Healthspan measures incorporate quality of life in ways that lifespan does not. Ira T. Nicolai/The Image Bank via Getty Images
Do you ever wake up some days and think, “When I was younger, I could survive on just four hours of sleep, but now it seems like I need 10”? Or have you ever walked out of the gym and “felt” your knees?
Almost everyone experiences these kinds of signs of aging. But there are some people who seem to defy their age. The late U.S. Supreme Court Justice Ruth Bader Ginsberg stayed on the bench until her death at age 87. The “Great British Bake Off” judge Mary Berry, now in her 80s, continues to inspire people all over the world to bake and enjoy life. And actor Paul Rudd was named People magazine’s “Sexiest Man Alive” in 2021 at age 52 while still looking like he’s in his 30s. Is age just a number then?
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Researchers have focused a lot of attention on understanding the causes and risk factors of age-related diseases like Alzheimer’s, dementia, osteoporosis and cancer. But many ignore the major risk factor for all of these diseases: aging itself. More than any individual risk factor such as smoking or lack of exercise, the number of years you’ve lived predicts onset of disease. Indeed, aging increases the risk of multiple chronic diseases by up to a thousandfold.
However, no two people age the same. Although age is the principal risk factor for several chronic diseases, it is an unreliable indicator of how quickly your body will decline or how susceptible you are to age-related disease. This is because there is a difference between your chronological age, or the number of years you’ve been alive, and your biological age – your physical and functional ability.
As the author notes in her TED Talk, aging is not just a number.
I am a scientist interested in redefining “age.” Instead of benchmarking chronological age, my lab is invested in measuring biological age. Biological age is a more accurate measure of healthspan, or years lived in good health, than chronological age, and doesn’t directly correlate with wrinkles and gray hairs. Rapid agers experience a faster rate of functional deterioration relative to their chronological age.
My grandmother, who lived to be 83 but was bedridden and could not remember who I was for the last few years of her life, was a rapid ager. My grandfather, on the other hand, also lived until he was 83, but he was active, functional and even did my homework with me until he passed away – he was a healthy ager.
With the unprecedented growth of the world’s aging population, I believe that figuring out ways to measure biological age and how to maintain or delay its advance is critical not only for individual health, but also for the social, political and economic health of our society. Detecting rapid agers early on presents an opportunity to delay, change or even reverse the trajectory of biological aging.
Genetics and biological age
Biological aging is multifaceted. It arises from a complex mix of genetic traits and is influenced by factors like microbiome composition, environment, lifestyle, stress, diet and exercise.
Genetics were once thought to have no influence on aging or longevity. However, in the early 1990s, researchers reported the first studies identifying genes that were able to extend the lifespan of a small roundworm. Since then, multiple observations support the influence of genetics on aging.
For example, children of long-lived parents and even those with long-lived siblings tend to live longer. Researchers have also identified multiple genes that influence longevity and play a role in resilience and protection from stress. These include genes that repair DNA, protect cells from free radicals and regulate fat levels.
However, it is clear from studies in identical twins – who share the same genes but not the same exact lifespans – that genes are not the only factor that influences aging. In fact, genes probably account for only 20% to 30% of biological age. This suggests that other parameters can strongly influence biological aging.
Environmental and lifestyle effects
Researchers have found that environmental and lifestyle factors heavily influence biological age, including social connectedness, sleeping habits, water consumption, exercise and diet.
Social connectedness is essential for well-being throughout life. But social connections can be challenging to maintain over time due to loss of family and friends, depression, chronic illness or other factors. Several studies have reported a strong link between social isolation and increased stress, morbidity and mortality.
Social connectedness and physical activity are linked to well-being throughout life. Filippo Bacci/E+ via Getty Images
Similarly, diet and exercise are strong influencers of biological age. Blue zones, which are areas around the world where people live long lives, attribute their successful aging to diet, exercise and social connectedness. Mostly plant-based meals and spurts of activity throughout the day are well-known “secrets” of healthspan and longevity. Although newer studies on the effects of diet interventions such as intermittent fasting and time-restricted feeding on longevity have not been rigorously tested, they do show multiple health benefits, including better glucose and insulin regulation
While genetics is difficult to control, diet and exercise can be modified to delay biological aging.
How to measure biological age
Currently, there is no effective test to predict an individual’s health trajectory early enough in life in order to intervene and improve quality of life with age. Scientists are interested in identifying a molecule that is sensitive and specific enough to serve as a unique fingerprint for biological age.
Considering the health and resilience of the individual instead of focusing solely on disease state is important in discussions on biological age. Resilience is the state of adapting and bouncing back from a health challenge and is often more predictive of functional health. A molecular aging fingerprint may provide a tool to help identify people who are less resilient and require more aggressive monitoring and early intervention to preserve their health and help reduce gender, racial and ethnic health disparities.
There are several promising molecular markers that may serve as biological age fingerprints.
One of these markers are epigenetic clocks. Epigenetics are chemical modifications of DNA that control gene function. Several scientists have found that DNA can get “marked” by methyl groups in a pattern that changes with age and could potentially act as a readout for aging.
It is important to note, however, that while epigenetic clocks have been valuable in predicting chronological age, they do not equate to biological age. In addition, it is unclear how these epigenetic marks work or how they contribute to aging.
Age is so much more than a number. Klaus Vedfelt/DigitalVision via Getty Images
Another well-regarded marker of biological age is the build-up of dysfunctional cells called senescent or zombie cells. Cells become senescent when they experience multiple types of stress and become so damaged that they cannot divide anymore, releasing molecules that cause chronic low-grade inflammation and disease.
Animal studies have shown that getting rid of these cells can improve healthspan. However, what clearly defines senescent cells in humans is still unknown, making them challenging to track as a measure of biological age.
Lastly, the body releases unique metabolites, or chemical fingerprints, as byproducts of normal metabolism. These metabolites play a dynamic and direct role in physiological regulation and can inform functional health. My lab and others are figuring out the exact makeup of these chemicals in order to figure out which can best measure biological age. A lot of work still remains on not only identifying these metabolites, but also understanding how they affect biological age.
People have long sought a fountain of youth. Whether such an elixir exists is still unknown. But research is starting to show that delaying biological age may be one way to live healthier, fuller lives.
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Aditi Gurkar receives funding from National Institute on Health, Richard King Mellon Foundation, AFAR/Hevolution.
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Healthiest states for seniors
Which states are the most and least healthy for senior populations?
To determine which states are most and least healthy for senior populations, Stacker consulted America's Health Rankings' 2022 Senior Report, where public health researchers analyzed metrics of senior health for every state, ranging from nursing home quality to preventable hospitalizations. The report was released in 2023.
Although the numbers in certain categories changed drastically in some states after the COVID-19 pandemic — and while that may have influenced the behavior of senior citizens regarding clinical preventive services — the health crisis was not considered individually in the report. The metrics are split into five categories: social and economic, physical environment, clinical care, behaviors, and health outcomes.
Nationwide, there have been demonstrable shifts in several key factors relative to overall health and quality of life for seniors. Poverty-stricken states rank poorly, and their seniors' eating and physical activity habits tend to be unhealthy. Seniors in these areas also tend to avoid getting medical attention due to the high costs of healthcare services. Drug-related deaths, for example, doubled between 2018 and 2020, while depression and obesity rose 9% and 16%, respectively, since 2011.
And yet, while early deaths rose 17% among seniors, "high health status," defined as adults over 65 reporting very good or excellent health, actually increased by 13%. This suggests that despite the concerning increases in certain deleterious factors, senior living, in some parts of the U.S., is improving.
Stacker included each state's overall score and its rank in all five categories in this story. Read on to see where your state stacks up against the national average.
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#50. Mississippi
- Overall score (relative to U.S. average): -0.917
- Social and economic rank: #50
- Physical environment rank: #44
- Clinical care rank: #49
- Behaviors rank: #47
- Health outcomes rank: #43
Mississippi faces serious challenges, with many of its seniors living in poverty. There is a concerning lack of access to proper geriatric health care and preventive clinical services. Poor nutrition and physical inactivity increase the odds of early death.
#49. Louisiana
- Overall score (relative to U.S. average): -0.902
- Social and economic rank: #48
- Physical environment rank: #26
- Clinical care rank: #47
- Behaviors rank: #45
- Health outcomes rank: #49
For Louisiana's seniors, there is a high risk of social isolation. Early deaths rose 23% from 2019 to 2020. Even though frequent physical distress is decreasing, the state ranks very low in critical features such as clinical care, social and economic factors, and health outcomes.
#48. Kentucky
- Overall score (relative to U.S. average): -0.891
- Social and economic rank: #46
- Physical environment rank: #13
- Clinical care rank: #37
- Behaviors rank: #50
- Health outcomes rank: #48
Drug-related deaths of senior citizens aged 65 and over in Kentucky increased 64% from 2018 to 2020, even though alcohol consumption remains low. The biggest challenge is the dire need for low-care nursing home staff to keep up with the rise in the number of residents.
#47. West Virginia
- Overall score (relative to U.S. average): -0.835
- Social and economic rank: #42
- Physical environment rank: #32
- Clinical care rank: #46
- Behaviors rank: #49
- Health outcomes rank: #50
Among seniors, West Virginia ranks high in several crucial categories: obesity, physical distress, multiple chronic conditions, and preventable hospitalizations. On the bright side, it's the state with the lowest rate of housing problems and the first in SNAP reach (food stamps provided to adults over 60 living in poverty).
#46. Oklahoma
- Overall score (relative to U.S. average): -0.728
- Social and economic rank: #45
- Physical environment rank: #33
- Clinical care rank: #43
- Behaviors rank: #46
- Health outcomes rank: #45
Poverty is widespread among seniors in Oklahoma, and clinical care is meager; however, the number of geriatric providers grew 37% between September 2018 and September 2021. There is a high early death rate, and suicides increased 34% in the two years before the pandemic.
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#45. Alabama
- Overall score (relative to U.S. average): -0.622
- Social and economic rank: #43
- Physical environment rank: #15
- Clinical care rank: #36
- Behaviors rank: #48
- Health outcomes rank: #46
Poverty rates have dropped in the state, but early deaths rose by 16% between 2019 and 2020. Few seniors in Alabama drink excessively, but they also tend to be physically inactive, and don't get enough sleep.
#44. Arkansas
- Overall score (relative to U.S. average): -0.615
- Social and economic rank: #47
- Physical environment rank: #7
- Clinical care rank: #34
- Behaviors rank: #41
- Health outcomes rank: #47
Not many seniors in Arkansas drink to excess, but they tend to be sedentary and have a high early death rate. On the positive side, flu vaccination rose by 18% from 2011 to 2020, and the suicide frequency among people 65 and over is above the national average.
#43. Nevada
- Overall score (relative to U.S. average): -0.489
- Social and economic rank: #35
- Physical environment rank: #46
- Clinical care rank: #45
- Behaviors rank: #43
- Health outcomes rank: #44
Behavioral health is the biggest challenge that Nevada seniors face. They rank second in the number of smokers 65 and over, which could be related to a high prevalence of mental distress and, ultimately, to increasing suicide rates. Flu vaccination remains low, but it did increase 24% from 2012 to 2020.
#42. Missouri
- Overall score (relative to U.S. average): -0.422
- Social and economic rank: #41
- Physical environment rank: #17
- Clinical care rank: #29
- Behaviors rank: #44
- Health outcomes rank: #42
The number of geriatric providers in Missouri increased 26% between September 2018 and September 2021. However, poverty rates remain high, as does physical distress. Drug-related deaths rose 186% from 2018 to 2020, and senior Missourians smoke heavily.
#41. New Mexico
- Overall score (relative to U.S. average): -0.360
- Social and economic rank: #49
- Physical environment rank: #21
- Clinical care rank: #23
- Behaviors rank: #35
- Health outcomes rank: #29
A high percentage of New Mexican seniors are poor, and the state has a high prevalence of food insecurity and violent crimes. Early deaths are on the rise, and so are suicide rates. Even so, the prevalence of multiple chronic conditions remains low, and frequent physical distress decreased 29% between 2019 and 2020.
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#40. Georgia
- Overall score (relative to U.S. average): -0.350
- Social and economic rank: #39
- Physical environment rank: #30
- Clinical care rank: #41
- Behaviors rank: #39
- Health outcomes rank: #37
Georgia has a low number of seniors who drink excessively compared to other states; however, drug-related deaths increased 61% from 2018 to 2020. Obesity rose 28% from 2011 to 2020. On the other hand, flu vaccination grew 19% during the same time frame.
#39. Tennessee
- Overall score (relative to U.S. average): -0.324
- Social and economic rank: #40
- Physical environment rank: #9
- Clinical care rank: #40
- Behaviors rank: #36
- Health outcomes rank: #39
Tennessee has a low prevalence of excessive drinking among seniors, though many of them are heavy smokers. High health status rose 21% between 2017 and 2020, but suicide rates have also increased 26% since 2011.
#38. Texas
- Overall score (relative to U.S. average): -0.216
- Social and economic rank: #44
- Physical environment rank: #34
- Clinical care rank: #35
- Behaviors rank: #24
- Health outcomes rank: #32
The Lone Star state has a high percentage of seniors living in poverty, and many avoid getting medical help due to high service costs. The good news is that Texan seniors have a low prevalence of mental and physical distress, and the number of geriatric providers grew 15% from September 2018 to September 2021.
#37. Ohio
- Overall score (relative to U.S. average): -0.212
- Social and economic rank: #28
- Physical environment rank: #31
- Clinical care rank: #27
- Behaviors rank: #42
- Health outcomes rank: #38
Ohio ranks low in air quality and also in seniors' eating and exercise habits. Obesity is prevalent and drug-related deaths have increased 157% since 2010. The state does have a wide range of dedicated health care providers and hospice care available.
#36. South Carolina
- Overall score (relative to U.S. average): -0.189
- Social and economic rank: #38
- Physical environment rank: #11
- Clinical care rank: #33
- Behaviors rank: #34
- Health outcomes rank: #36
Seniors in The Palmetto State struggle with a high prevalence of multiple chronic conditions, a high violent crime rate, and an increasing number of early deaths. On the bright side, mental distress ranks rather low, and the number of geriatric providers in South Carolina rose 24% from 2018 to 2020.
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#35. Indiana
- Overall score (relative to U.S. average): -0.087
- Social and economic rank: #24
- Physical environment rank: #27
- Clinical care rank: #27
- Behaviors rank: #33
- Health outcomes rank: #41
Indiana's seniors rank high in fruit and vegetable consumption and low in excessive drinking. From the periods of 2008-2010 and 2018-2020, drug-related deaths increased 111%. Other concerns include a high prevalence of smoking and rising obesity rates.
#34. North Carolina
- Overall score (relative to U.S. average): -0.072
- Social and economic rank: #29
- Physical environment rank: #10
- Clinical care rank: #24
- Behaviors rank: #38
- Health outcomes rank: #35
A large number of seniors get preventive clinical services—such as vaccines and cancer screenings—in North Carolina. But many of the state's seniors report frequent mental distress, and drug-related deaths have risen 85% since 2010.
#33. Illinois
- Overall score (relative to U.S. average): -0.055
- Social and economic rank: #31
- Physical environment rank: #45
- Clinical care rank: #50
- Behaviors rank: #29
- Health outcomes rank: #8
Illinois has a high number of able-bodied seniors, with a low prevalence of frequent mental distress and suicide. But many do not get adequate medical attention due to high costs. While flu vaccination increased 27% from 2012 to 2020, low numbers of cancer screenings remain a problem.
#32. New York
- Overall score (relative to U.S. average): -0.018
- Social and economic rank: #37
- Physical environment rank: #39
- Clinical care rank: #39
- Behaviors rank: #17
- Health outcomes rank: #16
Seniors in New York state do not get enough sleep, and they are at high risk of social isolation. While their high health status increased 30% from 2011 to 2020, early deaths increased 33% during the last year of the same period.
#31. Michigan
- Overall score (relative to U.S. average): -0.013
- Social and economic rank: #25
- Physical environment rank: #25
- Clinical care rank: #15
- Behaviors rank: #30
- Health outcomes rank: #40
Michigan has a high prevalence of obesity, and reports of frequent mental distress grew 61% between 2011 and 2020. The good news is that the number of seniors avoiding health care because of high costs decreased by 49% from 2016 to 2020.
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#30. Pennsylvania
- Overall score (relative to U.S. average): -0.007
- Social and economic rank: #22
- Physical environment rank: #36
- Clinical care rank: #18
- Behaviors rank: #40
- Health outcomes rank: #34
The number of low-care nursing home residents increased 128% in Pennsylvania between 2018 and 2020. Drug-related deaths rose an alarming 149% since 2010. Air pollution, low physical activity, and frequent physical distress are other factors that affect the lives of older Pennsylvanians.
#29. New Jersey
- Overall score (relative to U.S. average): 0.013
- Social and economic rank: #23
- Physical environment rank: #50
- Clinical care rank: #44
- Behaviors rank: #28
- Health outcomes rank: #13
New Jersey seniors are mostly non-smokers, and they tend to eat a healthy amount of fruits and vegetables. However, the number of early deaths rose 30% from 2019 to 2020. Though they tend to miss their pneumonia vaccinations, the overall health status of seniors in the Garden State increased 17% between 2017 and 2020.
#28. Florida
- Overall score (relative to U.S. average): 0.029
- Social and economic rank: #21
- Physical environment rank: #35
- Clinical care rank: #38
- Behaviors rank: #22
- Health outcomes rank: #33
Florida has a low prevalence of falls and a high percentage of four- and five-star nursing home beds in this popular state for retirement. Frequent physical distress dropped 24% from 2019 to 2020. Drug-related deaths, however, rose 58% since 2010.
#27. Kansas
- Overall score (relative to U.S. average): 0.052
- Social and economic rank: #34
- Physical environment rank: #28
- Clinical care rank: #22
- Behaviors rank: #20
- Health outcomes rank: #28
Kansas has a low number of seniors living in poverty, and most of them have healthy sleeping habits. Even so, early deaths increased 14% from 2019 to 2020, and the number of specialized geriatric providers is insufficient.
#26. California
- Overall score (relative to U.S. average): 0.060
- Social and economic rank: #36
- Physical environment rank: #49
- Clinical care rank: #25
- Behaviors rank: #11
- Health outcomes rank: #19
California's seniors are physically active and have a low smoking rate, but excessive drinking is alarming. Drug-related deaths also increased 70% since 2010. Home health care workers are available, and seniors are largely able to afford medical attention.
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#25. Wyoming
- Overall score (relative to U.S. average): 0.069
- Social and economic rank: #16
- Physical environment rank: #2
- Clinical care rank: #48
- Behaviors rank: #31
- Health outcomes rank: #22
Obesity is high and on the rise in Wyoming; between 2011 and 2020, 45% of seniors were critically overweight. Although the number of geriatric providers increased 35% from 2019 to 2020, early death rates also grew by 18% during the same time span.
#24. Alaska
- Overall score (relative to U.S. average): 0.131
- Social and economic rank: #12
- Physical environment rank: #43
- Clinical care rank: #42
- Behaviors rank: #15
- Health outcomes rank: #30
Alaska faces several challenges including a high prevalence of suicide—a 70% rise between 2018–2020—and excessive drinking. Nonetheless, the overall physical health of seniors is good, and there is a low rate of frequent mental distress.
#23. Arizona
- Overall score (relative to U.S. average): 0.133
- Social and economic rank: #32
- Physical environment rank: #38
- Clinical care rank: #30
- Behaviors rank: #9
- Health outcomes rank: #27
Arizona has a low percentage of obesity, despite the fact that physical inactivity increased to 29% between 2015 and 2020. Still, Arizona ranks poorly in air quality, public safety, and flu vaccination.
#22. North Dakota
- Overall score (relative to U.S. average): 0.167
- Social and economic rank: #26
- Physical environment rank: #1
- Clinical care rank: #31
- Behaviors rank: #36
- Health outcomes rank: #6
The physical environment for seniors in North Dakota is second to none. Water and air are top quality, and housing is sufficient and adequate. However, excessive drinking increased 50% among people ages 65 and over between 2011 and 2020.
#21. Iowa
- Overall score (relative to U.S. average): 0.193
- Social and economic rank: #30
- Physical environment rank: #8
- Clinical care rank: #10
- Behaviors rank: #25
- Health outcomes rank: #21
Seniors in Iowa are at low risk of social isolation, and most of them do not face severe housing problems. On the downside, excessive drinking is on the rise, and there are not enough geriatric care providers.
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#20. Montana
- Overall score (relative to U.S. average): 0.203
- Social and economic rank: #27
- Physical environment rank: #4
- Clinical care rank: #32
- Behaviors rank: #10
- Health outcomes rank: #25
Montana's strengths include high physical activity, low preventable hospitalization rates, and low prevalence of multiple chronic conditions. On the flipside there are a low number of seniors with a dedicated health care provider, and Montana has one of the highest suicide rates in the nation.
#19. Delaware
- Overall score (relative to U.S. average): 0.243
- Social and economic rank: #4
- Physical environment rank: #24
- Clinical care rank: #21
- Behaviors rank: #32
- Health outcomes rank: #31
Delaware has a low number of suicides among seniors, but it also has a problem with obesity, which rose 30% from 2011 to 2020. America's first state also has a high prevalence of seniors with multiple chronic conditions.
#18. Rhode Island
- Overall score (relative to U.S. average): 0.255
- Social and economic rank: #33
- Physical environment rank: #37
- Clinical care rank: #4
- Behaviors rank: #18
- Health outcomes rank: #10
The number of seniors in this New England state who can access geriatric care is high. From 2011 to 2020, the health status of people 65 and over in Rhode Island rose 32%, while those with frequent physical distress decreased 28% over the last two years of the same time frame.
#17. South Dakota
- Overall score (relative to U.S. average): 0.287
- Social and economic rank: #19
- Physical environment rank: #3
- Clinical care rank: #16
- Behaviors rank: #21
- Health outcomes rank: #23
The overall health status of seniors in South Dakota increased 23% between 2011 and 2020. Unfortunately, during the last two years of the same time span, early deaths rose 21%. The state has a low prevalence of mental distress among senior citizens, but also has the lowest ratio of geriatric providers in the nation.
#16. Virginia
- Overall score (relative to U.S. average): 0.301
- Social and economic rank: #15
- Physical environment rank: #12
- Clinical care rank: #26
- Behaviors rank: #19
- Health outcomes rank: #14
Virginia has a low percentage of seniors living in poverty. They sleep well and report experiencing mental distress at a lower rate than many other places. However, drug-related deaths grew 127% since 2010, and preventable hospitalization rates are high.
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#15. Idaho
- Overall score (relative to U.S. average): 0.342
- Social and economic rank: #14
- Physical environment rank: #13
- Clinical care rank: #19
- Behaviors rank: #14
- Health outcomes rank: #20
Idaho ranks high in sleep health, preventable hospitalizations, and nursing home quality. Suicide rates are high, though, and drug-related deaths increased a concerning 197% since 2010.
#14. Wisconsin
- Overall score (relative to U.S. average): 0.384
- Social and economic rank: #8
- Physical environment rank: #47
- Clinical care rank: #12
- Behaviors rank: #16
- Health outcomes rank: #18
Excessive drinking among seniors is alarming in Wisconsin, as is the low prevalence of cancer screenings. Though the overall health status rose 20% between 2017 and 2020, suicides increased 24% over the last two years alone during the same period.
#13. Maine
- Overall score (relative to U.S. average): 0.400
- Social and economic rank: #9
- Physical environment rank: #5
- Clinical care rank: #2
- Behaviors rank: #27
- Health outcomes rank: #26
Smoking among seniors is on the rise in Maine—up 46% between 2014 and 2020. Low exercise is a problem, too, and there is a high percentage of suicides among seniors. However, frequent physical distress decreased 25% from 2018 to 2020, and flu vaccination grew 17% from 2011 to 2020.
#12. Oregon
- Overall score (relative to U.S. average): 0.412
- Social and economic rank: #5
- Physical environment rank: #48
- Clinical care rank: #17
- Behaviors rank: #8
- Health outcomes rank: #23
Oregon seniors are physically active and eat healthy. However, air pollution, water quality, and housing problems are worrisome. Even though they don't often suffer multiple chronic conditions, reports of mental distress and suicide rates rank high in this West Coast state.
#11. Nebraska
- Overall score (relative to U.S. average): 0.431
- Social and economic rank: #18
- Physical environment rank: #6
- Clinical care rank: #11
- Behaviors rank: #13
- Health outcomes rank: #15
Nebraska's senior citizens enjoy a high health status that has grown 22% between 2011 and 2020. However, they tend to miss their cancer screenings, and early deaths increased 18% from 2019 to 2020.
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#10. Massachusetts
- Overall score (relative to U.S. average): 0.460
- Social and economic rank: #7
- Physical environment rank: #40
- Clinical care rank: #3
- Behaviors rank: #26
- Health outcomes rank: #7
Seniors in Massachusetts are on top of their preventive health care. Seniors here rank first in flu vaccination and cancer screenings. Massachusetts also has an optimal number of geriatric health care providers. On the other hand, drug-related deaths increased 155% since 2010.
#9. Maryland
- Overall score (relative to U.S. average): 0.467
- Social and economic rank: #13
- Physical environment rank: #29
- Clinical care rank: #5
- Behaviors rank: #12
- Health outcomes rank: #12
Though Maryland ranks high in clinical care, drug-related deaths of seniors increased an astonishing 323% since 2010. On the positive side, smoking remains low, as does the prevalence of frequent physical distress.
#8. Washington
- Overall score (relative to U.S. average): 0.540
- Social and economic rank: #6
- Physical environment rank: #41
- Clinical care rank: #9
- Behaviors rank: #6
- Health outcomes rank: #17
Early death rates are low in Washington, as is the amount of seniors with multiple chronic conditions. However, physical inactivity rose 25% between 2015 and 2020, and drug-related deaths increased 64% since 2010.
#7. Hawaii
- Overall score (relative to U.S. average): 0.549
- Social and economic rank: #11
- Physical environment rank: #20
- Clinical care rank: #14
- Behaviors rank: #23
- Health outcomes rank: #1
Hawaii was the healthiest state for seniors just a few years ago. It still has a low level of obesity, a low early death rate, and a high quality of nursing homes. But in recent years, two statistics have become concerning: a 62% increase in frequent mental distress, and a 129% rise in drug-related deaths.
#6. New Hampshire
- Overall score (relative to U.S. average): 0.567
- Social and economic rank: #3
- Physical environment rank: #18
- Clinical care rank: #20
- Behaviors rank: #7
- Health outcomes rank: #11
New Hampshire has a small number of seniors living in poverty, and they are at low risk of isolation. The seniors here rank second in physical activity, but face severe housing problems and drink excessively. Seniors' high health status grew 17% between 2011 and 2020.
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#5. Colorado
- Overall score (relative to U.S. average): 0.611
- Social and economic rank: #20
- Physical environment rank: #23
- Clinical care rank: #7
- Behaviors rank: #1
- Health outcomes rank: #5
Colorado's seniors are physically active, have a low rate of early deaths, and a low prevalence of food insecurity. There is much to improve on, though. Drug-related deaths went up by 70% since 2010, and there is a high prevalence of fall-related injuries.
#4. Connecticut
- Overall score (relative to U.S. average): 0.634
- Social and economic rank: #17
- Physical environment rank: #42
- Clinical care rank: #6
- Behaviors rank: #3
- Health outcomes rank: #2
Connecticut has high numbers of able-bodied seniors, a high SNAP enrollment, and a low prevalence of frequent physical distress. Not all the numbers are rosy, though. Suicide rates increased 41% from 2018 to 2020, and severe housing problems are high.
#3. Minnesota
- Overall score (relative to U.S. average): 0.715
- Social and economic rank: #9
- Physical environment rank: #22
- Clinical care rank: #1
- Behaviors rank: #5
- Health outcomes rank: #3
In Minnesota, heavy drinking is common, and obesity is on the rise. Although drug-related deaths are low, they almost tripled since 2010. Seniors here tend to sleep well and rarely suffer multiple chronic conditions.
#2. Vermont
- Overall score (relative to U.S. average): 0.752
- Social and economic rank: #2
- Physical environment rank: #18
- Clinical care rank: #13
- Behaviors rank: #2
- Health outcomes rank: #9
Vermont ranks high in social and economic factors, and seniors tend to eat healthy and exercise. This leads to low early death rates, and a low prevalence of multiple chronic conditions. The number of geriatric providers grew 21% between September 2018 and September 2020, but there was a 10% decrease in pneumonia vaccination between 2017 and 2020.
#1. Utah
- Overall score (relative to U.S. average): 0.763
- Social and economic rank: #1
- Physical environment rank: #16
- Clinical care rank: #8
- Behaviors rank: #4
- Health outcomes rank: #4
Utah's seniors enjoy favorable economic conditions, and stay physically active while largely avoiding smoking and drinking. The quality of care ranks high, improving the overall health status of senior citizens. However, drug-related deaths doubled since 2010.
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