Findings State Rankings | 2017 Senior Report

Minnesota is the leading state for senior health in 2017, a title it also held in the first two years of the America’s Health Rankings Senior Report. Utah (second) reached its highest ranking in the report’s five-year history, after rising four spots this year. Hawaii (third), Colorado (fourth) and New Hampshire (fifth) round out the top five states.
Massachusetts dropped from first place to sixth. 
Vermont also left the top five, taking eighth place this year.
All states, no matter their ranking, have strengths and challenges.  See your state's strengths, challenges and health highlights in the State Summary section.
Tables 1 and 2 display the 2017 rankings for all states, by rank and alphabetically.

Minnesota’s strengths include a low percentage of seniors who face the threat of hunger and a high percentage who visited a dentist. Improvements in the prevalence of excessive drinking, pain management and obesity in the state in the past year also influenced the state’s rise to the top spot this year. Minnesota continues to struggle with a low percentage of seniors with a dedicated health care provider and a high percentage of low-care nursing home residents. Minnesota maintained its No. 1 ranking in health outcomes and improved five rankings to third in health determinants.

Utah improved its health outcomes ranking this year moving up seven spots to second. The state ranks 27th this year in policy, rising 14 spots in the past year. A decline in geriatrician shortfall and the addition of healthcare-associated infection policies (a new measure this year) contributed to improvements in this category. Utah continues to rank first for a low smoking prevalence despite a 16 percent increase in the percentage of seniors smoking in the past year. Utah’s overall score is only 1 percent below Minnesota’s score (Figure 1).

All states, no matter their ranking, have strengths and challenges. See your state's strengths, challenges and health highlights in the state summary section.  Select your state from the "View Pages" menu on the left.

The healthiest states for seniors are spread throughout the United States, while the least-healthy states are clustered in the southern region (Figure 2). Mississippi is 50th this year. Other states in the bottom five are Kentucky (49th), Oklahoma (48th), Louisiana (47th) and Arkansas (46th). 
Kentucky lost some ground this year, moving down four rankings from 45th to 49th.
West Virginia improved one ranking this year to rise out of the bottom five. 
Mississippi faces challenges in food insecurity, poverty and premature death. The state’s behaviors ranking dropped from 22nd to 45th this year. These changes are potentially due to increases in the prevalence of obesity and physical inactivity, as well as the removal of the  underweight measure from the model this year, which, at third, was the state’s second-highest ranking measure in 2016 (see 2017 Edition Model and Measure Revisions). Despite this, Mississippi maintained high rankings in two other behaviors measures this year -- low prevalence of excessive drinking (third) and high prevalence of pain management among seniors with arthritis (ninth). 

In Kentucky, increases in the prevalence of physical inactivity and smoking negatively impacted the state’s ranking this year; all states in the bottom five continue to face these two challenges. Kentucky ranks 50th in health outcomes, representing no change from 2016, while dropping three rankings to 47th in health determinants. Most notable is the state’s large drop in policy ranking in the past year from 21st to 30th. 

The five healthiest states for seniors rank in top 10 for health determinants (Figure 3), but vary within the determinant categories -- behaviors, community & environment, policy and clinical care. The five least-healthy states rank in the bottom six for health determinants. 

The five healthiest states for seniors rank in the top five for health outcomes (Figure 4), while the least-healthy states rank in the bottom 10 for health outcomes and show similar clustering in the southern region to the overall ranking map. 

Largest Changes in Ranking Since 2016
This year, several states made notable gains in their relative ranking (Table 3). Seven states improved four or more rankings. California and South Dakota made the greatest strides. Several states also declined in ranking in the last year. Nine states dropped four or more rankings with Alaska and Pennsylvania experiencing the largest drops in ranking.

California achieved its highest ranking in the Senior Report’s five-year history. California improved 12 places from 28th to 16th. 
Decreases in the prevalence of smoking, physical inactivity and obesity in the past year, as well as maintaining a low prevalence of seniors with teeth extractions and a low premature death rate influenced its improvement. California ranks well in healthcare-associated infection policies, a new measure this year. 
Challenges to California’s senior health include a high prevalence of excessive drinking and falls, a low percentage of volunteerism and Supplemental Nutrition Assistance Program (SNAP) reach, and a high percentage of intensive care unit (ICU) use in the last six months of life. In addition, California has historically ranked in the bottom five states for home-delivered meals and this trend continues despite a revised definition of the measure this year (see 2017 Edition Model and Measure Revisions).
South Dakota reached its best ranking in the Senior Report’s five-year history. South Dakota improved 10 places from 25th to 15th.
In the past year, South Dakota experienced a decrease in the prevalence of excessive drinking, an increase in the percentage of able-bodied seniors, an increase in the prevalence of pain management for seniors with arthritis and an increase in the prevalence of seniors with a dedicated health care provider, all of which influenced the improvement in overall ranking. Additional factors include a continued high prevalence of volunteerism, a low prevalence of frequent mental distress and a low percentage of lCU use in the last six months of life.
South Dakota continues to be challenged by a low percentage of hospice care use and SNAP reach. A new challenge this year is an increase in the prevalence of smoking among seniors.
Delaware improved five places this year from its lowest ranking on record. Delaware improved five positions from 22nd to 17th. 
An increase in the percentage of nursing home beds rated four- or five-stars (a revised definition) and a decrease in the percentage of seniors living in poverty influenced Delaware’s improvement, as well as a continued decrease in the percentage of seniors suffering from food insecurity and increases in the prevalence of a dental visit and volunteerism. Delaware also received a high score in a new measure, healthcare-associated infection (HAI) policies (see 2017 Edition Model and Measure Revisions).
Challenges for Delaware are a continued high prevalence of frequent mental distress and a low prevalence of pain management among seniors with arthritis, as well as a decrease in the percentage of Medicare enrollees with creditable prescription drug coverage and increases in the prevalence of physical inactivity and excessive drinking this year.
Both Pennsylvania and Alaska dropped eight places after reaching their best Senior Report ranking in 2016. Pennsylvania dropped from 18th to 26th, Alaska dropped from 21st to 29th.
Pennsylvania seniors continue to struggle with a high percentage of ICU use in the last six months of life and a low percentage of quality nursing home beds (a revised definition), and had a slight drop in the percentage of seniors with a dedicated health care provider in the past year. Pennsylvania is also disadvantaged by a low prevalence of pain management among seniors with arthritis. 
Community support (a revised definition) expenditures remain a strength in Pennsylvania. The state also benefited from a high score in HAI policies (a new measure).
Factors impacting Alaska’s drop in ranking are increases in the prevalence of excessive drinking and obesity in older adults. Additional challenges for Alaska this year were a low percentage of hospice care use and diabetes management and a low prevalence of seniors with a dedicated health care provider.
On the positive side, Alaska experienced a large increase in the prevalence of pain management among seniors with arthritis.
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