The Best and Worst States for a Healthy Retirement

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35. Idaho
> Population: 1,787,065
> Pct. of population 65+: 16.2% — 16th lowest
> Disability, 65+: 43.2% — 25th lowest
> Older adults who don’t exercise: 26.7% — 8th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.6% — 16th lowest
> Flu vaccine in the past year, 65+: 53.0% — 21st lowest
> Primary care physicians: 66 per 100,000 — 9th fewest
> Avg. retirement income: $25,505 — 12th lowest

Idaho ranks among the 20 worst states for a healthy retirement in large part because the state’s 65 and older residents are less likely to be monitored with certain critical tests than residents of the same age group in most other states. For instance, just 66.4% of 65 and older women in Idaho reported getting a mammogram in the last two years — a lower share than all but five other states. Nationwide, more than 74% of women that age have gotten a mammogram during that time. Also, Idaho has the fourth lowest share of older residents who have had a cholesterol screening in the last five years, at just 94.4%, compared to 97.0% of all Americans in that age group.

Idaho’s 65 and older residents are much more likely to have been injured in a fall. In the past year, 12.2% of the state’s older residents were hurt in a fall, the fifth highest share among all states and 2 full percentage points higher than the share nationwide.

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34. New York
> Population: 19,453,561
> Pct. of population 65+: 16.9% — 25th lowest
> Disability, 65+: 44.1% — 21st highest
> Older adults who don’t exercise: 31.1% — 24th lowest
> 2 doses of COVID-19 vaccine administered, Mar 2: 7.8% — 17th lowest
> Flu vaccine in the past year, 65+: 44.8% — the lowest
> Primary care physicians: 82 per 100,000 — 14th most
> Avg. retirement income: $32,779 — 12th highest

New York ranks among the worst in the nation when it comes to taking certain critical steps to ensure 65 and older residents have a healthy retirement. According to 2018 data, the Empire State ranks dead last in the country in the percentage of older adults who got a flu vaccine in the past year, at just 44.8%.

New York also ranks last in the country in terms of the percentage of 65 and older residents with an underlying health condition who have ever gotten a pneumococcal vaccine. Similarly, 39% of older women nationwide are up to date on their clinical preventive services, but in New York, just 29.4% are — the only state in which that figure is below 31%. However, the state does not rank among the very worst states for a healthy retirement in part because older adults tend to have a balanced diet, with one of the highest shares reporting eating the recommended amount of fruits and vegetables.

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33. Illinois
> Population: 12,671,821
> Pct. of population 65+: 16.1% — 14th lowest
> Disability, 65+: 42.3% — 21st lowest
> Older adults who don’t exercise: 37.0% — 10th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 6.7% — 4th lowest
> Flu vaccine in the past year, 65+: 55.4% — 24th highest
> Primary care physicians: 80 per 100,000 — 18th most
> Avg. retirement income: $32,528 — 13th highest

Access to preventive care such as screenings necessary to detect cancer is only slightly worse in Illinois than it is across the country. Approximately 39.2% of men 65 and older are up to date on recommended preventive care procedures, just below the national averages of 39.9%. The share of 65 and older women who are up to date on these services is slightly higher. Older Illinois residents are considerably less likely than older Americans nationwide to receive regular screenings for colorectal cancer — only 70.7% of older Illinois residents do, the fourth lowest rate and compared with the 76.3% of older Americans nationwide who do.

Illinois residents 65 and older are less likely than all Americans of the age group to exercise. About 37.0% do not exercise on a regular basis, the 10th highest share nationwide. Exercising regularly can help reduce the likelihood of developing chronic diseases.

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32. South Dakota
> Population: 884,659
> Pct. of population 65+: 17.4% — 21st highest
> Disability, 65+: 44.5% — 19th highest
> Older adults who don’t exercise: 32.3% — 21st highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 10.9% — 4th highest
> Flu vaccine in the past year, 65+: 51.1% — 14th lowest
> Primary care physicians: 76 per 100,000 — 24th fewest
> Avg. retirement income: $23,799 — 4th lowest

Retirement-age South Dakota residents may be more likely than most retirement-age Americans to struggle financially. The state’s average annual retirement income among households 65 and older is just $23,799, well below the $30,512 average retirement income nationwide. Higher-income Americans are more likely to make regular doctor visits, receive preventive care, and be healthier.

Access to screenings necessary to detect cancer in South Dakota is worse than it is across the country. About 37.1% of men and 38.7% of women 65 and older are up-to-date on recommended preventive care procedures, each below the respective national averages of 39.9% and 39.0%.

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31. Ohio
> Population: 11,689,100
> Pct. of population 65+: 17.5% — 19th highest
> Disability, 65+: 44.9% — 17th highest
> Older adults who don’t exercise: 35.6% — 13th highest
> 2 doses of COVID-19 vaccine administered, Mar 2: 8.1% — 25th lowest
> Flu vaccine in the past year, 65+: 55.8% — 23rd highest
> Primary care physicians: 76 per 100,000 — 25th most
> Avg. retirement income: $27,260 — 22nd lowest

Ohio ranks below most states as a place for a healthy retirement. The state has among the top 10 highest shares of 65 and older adults who smoke regularly, at 10.7%. Nationwide, fewer than 9% of older adults smoke regularly. Ohio also has one of the highest obesity rates in 65 and older adults, at 32.7%, compared to the national rate of 29%.

However, Ohio also performs well in a number of health measures. More than 42% of both men and women 65 and older are up to date with certain preventive clinical services like disease screenings and immunizations. Nationwide, 39.9% of men 65 and older and 39.0% of women are up to date on these services.