The U.S. elderly population is growing rapidly. The number of Americans 65 and older grew from 35 million in 2000 to 41.4 million in 2011 and to an estimated 44.7 million in 2013. This trend is expected to continue as members of the baby boomer generation reach retirement age.

While it can be difficult to grow old in some U.S. states, life for seniors is often far worse in many other countries. Still, the United States will face increasingly large challenges. In the coming years, state officials, families, and individuals will need to pay more attention to the needs of the elderly — to improve medical care, access to services, infrastructure, or other amenities increasingly necessary late in life.

Click here to see the best states to grow old in

Click here to see the worst states to grow old in

HelpAge International evaluates each year the social and economic well-being of elderly country residents in its Global AgeWatch Index. Last year, the United States was among the better places to grow old in the world, at eighth place. However, domestically, each state offers a very different quality of life for its older residents. Based on an independent analysis by 24/7 Wall St., which incorporated a range of income, health, labor, and environmental indicators, Utah is the best state in which to grow old, while Mississippi is the worst.

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To be considered among the best states to grow old, senior citizens in the states had to have relatively strong income security, as measured by several indicators. While the national median income among families with a head of household 65 and older was $37,847 in 2013, comparable incomes in eight of the best states to grow old, for example, exceeded $40,000 in 2013. A typical elderly household in Hawaii led the nation in 2013 with a median income of $55,650.

Retirees often have fixed income, as they begin to tap into their savings and collect social security. Kate Bunting, CEO of AgeWatch USA, explained that, “It is really important for older people to have reliable access to a guaranteed income.” More than 90% of Americans 65 and older in the vast majority of all states received social security income in 2013. The average monthly social security benefit of $1,294, however, was likely not enough for many seniors.

As a result, many older Americans relied on non-social security income, such as withdrawals from 401Ks and savings as a supplement. In 2013, 47.9% of Americans 65 and older had such supplemental retirement incomes. More than 50% of older residents in four of the best states to grow old had such incomes. At stake, according to Bunting, is the elderly’s “ability to eat nutritious foods, which impacts their health, and their ability to access other critical services.”

With lower, and often fixed, incomes, elderly Americans are vulnerable financially. In addition, age often brings a host of health problems, causing greater reliance on medical and accessibility services. To determine how the states fare when it comes to health care, we examined health services and outcomes. In the best states, life expectancy was relatively high. In eight of the 10 states, it was at least 80 years.

A good education, which can lead to employment opportunities and higher incomes, is also an indication of well-being. While less than one-quarter of Americans 65 and older had at least a bachelor’s degree as of 2013, at least 28% of seniors in seven of the best states had attained such a level of education. More than 34% of Colorado’s elderly population were college-educated as of 2013, the highest rate nationwide.

As older people tend to be more vulnerable to criminals, the best states to grow old also needed to be relatively safe. In all of the 10 states, the violent crime in 2013 was less than 300 incidents per 100,000 people, all among the lower rates reviewed.

In addition, policies often shape the quality of life for a state’s elderly population. Smart Growth America rated state-level infrastructure policies and their effectiveness in serving all residents, including the elderly. While many states had not passed any such policies, a majority of the best states to grow old had done so in recent years. Bunting suggested that as the aging population grows, it will become increasingly “important that you have the right kinds of policies in place that help support a quality old age.” Adapting to these demographic patterns through age-friendly policy, Bunting continued, is “important and worthwhile to do, no matter what age you are.”

These are the best states to grow old

See our full methodology here.

The Best States to Grow Old In

10. Massachusetts
> Median household income (65+): $40,020 (15th highest)
> Pct. with a disability (65+): 34.1% (10th lowest)
> Pct. with a bachelor’s degree or higher (65+): 29.2% (7th highest)
> Violent crime rate: 404.0 per 100,000 residents (16th highest)

Based on income, health, labor, and environmental indicators, Massachusetts is the 10th best state to grow old. In particular, Massachusetts’ elderly population has the benefit of an exceptionally strong health care system. In a state where the vast majority of residents were insured in 2013, less than 0.5% of elderly residents aged 65 and over were not, among the lowest rate in the country. Older Massachusetts residents are also relatively well educated. Nearly 30% had at least a bachelor’s degree as of 2013, one of the higher rates. Also, as in a majority of the best states to grow old, Massachusetts’ policies are rated favorably for considering the needs of seniors and other groups that require more services. In particular, state officials introduced a directive that would require all public transportation land use plans to include features necessary to offer greater access for people of all capabilities.

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9. Washington
> Median household income (65+): $42,287 (12th highest)
> Pct. with a disability (65+): 37.4% (17th highest)
> Pct. with a bachelor’s degree or higher (65+): 29.8% (5th highest)
> Violent crime rate: 277.9 per 100,000 residents (21st lowest)

Less than 48% of America’s population 65 and older had some form of retirement income, excluding social security benefits. In Washington, nearly 53% of elderly residents had retirement incomes to supplement their social security benefits, one of the highest proportions among all states. In addition to relatively strong income security, seniors living in Washington rated their accessibility to services an 8.9 out of 10, better than how seniors rated their access in all other states. Older Washington residents were also well-educated compared to their peers in other states. Nearly 30% of people 65 and older in Washington had at least a bachelor’s degree as of 2013, one of the highest rates in the country.

8. Connecticut
> Median household income (65+): $44,240 (7th highest)
> Pct. with a disability (65+): 32.1% (2nd lowest)
> Pct. with a bachelor’s degree or higher (65+): 28.3% (11th highest)
> Violent crime rate: 254.5 per 100,000 residents (15th lowest)

Connecticut residents were expected to live nearly 81 years in 2011, the third highest life expectancy in the country. Just 32.1% of older Connecticut residents had a disability as of 2013, nearly the lowest rate. Physical health among older residents likely contributed to longer lives. According to a recent OECD study, Connecticut residents rated their general health a 7.8 out of 10. Also, the median household income among Connecticut elderly residents was more than $44,000, well above the national median of $37,847 in that age group. While the relationship between income and health is hotly debated by experts, high incomes likely allow older residents greater access to services.

7. Colorado
> Median household income (65+): $43,281 (10th highest)
> Pct. with a disability (65+): 34.3% (14th lowest)
> Pct. with a bachelor’s degree or higher (65+): 34.1% (the highest)
> Violent crime rate: 291.2 per 100,000 residents (24th lowest)

Colorado’s elderly population is especially well-educated, which likely helped improve their income security and quality of life. More than 34% of Colorado residents 65 and older had a bachelor’s degree or higher in 2013, the highest such rate nationwide. Older Colorado residents are less likely than most older Americans to have a retirement income as well as to be employed. Still, they had relatively high incomes. The median household income among the state’s 65 and older population was $43,281 in 2013, the 10th highest in the country.

6. Minnesota
> Median household income (65+): $38,531 (18th highest)
> Pct. with a disability (65+): 31.8% (the lowest)
> Pct. with a bachelor’s degree or higher (65+): 24.3% (22nd highest)
> Violent crime rate: 223.2 per 100,000 residents (9th lowest)

Minnesota had the second highest life expectancy at birth compared to other states in 2011, at 81.1 years. Less than 32% of the state’s elderly population reported having any disability whatsoever in 2013, the lowest rate in the country. Seniors were also among the most likely to have adequate access to nutritious and affordable food in 2011, which may have also helped foster longevity among residents. As older Americans tend to require more services than other age groups, services tend to be far more accessible in the best states to grow old. Services in Minnesota were rated the third most accessible nationwide, according to a recent OECD study. In addition, state residents of any age were among the most satisfied with the city they lived in compared to residents in other states, according to a Gallup poll.

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5. Virginia
> Median household income (65+): $44,440 (5th highest)
> Pct. with a disability (65+): 33.9% (9th lowest)
> Pct. with a bachelor’s degree or higher (65+): 28.0% (12th highest)
> Violent crime rate: 187.9 per 100,000 residents (3rd lowest)

Older Virginians have far better income security than most elderly Americans. While less than 48% of Americans 65 and older had retirement income to supplement social security benefits in 2013, more than 54% of elderly Virginians had such an income, the fifth highest rate nationwide. State households with at least one elderly member had a median income of $44,440 in 2013, also among the highest incomes in the age group reviewed. As a result, Virginians are much less likely to live in poverty and suffer from food insecurity late in life. Less than 4% of Virginia’s elderly population had inadequate access to nutritious and affordable food, the lowest percentage nationwide, and just 7.4% lived in poverty, versus the comparable national figure of nearly 10%.

4. Vermont
> Median household income (65+): $35,844 (20th lowest)
> Pct. with a disability (65+): 34.2% (13th lowest)
> Pct. with a bachelor’s degree or higher (65+): 32.7% (2nd highest)
> Violent crime rate: 114.9 per 100,000 residents (the lowest)

Senior citizens living in Vermont were especially well-educated, which likely helped improve their quality of life. While less than one-quarter of Americans 65 and older had at least a bachelor’s degree, nearly one-third of elderly Vermonters were college educated, the second highest rate nationwide. Unlike in many of the best states to grow old, older Vermont residents did not have especially strong income security. The median income among older households was less than $36,000 in 2013, one of the lower rates. However, less than 5% had inadequate access to food, the fourth lowest rate in the country. Vermont also had the lowest violent crime rate in the nation in 2013, with fewer than 115 crimes reported per 100,000 residents. Safety is especially important for older people, as they are often targeted by criminals.

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3. Hawaii
> Median household income (65+): $55,650 (the highest)
> Pct. with a disability (65+): 35.6% (25th lowest)
> Pct. with a bachelor’s degree or higher (65+): 26.0% (17th highest)
> Violent crime rate: 245.3 per 100,000 residents (13th lowest)

With the state’s 65 and older population accounting for nearly 16% of the overall population in 2013 — one of the higher proportions — Hawaii is a popular destination for older Americans. Older Hawaiians benefit from an exceptionally strong state health care system. Hawaii was the first state to introduce a near-universal health care system, passing legislation in 1976, which seems to have paid off. Hawaii led the nation in health on a recent OECD survey, and state residents were expected to live 81.3 years in 2011, the highest life expectancy at birth nationwide. Hawaii’s elderly population also had strong income security, with a median income for older households of nearly $57,000, the highest such figure nationwide. The relatively high incomes likely helped seniors in the state afford Hawaii’s exceptionally high cost of living.

2. New Hampshire
> Median household income (65+): $42,406 (11th highest)
> Pct. with a disability (65+): 34.6% (16th lowest)
> Pct. with a bachelor’s degree or higher (65+): 28.6% (10th highest)
> Violent crime rate: 199.6 per 100,000 residents (6th lowest)

Relatively few senior citizens live in poverty in the best states for older residents. Only 5.6% of New Hampshire’s elderly population lived below the poverty line in 2013, the lowest rate of any state except for Alaska. Low poverty rates and high median household incomes among residents 65 and over may allow them better access to safe and nutritious food. As of 2011, roughly 5% of New Hampshire’s senior population did not have access to healthy foods, lower than the vast majority of states. Perhaps as a result, life expectancy at birth as of 2011 was one of the highest in the country at 80.3 years. The state was also one of the safest in the country, according to both an OECD report and FBI data, which likely makes it more attractive to older people who may be more vulnerable targets of crimes.

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1. Utah
> Median household income (65+): $44,384 (6th highest)
> Pct. with a disability (65+): 36.0% (24th highest)
> Pct. with a bachelor’s degree or higher (65+): 30.9% (3rd highest)
> Violent crime rate: 209.2 per 100,000 residents (8th lowest)

Although the share of its elderly population is nearly the lowest in the country, Utah is nonetheless the best state in the nation in which to grow old. The state fared exceedingly well in all the measures reviewed. Older residents are well-educated, with nearly 31% having attained at least a bachelor’s degree as of 2013, the third highest figure in the country. Seniors also have relatively strong income security, due in part to a strong education and traditionally high employment rates among the 55-64 age group. Nearly 97% of Utah residents in that age group were employed in 2013, nearly the highest rate. Utah’s elderly households also had a median income of more than $44,000 in 2013, higher than in all but a handful of states. These factors likely helped improve the overall satisfaction — not just among the elderly but all residents. More than 91% of residents told Gallup they were satisfied with their city in 2013, the second-highest such rate reviewed.

Methodology

To determine the best and worst states in which to grow old, 24/7 Wall St. compiled data from a variety of sources and grouped them into four broad categories: income, health, labor, and environment and access.

To construct our index we used the min-max normalization method. A similar methodology was used in constructing HelpAge International’s Global AgeWatch Index and the United Nation’s Human Development Index. First, all indicators were modified so that higher values indicated better outcomes. For example, rather than use the percentage of the population with a disability, our index used the percentage of people 65 and over without a disability. Second, each indicator was normalized to fall between 0 and 1 using the indicator’s minimum and maximum values. Third, we calculated the geometric mean of the indicators in each category to obtain an index of each category. Geometric means were used to account for relationships between indicators that may be causal. Our final index was calculated as a geometric mean of the category-specific indices.

Included in the income category are data from the U.S. Census Bureau’s 2013 American Community Survey (ACS) regarding the 65 and older population with retirement income, poverty rates, and median household income. The health category includes data from the Census Bureau on the percent of people 65 and over with a disability. Also included are data on the percentage of seniors insecure about food from Feeding America’s 2013 report, Spotlight on Senior Hunger. We also included 2011 life expectancy at birth from the Organization for Economic Cooperation and Development (OECD), the OECD’s health index, and a survey question from Gallup on whether people have a personal doctor. The labor category incorporates data from the Census on the share of people 65 and over with a bachelor’s degree or higher, as well as employment rates for people aged 55-64 from the Bureau of Labor Statistics. The environment and access category includes data from the OECD on how accessible a variety of services are in each state. From Gallup, we considered how safe people feel walking alone at night and how satisfied people are with the places they live. Finally, we included data on violent crime rates from the Federal Bureau of Investigation.

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