dropped four spots in these rankings since last year. While only 5.6 percent of California seniors smoke, just 1,484 out of every 100,000 between 65 and 75 die early, 80 percent get health care screenings, and 10.3 percent of all seniors in California live in poverty. In the past year, physical inactivity increased 18 percent among adults aged 65 or older in fair or better health, while falls among that same group increased 6 percent during the past four years.

senior couple mountain biking on a forest trail
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19. NORTH DAKOTA

Change since last year: Down one
North Dakota faces a whole lot of obstacles to caring for its seniors. Roughly 32 percent are obese, 31.7 percent are physically inactive, 9.5 percent smoke, and 7.4 percent drink excessively. Just 39.7 percent of seniors here are considered to be in high health, with just 92 percent having a dedicated health care provider and 68 percent getting health screenings. But North Dakota is throwing everything it has at senior health. It spends $1,106 per person on the 7.6 percent of seniors in poverty. Just 6.1 percent of seniors here worry about hunger, just 4.2 percent report frequent mental distress, and a whopping 36 percent volunteer when possible.

senior man smiling with coffee in New York City
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18. NEW YORK

Change since last year: Up three
The Empire State is up one spot from last year with good reason. Roughly 96 percent of New Yorkers have a dedicated health care provider, 88 percent get prescription drug coverage and 72 percent get regular health screenings. But all of that masks some serious ills: Despite spending $922 a year on seniors in poverty, New York has more than 11 percent of its senior population living below the poverty line. While there are 251 home health care workers for every 1,000 seniors over 75, New York seniors are still heavily reliant upon hospitals. More than 15 percent who are hospitalized are readmitted, while 30 percent die in hospitals.

senior woman smiling with service dog Longwood Gardens, Pennsylvania
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17. PENNSYLVANIA

Change since last year: Up nine
Jumping up nine places since 2017, Pennsylvania has a senior population in which 96 percent have a dedicated health care provider, 74 percent get regular health screenings, 65.5 percent get the flu vaccine, and just 5.9 percent suffer frequent mental distress. There are 137.4 home health care workers per 1,000 adults ages 75 and older (up 8 percent from 2017), while 62 percent of those living with arthritis are managing their pain. That said, excessive drinking has increased 35 percent, to 8.1 percent of all seniors, while the number of early deaths among seniors sits at 1,856 per 10,000.

senior mountain biking in Washington
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16. WASHINGTON

Change since last year: Down seven
There are upsides and downsides to a state where seniors can be physically active. In Washington, where more than 79 percent of seniors are active, 44 percent of seniors are in high health and 30 percent volunteer. The downside is that 33 percent injure themselves in falls, and just 64 percent consider themselves able-bodied. Meanwhile, while 63 percent of nursing home beds here are high-quality (four stars or above), the state spends just $263 on each of the 7.6 percent of impoverished seniors who can't afford them.

senior couple on the coast looking out to the sea
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15. OREGON

Change since last year: Down three
When Oregon seniors are healthy, they're really healthy. More than 81 percent are active (tops in the land), 47.5 percent are in high health, and only 34 out of every 1,000 are admitted to hospitals with a preventable condition. When those seniors aren't healthy, it's dire. Despite that activity, just 62.6 percent of Oregon seniors are able bodied. About 45 percent of seniors with arthritis aren't managing their pain, 8.1 percent drink excessively, and a paltry 51.5 percent get the flu vaccine. While just 7.2 percent live in poverty, Oregon commits only $372 toward helping those seniors out of poverty.

senior man looking out from top of mountain in Acadia National Park, Maine
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14. MAINE

Change since last year: Down three
Don't tell Maine seniors they've dropped three spots in the rankings since 2017. The 67 percent of them that are able-bodied and 47.6 percent in high health just may want to have a word with you outside. About 97 percent of Maine seniors have a designated health care provider, while 78 percent get regular health screenings. So what's dragging Maine down? The 9 percent of seniors in poverty and the 15.6 percent who don't know how they're going to feed themselves. Couple that with 7.8 percent who drink excessively and 32.5 percent who suffer falls, and Maine has some areas in which it could be far healthier.

senior man hiking meadow in Vermont
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13. VERMONT

Change since last year: Down five
It's a good ranking, but still down five places from last year. Roughly 69 percent of all senior Vermonters are able-bodied, with 52 percent in high health (best in the country) and only 4.4 percent ending up in intensive care (another best in the country). Just 1,560 out of every 100,000 Vermonters between 65 and 75 die early, but this doesn't mean they have nothing to worry about. More than 35 percent of Vermont seniors are injured in falls, nearly 9 percent drink excessively, and 23 percent die in the hospital. In the past year, home health care workers decreased 6 percent, to 161.8 aides per 1,000 adults aged 75 and older from 172.3, while SNAP reach decreased 30 percent over the past three years, to 95.2 participants per 100 adults aged 60 and over in poverty. Finally, in the past five years, flu vaccination coverage decreased 10 percent, to 59 percent of all seniors.

senior couple canoeing Wisconsin forest lake
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12. WISCONSIN

Change since last year: Down two
This state's seniors are proactive about their health. More than 96 percent have designated health care providers, 79 percent get regular health screenings, and 76 percent go to the dentist regularly. The only area where this isn't the case is flu vaccinations, where a worst-in-the-nation 49.5 percent of seniors get their shots. Wisconsin seniors aren't great about their vices, either: 11.3 percent drink excessively (worst in the country), 35 percent are obese, and 7.6 percent report frequent mental distress.

senior woman with service dog
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11. DELAWARE

Change since last year: Up six
This state was No. 17 last year, but with nearly 80 percent of seniors getting health screenings and 69 percent of seniors considered able-bodied (second-best in the nation), there's been a lot of improvement. Despite 8.7 percent of seniors drinking excessively and 16 percent needing full-mouth teeth extractions, they can take solace knowing that four- or five-star rated nursing home beds increased 14 percent within the past year, while community support and SNAP reach increased 16 percent and 58 percent, respectively, among seniors in poverty during the past four years.

senior woman in wheelchair smiling with flowers
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10. IOWA

Change since last year: Up nine
Iowa jumped nine spots in these rankings since 2017, for reasons it should crow about. Just 6.9 percent of Iowa seniors live in poverty, while 89 percent have prescription drug coverage and 67 percent have access to the flu vaccine. More than 68 percent of Iowa seniors are able-bodied, while just 5.1 percent report feeling frequent mental distress. It's getting better, too, as smoking among seniors decreased 13 percent in the past year, while SNAP reach increased 5 percent in the past two. If you're thinking of moving here, the number of four- or five-star rated nursing home beds increased 11 percent within the past three years, while the number of home health care workers increased 32 percent in the past five.

gay senior couple having pie on porch
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9. MARYLAND

Change since last year: Up five
Up five spots and into the Top 10, Maryland counts 68.7 percent of its seniors among the able-bodied and only 7.2 percent of seniors among the ranks of its smokers. But the $280 it spends on seniors age 60 or over in poverty is dreadful, as is the dead-last 76 percent of Maryland seniors with prescription drug coverage. Don't get too comfortable in the Top 10, Maryland, there's still work to do.

senior man on rocky coast, smiling in Rhode Island
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8. RHODE ISLAND

Change since last year: Up five
If you're a senior who needs health care, few places provide it with better quality than Rhode Island. The 65.2 percent of "quality" nursing-home beds is first in the country, as are the 97 percent of seniors who have a dedicated health care provider. Roughly 88 percent of seniors here have prescription drug coverage, with 79 percent getting regular health screenings. Nearly 68 percent of all Rhode Island seniors are able-bodied, while 45 percent are in high health. Rhode Island has to have such great care, considering that its seniors are still among the unhealthiest in the nation. About 31 percent are physically inactive, only 20 percent volunteer, 54 out of every 1,000 senior hospital visits are preventable, and the state provides only $207 a year to seniors in poverty.

senior couple smiling outdoors
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7. MASSACHUSETTS

Change since last year: Down one
With a state-run health care system that was the predecessor to the Affordable Care Act, Massachusetts makes senior health care a priority. The $2,792 it spends on seniors in poverty is second only to North Dakota, and 79.6 percent of seniors get health screenings as a result. In Massachusetts, 71 percent of seniors make regular dental visits, 97 percent have a dedicated health care provider, and just 8 percent smoke or live in poverty. As a result, just 1,524 out of every 100,000 seniors between 65 and 75 dies early. Though 47 percent are in high health, 8.5 percent report frequent mental distress and 8 percent drink excessively.

two senior woman jogging on a bridge along the water
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6. CONNECTICUT

Change since last year: Up one
In healthy New England, Connecticut comes in second by a small margin. Just 6.5 percent of its seniors live in poverty, just 24.9 percent are obese, and only 1,494 in 100,000 die early. In the past two years, poverty decreased 17 percent, while SNAP reach increased 44 percent. But there are issues. Roughly 8 percent of Connecticut seniors drink excessively, while the suicide rate among them has increased 38 percent in the past four years.

senior man paddling on mountain lake in the Rocky Mountains, Colorado
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5. COLORADO

Change since last year: Down one
Knocked down one spot from last year, Colorado's seniors are still in really good shape. Just 21 percent are obese (second-lowest in the nation), just 1,435 out of every 100,000 between 65 and 75 die early (again, second-lowest), and 64.7 percent get the flu vaccine. While diabetes management and delivered meals aren't all they could be, food insecurity decreased 26 percent from last year, while physical inactivity decreased 7 percent.

grandpa with granddaughter on dirt road
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4. MINNESOTA

Change since last year: Down three
Minnesota lost its No. 1 ranking from 2017, but still has a lot going right. In Minnesota, 89 percent of seniors have prescription drug coverage, 76.1 percent get regular dental visits, 63 percent have access to the flu vaccine, and 37 percent volunteer in their spare time. Just 9.5 percent don't know where their next meal is coming from, while just 1,498 out of 100,000 between 65 and 75 die early. Though 69 percent of seniors here are able-bodied, with 48 percent in high health, 9 percent drink to excess and just 90 percent have a dedicated health care provider.

senior woman relaxing near waterfall, Franconia Notch State Park, New Hampshire
Photo credit: pchoui/istockphoto

3. NEW HAMPSHIRE

Change since last year: Up two
Given the choice, New Hampshire seniors more often choose the "Live Free" part of the state motto over the "Die" part. A whopping 69 percent of seniors here are able-bodied, with 52 percent in high health — both best in the nation. That's because 96 percent have a dedicated health care provider, 77 percent get regular health screenings and 62 percent are vaccinated against the flu. Thank New Hampshire itself: The state funnels $1,965 toward every senior in poverty, reducing the state's senior poverty rate to just 4.6 percent. While it isn't great that 8 percent of seniors here drink excessively or that just 79 percent have prescription drug coverage, the relatively low quality of nursing home and hospice facilities are a more acute concern for a state in which just 1,560 out of every 100,000 seniors between 65 and 75 dies early.

senior woman smiling at table in Hawaii
Photo credit: CREATISTA/istockphoto

2. HAWAII

Change since last year: Up one
Hawaii is about one step away from this nation's ideal of perfect health. Only 16 percent of Hawaiian seniors are obese, the lowest percentage in the nation. Roughly 78 percent get regular dental visits, the highest rate in the nation. The 22.7-percent shortage of geriatric physicians is the lowest in the nation, while the 12.2 percent of seniors readmitted to hospitals and 23.3 percent of preventable hospitalizations among 1,000 patients are also the lowest in the land. Where can Hawaii improve? Well, it can improve hospitals so 26.7 percent of the seniors admitted don't die.

senior cowboy in Utah
Photo credit: Sisoje/istockphoto

1. UTAH

Change since last year: Up one
Utah moved up from No. 2 in 2017, knocking Minnesota from the top spot. Thanks largely to social mores and religious beliefs that shun certain vices, Utah had the lowest prevalence of excessive drinking (2.6 percent of adults aged 65 and older), smoking (3.7 percent), preventable hospitalizations (27.9 discharges per 1,000 Medicare enrollees), hospital readmissions (12.3 percent of Medicare enrollees), and full-mouth teeth extractions (9.9 percent), as well as scoring highly in volunteerism, with 45.9 percent of adults aged 65 and older giving their time to a cause or service. That said, Utah also has a high geriatric doctor shortfall (77.5 percent of geriatricians needed), low SNAP enrollment (46.6 per 100 eligible adults aged 60 and older in poverty), low flu vaccination coverage (54.9 percent of adults aged 65 and older), a low percentage of dedicated health care providers (91.9 percent of adults aged 65 and older), and a low number of home health care workers (82.6 workers per 1,000 adults aged 75 and older).

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