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Executive BriefForewordIntroductionNational HighlightsFindingsHealth OutcomesSocial and Economic FactorsClinical CareBehaviorsState RankingsAppendixMeasures TableData Source DescriptionsMethodologyState Summaries
US Summary
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
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South Carolina
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Texas
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West Virginia
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Wyoming
US SummaryAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingThe United Health Foundation is proud to release the America’s Health Rankings® 2023 Senior Report, which provides a portrait of the health and well-being of older adults across the United States.
The report features successes and challenges in a broad range of health measures and, because most measures include data from 2021 or later, the report highlights some of the effects that the COVID-19 pandemic had on older adults.
For the second year in a row, the early death rate continued to increase, reversing a decade-long decline. Other challenges affecting older adults included an ongoing rise in drug deaths and increases in multiple chronic conditions, frequent physical distress, physical inactivity and poverty. A new measure in this year’s report shows that many older adults spent more than 30% of their income on housing. Despite these challenges, the number of geriatric providers and home health care workers per capita both increased, while food insecurity continued to decline amid increases in home-delivered meals.
As the early death rate continued to rise, the percentage of the United States population ages 65 and older declined for the first time in the 11 years of the Senior Report, from 16.9% to 16.8% between 2020 and 2021. However, the overall number of older adults still increased — in 2021, there were 55.8 million adults ages 65 and older in the U.S., 188,588 more than in 2020. That population is projected to continue increasing despite the pandemic’s impact.
The demographic makeup of the older adult population has become more racially and ethnically diverse. Between 2018 and 2021, the proportion of white (83.6% to 75.1%), Asian (5.1% to 4.8%) and Black (9.9% to 9.4%) older adults decreased, while the proportion of Hispanic (8.4% to 9.0%) and multiracial (0.8% to 0.9%) older adults increased. During the same period, the proportion of American Indian/Alaska Native older adults stayed the same (0.6%).
Older adults comprise a much larger share of the population in some states than in others. In 2021, Maine had the highest proportion of adults ages 65 and older (21.7%) and Utah had the lowest (11.7%).
The demographic makeup of the older adult population has become more racially and ethnically diverse.
No matter the size of the older adult population, strengths, challenges and disparities are present in every state, as demonstrated by the findings in this report. It is essential that policymakers, community leaders and public health officials who work to safeguard and improve the health of older Americans consider these measures collectively, as each measure influences and is influenced by other measures of health as well as factors that affect older adults’ everyday lives. Public health and community leaders are encouraged to use the data in this report to guide their efforts to engage older adults with resources in their communities and address these health challenges. It is particularly critical to address the unique challenges and disparities of the older adult population as it continues to diversify.
Objective
America’s Health Rankings aims to inform and drive action to build healthier communities by offering credible, trusted data that can guide efforts to improve health and health care. To achieve this, a comprehensive set of measures were analyzed to assess the health of older adults across the nation. The report is based on:
- Fifty-two measures. These include 35 ranking and 17 non-ranking measures. New non-ranking measures in this year’s report include firearm deaths, motor vehicle deaths, housing cost burden and rural population, all among adults ages 65 and older.
- Five categories of health. These include health outcomes and four other categories that are determinants of health: social and economic factors, physical environment, behaviors and clinical care.
- Twenty-two data sources. Data included in this report are from many different sources, including the Centers for Disease Control and Prevention’s (CDC’s) Behavioral Risk Factor Surveillance System and the Centers for Medicare & Medicaid Services’ (CMS’) Mapping Medicare Disparities Tool.
The America’s Health Rankings Senior Report aims to improve population health by:
- Presenting a holistic view of health. This report goes beyond measures of clinical care and health behaviors by considering social, economic and physical environment measures, reflecting a growing understanding of the impact of social determinants on health.
- Providing a benchmark for states. Each year the report presents trends, strengths, challenges and highlights for every state using the 11 years of data analyzed in the America’s Health Rankings Senior Report. Public health advocates can monitor health trends over time and compare their state with neighboring states and the nation. This year, state summaries are available on the website as a separate download.
- Stimulating action. The report is intended to drive change and improve health by promoting data-driven discussions among individuals, community leaders, public health workers, policymakers and the media. States can incorporate the report into their annual review of programs, and many organizations use the report as a reference when assigning goals for health improvement plans.
- Highlighting disparities. The report shows differences in health between states and among population groups at state and national levels, with groupings based on metropolitan status, education level, income level, gender, age and race/ethnicity. These analyses often reveal differences among groups that national or state aggregate data may mask.
Model for Measuring America’s Health
America’s Health Rankings is built upon the World Health Organization’s definition of health: “Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” The model was developed under the guidance of the America’s Health Rankings’ advisory council and committees, with insights from other rankings and health models, namely County Health Rankings & Roadmaps and Healthy People. The model serves as a framework across all America’s Health Rankings reports for identifying and quantifying health drivers and outcomes that impact state and national population health.
America’s Health Rankings Model
