Driven largely by baby boomers, who started turning 65 in 2011, the U.S. elderly population is expanding at a record pace. The number of Americans 65 and older is estimated to reach 83.7 million by 2050, nearly double the elderly population of 43.1 million in 2012. As a percentage of the population, elderly Americans are expected to make up more than 20% of U.S. residents by 2030, versus less than 15% in 2012 and less than 10% in 1970.

Americans of all ages face everyday economic, social, or medical challenges. However, low incomes, poverty, violent crime, medical expenses, and other such difficulties disproportionately hurt older people. Most older Americans will require some level of support sooner or later, and many elderly individuals need long-term care and support services. The experience of growing old can also differ substantially between states.

According to Lisa McGuire, Ph.D, lead of the Healthy Aging Program at the Centers for Disease Control and Prevention (CDC), the differences between states is due to a great many factors, from social and economic conditions over the course of a lifetime to the food and water supply in an area. Perhaps even the genetics of people who have chosen to settle in a region can influence outcomes for elderly people in a given region over time, McGuire explained.

Click here to see the best (and worst) states to grow old.

As the elderly population continues to grow, the need for care will increase while at the same time the number of people available to provide the care will decrease. “When we talk about the long-term care support services,” McGuire added, “we’re not just talking about paid care, we’re also talking about informal care that we all provide to our family and loved ones.”

Currently, there are approximately 23 elderly Americans nationwide for every 100 working-age adults. This proportion, known as the dependency ratio, varies considerably within both the best and the worst states for the elderly. For the states on the lower end, however, not only will there be greater numbers of older residents in need of assistance, but also each will likely also need greater care than in the better states.

For example, for elderly individuals in particular, economic factors are closely tied to health outcomes. Recent Kaiser Family Foundation research found that while older Americans are less likely than working-age adults to live in poverty according to the official rate, this is not the case when benefits such as food stamps, tax liabilities, and especially out-of-pocket medical spending are taken into account. Based on the Supplemental Poverty Measure (SPM), poverty in the United States actually increases with age, and the U.S. elderly population is as likely — if not more likely — to live in poverty than members of other, younger age groups.

The median annual income among elderly households in 15 of the 25 top states for older Americans exceeds the national median income for such households of $39,186. The opposite tends to be true on the other end of the spectrum. Similarly, the poverty rate in only three of the top 25 states exceeds the national elderly poverty rate of 9.5%, versus 12 of the bottom 25 states. Looking at the SPM, poverty is far higher for older state resident across the board.

Medical spending is higher in states where greater shares of elderly individuals have disabilities. Nationwide, 36% of noninstitutionalized 65 and older residents have a disability. In 19 of the 25 worst states in which to grow old, older residents are more likely than their nationwide peers to live with a disability. Conversely, the disability rate exceeds the national rate in only three of the top 25 states.

Other medical conditions are also more common in the worst states for elderly Americans. According to McGuire, “There is a well-documented stroke belt that goes through the South.” Of the 25 worst states for older Americans, 11 are in the Southern United States.

Environmental factors also disproportionately hurt the elderly. The quality of an area’s public transit system, for example, can have a major impact on the quality of an elderly resident’s life. McGuire explained that a poor transportation system “can impair or affect the person’s ability to seek medical care and also can affect their social networks.” The percentage of workers commuting by public transit is one way to look at the quality of a transit system. Compared to the lower 25 states for the elderly, residents of the top states are far more likely to use public transit.

The violent crime rate is another major factor in quality of life in old age. The violent crime rate exceeds the national rate of 366 incidents per 100,000 people in only five of the 25 top states for the elderly. Among the lower 25 states, violent crime is more common in 16 states. “[Crime] may have a more social isolating impact which can then have crippling consequences,” McGuire said.

Click here to read our methodology.

These are the best (and worst) states to grow old.

1. Hawaii
> Pct. of pop. age 65 and up: 16.1% (8th highest)
> 65 and over poverty rate: 8.2% (20th lowest)
> 65 and over bachelor attainment: 27.8% (14th highest)
> Life expectancy at birth: 80.6 years (the highest)

Hawaii leads the nation as the best place in which to grow old. Its geographical location in the center of the Pacific Ocean makes moving there cost-prohibitive for most Americans. Living in Hawaii is more expensive than living in any other state, which means state residents, including the elderly, tend to have high incomes. The typical home with an elderly head of household earns $58,150 annually, the second highest in the country. The elderly population in Hawaii is relatively large — 16.1% of residents are 65 or older, the eighth highest share nationwide. Many of the state’s elderly residents are likely in relatively good health, as Hawaii residents also tend to live longer than most Americans. The state’s life expectancy of nearly 81 years is the highest in the nation.

2. Wyoming
> Pct. of pop. age 65 and up: 13.8% (10th lowest)
> 65 and over poverty rate: 6.2% (3rd lowest)
> 65 and over bachelor attainment: 26.0% (20th highest)
> Life expectancy at birth: 78.0 years (19th lowest)

Wyoming’s elderly population is well off financially compared to elderly populations in other states. Just 6.2% of the state’s 65 and older population lives in poverty, the third lowest rate compared with other states. Also, 4.3% of elderly Wyoming households rely on food stamps, the lowest such share in the country. By contrast, 9.0% of Americans 65 and older receive SNAP benefits. Housing is also relatively affordable for elderly Wyoming residents. More than half of elderly American renters spend more than 30% of their incomes on housing costs. In Wyoming, just 40.2% of renters 65 and older spend such a high share, nearly the lowest proportion nationwide.

3. New Hampshire
> Pct. of pop. age 65 and up: 15.8% (11th highest)
> 65 and over poverty rate: 5.1% (2nd lowest)
> 65 and over bachelor attainment: 30.4% (4th highest)
> Life expectancy at birth: 79.9 years (7th highest)

Nearly 16% of New Hampshire’s 1.3 million residents are 65 and older. The poverty rate among the state’s elderly population is only 5.1%. Only Alaska’s elderly population has a lower poverty rate. The elderly are especially vulnerable to food insecurity, as inadequate access to nutritious food will hinder the mental and physical health of senior citizens more than other adults. In the Granite State, only 5.1% of seniors report being unable to afford food on a regular basis, one of the smallest shares in the nation and much less than the 8.4% food insecurity rate among the elderly across the country. The elderly are often perceived as more vulnerable and are therefore often targeted by criminals. However, living in New Hampshire is especially safe as the state’s violent crime rate of 196.1 incidents per 100,000 people is one of the lowest in the nation.

4. Colorado
> Pct. of pop. age 65 and up: 12.7% (5th lowest)
> 65 and over poverty rate: 7.1% (7th lowest)
> 65 and over bachelor attainment: 34.0% (the highest)
> Life expectancy at birth: 79.6 years (10th highest)

Though the share of Colorado’s elderly population is relatively small, the state’s senior citizens are among the best situated in the country. Only 7.1% of 65 and older residents live in poverty, a much smaller share than the 9.5% of American seniors living in poverty. Higher college attainment rates typically lead to lower unemployment rates, higher incomes, and a generally higher quality of life. In Colorado, 34% of those 65 and older have a bachelor’s degree, the highest college attainment rate among seniors in any state. Perhaps as a result, median household income in Colorado among those 65 and older is slightly more than $45,000, roughly $6,000 more than the corresponding national average.

5. Minnesota
> Pct. of pop. age 65 and up: 14.3% (17th lowest)
> 65 and over poverty rate: 7.5% (12th lowest)
> 65 and over bachelor attainment: 26.2% (18th highest)
> Life expectancy at birth: 80.4 years (3rd highest)

Fewer than one in three 65 and older Minnesota residents are considered disabled, the third lowest proportion and well below the national average of 36%. While this does not consider the institutionalized population, many of whom are in nursing homes and likely also disabled, the low share reflects relative health among the state’s elderly. Food insecurity, a difficult challenge for older Americans in particular, is also relatively uncommon in Minnesota. Just 4.8% of seniors struggle to afford food on a regular basis, the fourth lowest percentage nationwide. A relatively low incidence of disability and strong access to nutritious food reflect relative health among the state’s elderly. A healthy older population helps extend life expectancy for the population as a whole. In Minnesota, the life expectancy of over 80 years is among the highest in the country.

6. Montana
> Pct. of pop. age 65 and up: 16.6% (6th highest)
> 65 and over poverty rate: 8.3% (22nd lowest)
> 65 and over bachelor attainment: 26.1% (19th highest)
> Life expectancy at birth: 78.3 years (24th lowest)

Nearly 17% of Montana residents are 65 and older, one of the highest shares in the country. The elderly tend to need more medical attention than the younger population and a higher concentration of medical institutions may benefit the elderly population. In Montana, there are roughly 6.6 hospitals for every 100,000 people, nearly three times the number of hospitals per capita nationwide. Social interactions are often key attributes of healthy lifestyles, and Montana has more social establishments, including churches, restaurants, and social clubs, than any other state. Seniors are likely among those benefitting from the roughly 50 social establishments for every 10,000 people, which is considerably more than the 30 social establishments for every 10,000 people in the United States.

7. Vermont
> Pct. of pop. age 65 and up: 17.0% (4th highest)
> 65 and over poverty rate: 7.1% (7th lowest)
> 65 and over bachelor attainment: 31.8% (3rd highest)
> Life expectancy at birth: 79.5 years (12th highest)

Not only does an education help foster economic prosperity, but also it is a major factor in improving quality of life. In Vermont, 31.8% of elderly state residents have at least a bachelor’s degree, the third highest attainment rate among that age cohort in the nation. Vermont’s population is also relatively old. With 17% of residents aged 65 and older, the median age is 43, the second highest median age nationwide. The large share is not necessarily a strength, however. It also means that the state has fewer working-age adults to support older residents, both as members of a broader tax base and in professions supporting the elderly. For every 100 working-age Vermonters, there are 27 elderly residents, the fifth highest dependency ratio in the nation. Still, the state seems to take relatively good care of its elderly population. Perhaps due in part to the 11.6% of 65 and older residents relying on food stamps — the sixth highest percentage — less than 5% of seniors are considered food insecure, the fourth lowest share.

8. Washington
> Pct. of pop. age 65 and up: 14.1% (13th lowest)
> 65 and over poverty rate: 8.4% (23rd lowest)
> 65 and over bachelor attainment: 30.4% (4th highest)
> Life expectancy at birth: 79.6 years (11th highest)

Washington provides a fairly senior-friendly environment. For example, the state provides a relatively high quality transit system, which can be essential for maintaining independence in old age. Frequent use of public transit is often a reflection of quality, and one in 10 residents commutes to work by public transit or walking in Washington — the seventh highest share in the compared with other states. Washington has one of the wealthiest and more well-educated senior populations of any state, which can contribute to both economic prosperity and greater independence overall. The 30.4% of Washington residents aged 65 or older with a bachelor’s degree or higher is the fourth largest such share nationwide. Also, the typical senior household in Washington earns $44,104 a year — higher than the $39,186 median household income for elderly households nationwide.

9. Virginia
> Pct. of pop. age 65 and up: 13.8% (10th lowest)
> 65 and over poverty rate: 7.8% (14th lowest)
> 65 and over bachelor attainment: 28.9% (11th highest)
> Life expectancy at birth: 78.5 years (25th highest)

Virginia’s elderly residents are relatively financially stable. Of homes with elderly heads of household in the state, median income is $45,966, considerably higher than the comparable national figure of $39,186. With higher incomes, a smaller share of Virginia’s elderly households are dependent on food stamps. Only 7.2% of the Old Dominion State’s elderly households receive food stamps, less than national percentage of 9.0%. Virginia’s elderly residents are also more likely to have access to quality food. Only 3.7% of seniors struggle to afford adequate and nutritious food on a regular basis, the lowest level of food insecurity of any state’s elderly population in the country.

10. Connecticut
> Pct. of pop. age 65 and up: 15.4% (17th highest)
> 65 and over poverty rate: 7.8% (14th lowest)
> 65 and over bachelor attainment: 30.4% (4th highest)
> Life expectancy at birth: 80.4 years (2nd highest)

Annual incomes for those 65 and older tend to be fixed and lower than incomes of younger segments of the population. While this is also the case in Connecticut, the state’s elderly residents are less likely to face financial hardship than their peers in most other states. The median income among homes with elderly heads of household is $46,216 a year in the Nutmeg State, more than in all but three other states. Relatively high incomes are due in part to the large share of retired Connecticut residents who receive retirement income from pensions, 401(k)s, and other sources. Slightly more than half of all those 65 and older in Connecticut receive retirement income, a larger share than in the vast majority of states.

11. South Dakota
> Pct. of pop. age 65 and up: 15.2% (22nd highest)
> 65 and over poverty rate: 10.6% (8th highest)
> 65 and over bachelor attainment: 20.5% (14th lowest)
> Life expectancy at birth: 78.9 years (22nd highest)

South Dakota has established itself as one of the most senior-friendly places in the country. Elderly individuals often require more assistance and medical attention than their younger peers, and more health institutions in an area can make life easier for older Americans. South Dakota is home to the most hospitals per capita nationwide and the third most social establishments per person. Older people also tend to struggle to afford adequate and nutritious food compared with other adults, and the amount of food insecure seniors within the United States is on the rise. In South Dakota, however, just 5.4% of seniors lack sufficient access to healthy food, the seventh lowest share of any state.

12. North Dakota
> Pct. of pop. age 65 and up: 14.2% (14th lowest)
> 65 and over poverty rate: 8.7% (25th highest)
> 65 and over bachelor attainment: 20.3% (13th lowest)
> Life expectancy at birth: 79.3 years (13th highest)

North Dakota is one of the best states in the country in which to grow old. The state’s oil industry, while reporting job losses in recent months, has contributed to one of the nation’s strongest job markets in recent years. The economic prosperity has likely paid off for older North Dakotans as well. Of the 55-64 year old population, just 1.4% are out of a job, the second lowest unemployment rate in the country. Of homes with elderly heads of household, however, just 37.9% receive retirement income in the form of 401(k)s, pensions, and other sources, the second smallest share in the country.

13. Maine
> Pct. of pop. age 65 and up: 18.2% (2nd highest)
> 65 and over poverty rate: 8.9% (22nd highest)
> 65 and over bachelor attainment: 26.4% (17th highest)
> Life expectancy at birth: 78.7 years (23rd highest)

Older people are frequently perceived as more vulnerable and as a result often targeted by criminals. In Maine, however, senior citizens have the benefit of safer communities compared to elderly populations in much of the rest of the country. The state’s violent crime rate of 128 incidents per 100,000 people is lower than in every state except for Vermont. With a 98% employment rate among those between the ages of 55-64, older Maine residents have comparatively strong job security and relatively few older people are out of a job.

14. Massachusetts
> Pct. of pop. age 65 and up: 15.1% (24th highest)
> 65 and over poverty rate: 9.3% (18th highest)
> 65 and over bachelor attainment: 30.0% (9th highest)
> Life expectancy at birth: 80.2 years (5th highest)

While chronic diseases and disabilities disproportionately affect the elderly, poor health is by no means an inevitable consequence of aging. Of noninstitutionalized elderly individuals in Massachusetts, fewer than one in three have a disability, one of the lowest proportions in the nation and well below the national average share of 36%. Relatively good health among older state Massachusetts residents likely helps explain the state’s high life expectancy of over 80 years, which is fifth highest in the country.

Well-designed and accessible public infrastructure can help elderly individuals in particular maintain their independence, which is often essential to quality of life. Massachusetts has one of the most-used public transit systems in the country.

15. New Jersey
> Pct. of pop. age 65 and up: 14.7% (24th lowest)
> 65 and over poverty rate: 8.6% (25th lowest)
> 65 and over bachelor attainment: 27.5% (15th highest)
> Life expectancy at birth: 79.8 years (8th highest)

While old age does not imply poor health, the elderly are more likely to suffer from chronic diseases and conditions that require medical attention than younger segments of the population. In states with high quality health systems, which disproportionately benefit elderly individuals, relatively large shares of the population have primary care physicians. Only 18.2% of New Jersey adults do not have a personal doctor, one of the smallest such shares in the country. With relatively strong health care infrastructure, only about a third of noninstitutionalized Garden State residents 65 and older have a disability, one of the smallest shares of any state in the country.

16. Oregon
> Pct. of pop. age 65 and up: 16.0% (9th highest)
> 65 and over poverty rate: 8.8% (23rd highest)
> 65 and over bachelor attainment: 28.3% (13th highest)
> Life expectancy at birth: 79.1 years (18th highest)

Oregon’s 65 and over population is relatively well educated. Of the state’s elderly residents, 28.3% have at least a bachelor’s degree, and 31.8% have completed at least some college or an associate’s degree, each among the higher percentages nationwide. The higher education level helps improve quality of life. But while a good education also often leads to high incomes, Oregon’s older residents are not as well off financially compared to many other states at the upper end of this list. The typical home in Oregon with an elderly head of household earns less than $40,000 annually, and fewer than half of elderly residents have retirement income, each in line with the respective national averages. Also, 61.3% of older renters in the state pay 30% or more of their income in housing costs, the second highest share.

17. Nebraska
> Pct. of pop. age 65 and up: 14.4% (20th lowest)
> 65 and over poverty rate: 7.9% (16th lowest)
> 65 and over bachelor attainment: 20.7% (15th lowest)
> Life expectancy at birth: 79.2 years (16th highest)

Relatively large shares of Nebraska’s elderly residents are financially stable and independent. Only 7.9% of those 65 and older in the Cornhusker State live in poverty, considerably lower than the corresponding national rate of 9.5%. Additionally, only 5.8% of elderly households receive food stamps, one of the smallest shares of any state in the country. One likely explanation for financial independence among the state’s elderly population is the high employment rate among those just below retirement age. Roughly 98% of those between ages 55-64 are employed, the third highest share of any state in the country.

18. Maryland
> Pct. of pop. age 65 and up: 13.8% (10th lowest)
> 65 and over poverty rate: 7.4% (10th lowest)
> 65 and over bachelor attainment: 31.9% (2nd highest)
> Life expectancy at birth: 78.5 years (25th lowest)

By many measures, Maryland is one of the more habitable states for older Americans. Maryland has the highest median household income of any state overall, and its elderly population is similarly wealthy. The typical Maryland home with an elderly head of household earns $52,458 annually, the third most after Alaska and Hawaii. For most people, retirement pensions and 401(k)s are a significant source of income in old age. Of elderly households in the state, 55.3% receive retirement income, the fourth highest share nationwide. Social Security benefits in the state, however, are relatively low. Just 85.9% of elderly households in the state receive such benefits, the second smallest such share.

Safe neighborhoods are especially important for elderly populations, and many parts of Maryland are some of the most violent in the country. Across the state, there are 446 incidents per 100,000 people each year, well above the national rate.

19. Delaware
> Pct. of pop. age 65 and up: 16.4% (7th highest)
> 65 and over poverty rate: 7.5% (12th lowest)
> 65 and over bachelor attainment: 25.7% (22nd highest)
> Life expectancy at birth: 78.1 years (20th lowest)

Access to medical care and stable housing, among other things, make Delaware one of the more senior-friendly places in the country. Delaware has the smallest share of disabled seniors of any state. This reflects relatively strong health among the state’s elderly. In addition, homeownership can provide stability. Nearly 85% of homes with elderly heads of households are owned by their occupants, the third highest old-age homeownership rate in the country. Retirement planning and financial stability among older states residents may contribute to the widespread home ownership among the elderly, as 58.6% of elderly households in Delaware receive retirement income — the highest share in the nation. Unlike many other states at the higher end of this list, however, Delaware is not especially safe. The state’s violent crime rate of 489 incidents per 100,000 people is one of the highest in the nation.

20. New York
> Pct. of pop. age 65 and up: 14.7% (24th lowest)
> 65 and over poverty rate: 11.7% (4th highest)
> 65 and over bachelor attainment: 25.7% (22nd highest)
> Life expectancy at birth: 80.0 years (6th highest)

Life expectancy in New York is about a year and a half longer than the 78.5 year national average, which reflects strong health among elderly and younger residents alike. New Yorkers may owe their relative health to strong access to medical care. Only 18.5% of adults in the Empire State do not have a personal physician, one of the smallest shares of any state in the country.

While New York’s elderly residents may have better health and access to health care, they are more likely to face financial hardship than most elderly Americans elsewhere. Nearly 16% of elderly households receive food stamps, a larger share than in any other state. Similarly, 11.7% of New Yorkers 65 and older live in poverty, one of the highest poverty rates among the elderly populations in any state.

21. Idaho
> Pct. of pop. age 65 and up: 14.4% (20th lowest)
> 65 and over poverty rate: 9.5% (16th highest)
> 65 and over bachelor attainment: 23.1% (19th lowest)
> Life expectancy at birth: 78.9 years (21st highest)

Obtaining adequate food can become more difficult later in life, and food insecurity is a growing problem among the U.S. elderly. In Idaho, however, just 4.4% of seniors are considered food insecure, the third smallest share in the country. The high homeownership rate among state seniors also reflects stability for the state’s older population. As many as 83.1% of elderly Idaho households are owned by their occupants, the seventh highest old-age homeownership rate of any state.

Despite these relatively strong measures, Idaho’s elderly also report some of the nation’s lowest income. The typical home with an elderly head of household earns just $36,048 annually, lower than the comparable figure in all but a handful of other states.

22. California
> Pct. of pop. age 65 and up: 12.9% (6th lowest)
> 65 and over poverty rate: 10.6% (8th highest)
> 65 and over bachelor attainment: 29.5% (10th highest)
> Life expectancy at birth: 80.4 years (4th highest)

With a median age of only 36, California is one of the youngest states in the country. The state’s elderly population does not fare especially well, however. Only 44.7% of elderly households earn a retirement income from sources such as 401(k)s or pensions, considerably less than the 48.1% national average, and 86% receive income from social security, the third smallest share in the country after Alaska and Maryland. High rent areas in the Golden State may be the source of added financial strain among the state’s elderly. Though it is not economically prudent to spend more than 30% of one’s income on rent, nearly 63% of Californians over the age of 65 do, the largest share of any state in the country. The state’s old-age poverty rate is roughly equivalent to the nation as a whole. However, when adjusted for the high cost of California housing, out-of-pocket medical expenses, and other basic necessities, the state’s seniors have the highest supplemental poverty rate in the nation.

23. Iowa
> Pct. of pop. age 65 and up: 15.8% (11th highest)
> 65 and over poverty rate: 7.4% (10th lowest)
> 65 and over bachelor attainment: 20.1% (9th lowest)
> Life expectancy at birth: 79.0 years (20th highest)

When factors such as out-of-pocket medical expenses, food, and clothing are taken into account, just 9.0% of Iowa’s elderly residents live below the poverty line, the lowest old-age supplemental poverty rate in the country. Social Security may help keep Iowa seniors financially afloat, as 93.7% of senior-led households receive Social Security income — the second highest share of any state. In addition to financial stability, elderly residents have access to strong medical infrastructure. The 19.5% of adults who do not have a personal doctor is a smaller share than the 22.9% national average, and the 4.7 hospitals per 100,000 state residents is over twice that of the nation overall. Just 31.8% of elderly Iowans have a disability, the third smallest share in the country.

Low educational attainment is tied with a number of health consequences as well as a lower quality of life in old age. In Iowa, just one in five senior citizens have at least a bachelor’s degree, a smaller share than in all but a handful of states.

24. Wisconsin
> Pct. of pop. age 65 and up: 15.2% (22nd highest)
> 65 and over poverty rate: 7.2% (8th lowest)
> 65 and over bachelor attainment: 22.0% (18th lowest)
> Life expectancy at birth: 79.3 years (14th highest)

Of Wisconsin’s elderly population, 7.2% live in poverty, one of the lowest rates in the nation. Even when costs associated with out-of-pocket medical expenses, food, clothing, and other basic necessities are taken into account, the level of poverty among the elderly is among the lowest. Social Security is well distributed in the state and may help the state’s elderly stay financially afloat, as 93.8% of senior households in Wisconsin receive such benefits, the highest recipiency rate of any state. While a high share of Wisconsin’s elderly residents manage to stay out of poverty, incomes are still relatively low. The median income for elderly households is $36,606, about $2,600 less than the national average income.

25. Kansas
> Pct. of pop. age 65 and up: 14.4% (20th lowest)
> 65 and over poverty rate: 7.9% (16th lowest)
> 65 and over bachelor attainment: 26.0% (20th highest)
> Life expectancy at birth: 78.2 years (22nd lowest)

Approximately 7.9% of senior citizens in Kansas live in poverty, a slightly smaller share than the 9.5% poverty rate among the country’s elderly citizens. Also, a relatively small share of the elderly population receives food stamps. Only 4.8% of homes with elderly heads of households in Kansas depend on food stamps, considerably less than the 9.0% food stamp recipiency rate for elderly households across the nation.

Kansas’s seniors tend to be less prepared financially for retirement than is typical across the country. Only 45.6% of elderly residents in the state have retirement income from sources other than social security, like pensions or 401(k)s.

26. Rhode Island
> Pct. of pop. age 65 and up: 15.8% (11th highest)
> 65 and over poverty rate: 9.7% (14th highest)
> 65 and over bachelor attainment: 25.4% (25th highest)
> Life expectancy at birth: 79.1 years (17th highest)

Access to medical care and social opportunities can provide stability and stimulation in old age, and ultimately improve quality of life. There are about 39 social establishments per 10,000 Rhode Island residents, the seventh most per capita in the country. Also, almost 86% of adults in Rhode Island have a personal doctor, the fourth largest share nationwide and an indication that the state’s health system is relatively strong. Rhode Island’s elderly are more likely to struggle to afford food than those in other states, however. More than one in 10 seniors in the state report food insecurity, one of the highest rates nationwide.

27. Illinois
> Pct. of pop. age 65 and up: 13.9% (11th lowest)
> 65 and over poverty rate: 8.8% (23rd highest)
> 65 and over bachelor attainment: 24.2% (24th lowest)
> Life expectancy at birth: 78.7 years (24th highest)

Well developed public transportation systems and walkable communities are especially important for elderly residents as driving often becomes more challenging in old age. Illinois is home to one of the most widely used public transit systems in the country.

Otherwise, by many measures, lives of seniors in Illinois are comparable to their counterparts across the country. Of Illinois homes with 65 and older householders, the annual median income of $39,898 is only slightly higher than the corresponding nationwide figure of $39,186. Similarly, at 78.7 years, life expectancy in the Prairie State is in line with the national average life expectancy.

28. Arizona
> Pct. of pop. age 65 and up: 15.9% (10th highest)
> 65 and over poverty rate: 9.4% (17th highest)
> 65 and over bachelor attainment: 27.3% (16th highest)
> Life expectancy at birth: 79.3 years (15th highest)

In terms of several economic measures, Arizona’s elderly population fares about as well as older Americans in other states. The typical elderly Arizona home earns $40,195 annually, approximately $1,000 more than the corresponding nationwide figure. Similarly, Arizona’s 9.4% poverty rate among the elderly is close to the national figure. While it is not financially prudent to pay more than 30% of annual income on rent, 54.5% of Arizonans 65 and older pay at least this much on housing, just slightly below the national average proportion. Also, life expectancy in the Grand Canyon State of 79.3 years is only slightly higher than it is across the country.

29. Utah
> Pct. of pop. age 65 and up: 10.0% (2nd lowest)
> 65 and over poverty rate: 6.7% (4th lowest)
> 65 and over bachelor attainment: 30.4% (4th highest)
> Life expectancy at birth: 79.7 years (9th highest)

A good education can contribute to higher quality of life in old age. In Utah, 35.1% of seniors have attended some college and 30.4% have at least a bachelor’s degree, the highest and fourth highest shares in the country. College credentials also partially explain the high incomes in the state. Supplemented with retirement income, the median earnings for senior households in Utah of $45,738 a year is the seventh most of any state. Also, the 6.7% poverty rate among elderly state residents is the fourth lowest.

Access to golf courses, churches, restaurants and other social venues can improve quality of life for elderly individuals in particular. In Utah however, residents have access to just 20 social establishments per 10,000 residents, the lowest per capita of any state.

30. Texas
> Pct. of pop. age 65 and up: 11.5% (3rd lowest)
> 65 and over poverty rate: 10.9% (7th highest)
> 65 and over bachelor attainment: 24.3% (25th lowest)
> Life expectancy at birth: 78.1 years (21st lowest)

A relatively young state, the median age in Texas is 34, and only 11.5% of Texans are 65 and older, one of the smallest shares in the country. For the state’s elderly population, life is a little tougher in Texas than it is in many other states. Roughly 11% of those 65 and older are living in poverty in the Lonestar State, one of the highest shares in the country. As is the case in many states, a high poverty rate accompanies a high food insecurity rate among Texas seniors. More than one in 10 elderly residents struggle to put food on the table, one of the largest proportions of any state in the country. Seniors in the state may also be less likely to receive regular preventative medical care as roughly 33% of state adults do not have a personal doctor, a higher share than in all but two other states.

31. North Carolina
> Pct. of pop. age 65 and up: 14.7% (24th lowest)
> 65 and over poverty rate: 9.7% (14th highest)
> 65 and over bachelor attainment: 23.2% (21st lowest)
> Life expectancy at birth: 77.4 years (13th lowest)

By many economic, health, and environmental measures, North Carolina is about as habitable to seniors as the rest of the country. The 16% of seniors who live in poverty when factors such as out-of-pocket medical expenses, clothing, food, and other basic necessities are taken into account is just slightly higher than the 15% national supplemental poverty rate. Health outcomes for the elderly are also similar, as 37.1% of seniors have a disability, a slightly larger share than the 36.0% national percentage.

32. Michigan
> Pct. of pop. age 65 and up: 15.4% (17th highest)
> 65 and over poverty rate: 8.1% (19th lowest)
> 65 and over bachelor attainment: 21.8% (17th lowest)
> Life expectancy at birth: 77.8 years (15th lowest)

When food, clothing, out-of-pocket medical expenses and other basic necessities are taken into account, just one in 10 Michigan seniors lives below the poverty line, the fifth lowest supplemental poverty rate in the country. Responsible retirement planning may help keep Michigan’s elderly financially afloat as the state is home to the second highest share of senior households receiving retirement income. Similarly, 93% of senior households receive Social Security income, the fifth highest share. Relative wealth among senior residents has not led to similarly strong health outcomes, however. Life expectancy is 77.8 years in Michigan, one of the shorter life expectancies in the country. Also, 36.1% of seniors have a disability, in line with the national share.

33. Pennsylvania
> Pct. of pop. age 65 and up: 16.7% (5th highest)
> 65 and over poverty rate: 8.1% (19th lowest)
> 65 and over bachelor attainment: 20.2% (10th lowest)
> Life expectancy at birth: 78.3 years (23rd lowest)

Senior citizens make up 16.7% of Pennsylvania’s population, the fifth highest share in the country. While such a high share can imply positive factors for elderly residents in the state, it can also mean a greater burden on the working-age population and can strain funding retirement and disability pensions. For every 100 working-age Pennsylvanians, there are 27 senior citizens, the fifth highest old-age dependency ratio nationwide. Nevertheless, Pennsylvania’s seniors fare about as well as those in the rest of the country. Nearly 35% of seniors have a disability, just slightly better than the 36.0% national share. Similarly, the state has 2.3 hospitals for every 100,000 residents, roughly equivalent to the 2.2 hospitals for every 100,000 Americans across the country.

34. Florida
> Pct. of pop. age 65 and up: 19.1% (the highest)
> 65 and over poverty rate: 10.5% (11th highest)
> 65 and over bachelor attainment: 25.6% (24th highest)
> Life expectancy at birth: 79.0 years (19th highest)

Slightly more than 19% of Florida’s population is over the age of 64, the largest share of any state in the country. Though many senior citizens with means choose Florida as a place to retire because of its warm climate and low taxes, elderly residents in the Sunshine State lag behind their peers in much of the rest of the country by many measures. Only 44.1% of households with residents 65 and older receive retirement income from sources other than Social Security, such as 401(k)s and pension plans. Nationwide, 48.1% of seniors receive income from such sources. Also, likely due to high rent prices, many seniors in Florida may not be living within their means. Approximately 59% of those 65 and older spend 30% or more of their income on rent, one of the highest shares in the country. Also, while the share of Florida seniors living in poverty is roughly similar to the national old-age poverty rate, when adjusted for the high costs of housing and other basic needs in the state, the poverty rate is second highest in the country.

35. Georgia
> Pct. of pop. age 65 and up: 12.4% (4th lowest)
> 65 and over poverty rate: 10.4% (12th highest)
> 65 and over bachelor attainment: 23.2% (21st lowest)
> Life expectancy at birth: 76.9 years (10th lowest)

While old age and poor health are not synonymous, the elderly tend to need more frequent medical attention than younger age segments. In Georgia, 28.5% of adults do not have their own doctor, one of the highest shares in the country. Inadequate and irregular doctor visits may partially explain the relatively low life expectancy among state residents. Life expectancy at birth in the Peach State is just under 77 years, among the lowest in the nation.

Median income among Georgia’s older residents is below the corresponding national figure. The typical income among households in the states with residents 65 and older is only $36,859, well below the national median income for elderly households.

36. Ohio
> Pct. of pop. age 65 and up: 15.5% (16th highest)
> 65 and over poverty rate: 8.1% (19th lowest)
> 65 and over bachelor attainment: 19.7% (7th lowest)
> Life expectancy at birth: 77.4 years (14th lowest)

Compared to the rest of the country, Ohio is not a particularly favorable place for older Americans. About 4.8% of residents 65 and older die each year, one of the highest mortality rates in that age group. Ohio residents’ average life expectancy of 77.4 years is about a year less than the national average. Also, 35.4% of noninstitutionalized seniors have a disability, roughly equivalent to the national average. While health outcomes in the state are unremarkable, Ohio residents are more likely to have access to medical treatment. Just 19.8% of adults do not have a personal doctor compared to a 22.9% national share. Similarly, there are 5.2 nursing homes per 10,000 seniors, the ninth most per capita of any state.

37. South Carolina
> Pct. of pop. age 65 and up: 15.8% (11th highest)
> 65 and over poverty rate: 9.3% (18th highest)
> 65 and over bachelor attainment: 23.9% (23rd lowest)
> Life expectancy at birth: 76.5 years (9th lowest)

By measures of health and wealth, South Carolina is not particularly senior-friendly. When basic necessities such as out-of-pocket medical expenses, food, and clothing are taken into account, 18% of South Carolina seniors live below the poverty line, the second highest supplemental poverty rate in the country. The life expectancy of just 76.5 years and the 37.3% of seniors who have a disability are both worse than the corresponding national averages. There are just 2.2 nursing facilities per 10,000 South Carolina seniors, one of the smallest per capita shares of any state.

However, 85% of seniors own their homes, which is the second highest share in the country. Homeownership can provide stability, financial security, and above all peace of mind that can improve quality of life in old age.

38. Missouri
> Pct. of pop. age 65 and up: 15.4% (17th highest)
> 65 and over poverty rate: 9.0% (21st highest)
> 65 and over bachelor attainment: 20.3% (13th lowest)
> Life expectancy at birth: 77.2 years (11th lowest)

The median household income among Missouri’s elderly residents of $36,059 is well below the corresponding national figure of $39,186. Despite lower incomes, the elderly in Missouri are more likely to live within their means. It is not financially prudent to spend more than 30% of one’s income on rent, yet 55% of American aged 65 and older do so. In Missouri, the corresponding share is only 48%, one of the smallest of any state in the country.

Despite some positive economic measures, 11.4% of seniors in the state struggle to put food on the table, one of the largest shares in the country. Inadequate nutrition among the state’s elderly may partially explain why life expectancy in Missouri falls short of the national life expectancy by over a year.

39. Indiana
> Pct. of pop. age 65 and up: 14.3% (17th lowest)
> 65 and over poverty rate: 7.0% (5th lowest)
> 65 and over bachelor attainment: 18.9% (4th lowest)
> Life expectancy at birth: 77.2 years (12th lowest)

Compared to the rest of the country, conditions in Indiana are not particularly favorable for its elderly population. About 4.8% of residents 65 and older die every year, the fifth highest mortality rate of any state for that age group. The life expectancy in Indiana of 77.2 years is among the lowest in the country, and 37.5% of noninstitutionalized seniors have a disability — a slightly larger share than the 36.0% of disabled American seniors overall. Indiana’s elderly fare better in economic measures than in health. Despite a median household income below the national figure, just 7.0% of Indiana’s elderly live in poverty — the fifth lowest old-age poverty rate nationwide. However, when adjusted for out-of-pocket medical expenses and the costs of other basic necessities, Indiana’s supplemental poverty rate is considerably higher.

40. Alaska
> Pct. of pop. age 65 and up: 9.5% (the lowest)
> 65 and over poverty rate: 4.3% (the lowest)
> 65 and over bachelor attainment: 30.4% (4th highest)
> Life expectancy at birth: 77.9 years (16th lowest)

Alaska is the only state in the country where less than 10% of the population is 65 and older. That small share of senior citizens living in the state are among the most financially stable of their age group in the country. The $58,311 median elderly household income is the highest in the country. Correspondingly, only 4.3% of Alaska’s senior citizens live in poverty, the smallest share of any state in the country.

However, Alaska lags behind much of the country in several health measures. More than a third of adults in the state do not have a personal doctor, one of the highest shares in the country. Additionally, just over 41% of the noninstitutionalized population 65 and older is living with a disability, also among the highest shares of any state.

41. New Mexico
> Pct. of pop. age 65 and up: 15.3% (21st highest)
> 65 and over poverty rate: 13.2% (the highest)
> 65 and over bachelor attainment: 28.8% (12th highest)
> Life expectancy at birth: 77.9 years (18th lowest)

Among New Mexico’s older residents, 13.2% live in poverty, the highest elderly poverty rate in the country. Furthermore, roughly 31% of adults in the Land of Enchantment do not have a personal doctor, indicating that many of the state’s elderly may not be getting the medical care they need.

Despite a nation-leading poverty rate and other substandard measures, New Mexico’s elderly are more likely to own their own home than most American senior citizens. Nearly 83% of those 65 and older are homeowners, one of the highest rates among the age group in the country.

42. Oklahoma
> Pct. of pop. age 65 and up: 14.5% (21st lowest)
> 65 and over poverty rate: 8.5% (24th lowest)
> 65 and over bachelor attainment: 21.3% (16th lowest)
> Life expectancy at birth: 75.6 years (5th lowest)

Fewer than half of elderly Oklahoma households have retirement income. At 45.1%, the percentage is also among the lowest in the nation. The typical household headed by an older resident earns $36,820 annually, not especially low compared with the other states in the bottom 10 but still well below the national median income for the elderly of $39,186.

Elderly individuals are often more vulnerable to crime levels in an area, and a high crime rate can contribute to and worsen physical ailments. It can also drive up isolation among older people in particular who choose to avoid unsafe neighborhoods by staying indoors. Oklahoma’s violent crime rate of 406 incidents per 100,000 people is well above the national rate.

43. Kentucky
> Pct. of pop. age 65 and up: 14.8% (25th lowest)
> 65 and over poverty rate: 11.3% (5th highest)
> 65 and over bachelor attainment: 17.1% (2nd lowest)
> Life expectancy at birth: 75.7 years (6th lowest)

More than one-quarter of those 65 and older in Kentucky did not complete high school, the highest share of any state in the country. Relatively limited education predictably led to negative economic outcomes. The 11.3% poverty rate among the state’s elderly population is one of the highest in the country. Economic burdens in the state are made worse by physical burdens. Of those 65 and older who are not institutionalized, 43.1% have a disability — a larger share than in all but two other states.

Multiple negative measures in the state culminate in one of the lowest life expectancies in the country. The life expectancy of Kentucky residents is only 75.7 years, roughly three fewer years than the national average.

44. Louisiana
> Pct. of pop. age 65 and up: 13.6% (7th lowest)
> 65 and over poverty rate: 12.8% (3rd highest)
> 65 and over bachelor attainment: 20.3% (13th lowest)
> Life expectancy at birth: 75.4 years (4th lowest)

Louisiana is one of only seven states where life expectancy does not exceed 76 years. A range of factors contribute to lower than average longevity among state residents. With 515 violent crimes for every 100,000 state residents, Louisiana is more dangerous than all but six other states. Additionally, more than one-quarter of adults in the state do not have a personal doctor, one of the largest shares in the country.

Economic woes among the state’s elderly population also likely play a role in their relatively poorer health. Median income among elderly households only $32,870, less than in all but two other states. In addition, the state’s elderly poverty rate is high. Nearly 13% of seniors in the state live in poverty, a considerably larger share than the national poverty rate among the elderly of 9.5%.

45. Arkansas
> Pct. of pop. age 65 and up: 15.7% (15th highest)
> 65 and over poverty rate: 10.6% (8th highest)
> 65 and over bachelor attainment: 17.7% (3rd lowest)
> Life expectancy at birth: 75.8 years (7th lowest)

The elderly are more vulnerable to chronic diseases and disabilities. Of noninstitutionalized 65 and over state residents, 42.6% have a disability, the fourth largest share nationwide. Poor health outcomes are closely tied to financial instability, and the relatively high poverty level in Arkansas likely contributes to both the prevalence of disabilities as well as a greater incidence of premature death. More than one in 10 state residents 65 and older live in poverty, among the highest rates compared to elderly populations in other states. Arkansas’s life expectancy of 76 years is also the seventh lowest in the country.

46. West Virginia
> Pct. of pop. age 65 and up: 17.8% (3rd highest)
> 65 and over poverty rate: 9.3% (18th highest)
> 65 and over bachelor attainment: 13.7% (the lowest)
> Life expectancy at birth: 75.4 years (3rd lowest)

In West Virginia, 17.8% of the population is 65 or older, the third highest percentage nationwide. Looking at state residents of all ages, West Virginia is also the fourth oldest states in the country, with a median age of 42 years.

Seniors living in West Virginia are among the most likely to have retirement income — 55% of elderly households receive retirement income from pensions, 401 (k) plans, and other sources, the fifth highest share nationwide. However, these incomes are not especially high. The median income among elderly households of $32,219 is the second lowest in the country after Mississippi. Economic measures are closely tied to health outcomes, and the low incomes in West Virginia may contribute to more chronic illness and disability, especially among the elderly. Of the noninstitutionalized 65 and over population, 44.3% are disabled, the second highest share of all states.

47. Alabama
> Pct. of pop. age 65 and up: 15.4% (17th highest)
> 65 and over poverty rate: 11.2% (6th highest)
> 65 and over bachelor attainment: 19.0% (5th lowest)
> Life expectancy at birth: 75.2 years (2nd lowest)

Poor socioeconomic measures are closely tied to health outcomes. In Alabama, where 11.2% of elderly residents live in poverty. Poor health among Alabama’s elderly population likely contributes to the state’s life expectancy of just 75 years, the second lowest in the country. Educational attainment, both as a factor in economic prosperity and in self care, contributes substantially to personal well-being and independence among the elderly. But in Alabama, fewer than one in five people 65 and older have at least a bachelor’s degree, the fifth lowest college attainment rate in the nation.

48. Tennessee
> Pct. of pop. age 65 and up: 15.1% (24th highest)
> 65 and over poverty rate: 10.1% (13th highest)
> 65 and over bachelor attainment: 20.0% (8th lowest)
> Life expectancy at birth: 76.1 years (8th lowest)

Looking at financial and social measures as well as health systems and health outcomes of elderly Americans, Tennessee is one of the worst places to grow old in the country to grow old. The median annual income for homes with elderly heads of household is $34,224 in Tennessee, among the lowest in the country. While government subsidies can help poor families make ends meet, the level of assistance is likely insufficient for a number of Tennessee families. Of all elderly households in the state, 11.5% rely on food stamps, one of the highest percentages nationwide. Yet, nearly 12% of seniors in the state struggle to afford adequately nutritious meals, the second highest level of food insecurity among seniors nationwide.

49. Nevada
> Pct. of pop. age 65 and up: 14.1% (13th lowest)
> 65 and over poverty rate: 8.3% (22nd lowest)
> 65 and over bachelor attainment: 23.6% (22nd lowest)
> Life expectancy at birth: 77.9 years (17th lowest)

Like in a number of states where life tends to be more difficult for elderly residents, violence in Nevada may contribute to higher stress levels and disproportionately impact the elderly. Researchers have found that for older individuals — especially those living in poverty — even the perception of poor neighborhood safety can damage health in old age. Nevada’s violent crime rate of 636 incidents per 100,000 people in a single year is the worst in the nation after only Alaska. The median income among Nevada’s older households and the poverty rate of 65 and older residents, at $40,482 and 8.3%, are each better than the corresponding national averages and exceptionally strong compared with the worst states in which to grow old.

Still, Nevada’s elderly seem to be struggling financially in other ways. More than 58% of elderly renters pay more than 30% of their income for housing, for example, the sixth highest percentage. Also, more than one in 10 seniors in the state struggle to afford food, one of the highest levels of food insecurity. When basic necessities such as housing, food, and out-of-pocket medical expenses are considered, Nevada’s supplemental poverty rate is actually the second highest in the country.

50. Mississippi
> Pct. of pop. age 65 and up: 14.3% (17th lowest)
> 65 and over poverty rate: 13.2% (the highest)
> 65 and over bachelor attainment: 19.1% (6th lowest)
> Life expectancy at birth: 74.5 years (the lowest)

Mississippi — and its population overall — often ranks last in many social and economic measures, the state’s elderly population also reports some of the nation’s worst outcomes compared to older Americans in other states. More than one in four residents 65 and older did not graduate from high school, the second highest such proportion in the country. The low level of education among Mississippi’s elderly residents partially explains the similarly low incomes. A typical household in the state headed by an elderly resident earns $30,254 annually, the lowest in the country. Additionally, the elderly poverty rate of 13.2% in the state is the highest compared to poverty rates of seniors living elsewhere. Older Americans are among the most vulnerable to chronic diseases and disabilities, and this is especially the case in Mississippi. Of noninstitutionalized residents 65 and over, 44.5% have a disability, the highest percentage nationwide. Relatively poor health among elderly Mississippians likely partially explains the state’s low life expectancy at birth, which at less than 75 years is the lowest of all states.

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 indicate better outcomes. For example, rather than use the percentage of the population with a disability, our index uses the percentage of people 65 and older 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 value for 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 index values for each category.

Included in the income category are data from the U.S. Census Bureau’s 2014 American Community Survey (ACS) for the 65 and older population’s retirement income, poverty rates, and median household income. The health category includes data from the Census Bureau on the percentage of noninstitutionalized people 65 and over with a disability. Also included are data on the percentage of seniors who struggle to afford food — known as the food insecurity rate — from Feeding America’s 2013 report, Spotlight on Senior Hunger.

We also included 2010 life expectancy at birth from the Institute for Health Metrics and Evaluation, a global health research center affiliated with the University of Washington, the percentage of adults who reported having a personal doctor in 2013 from the Kaiser Family Foundation, as well as the 2013 crude elderly mortality rate per 100,000 people 65 and over in each state from the CDC.

The labor category incorporates data from the ACS on the share of people 65 and over with a bachelor’s degree or higher, as well as 2014 employment rates for people aged 55-64 from the Bureau of Labor Statistics (BLS).

The environment and access category includes 2014 violent crime rates from the FBI’s Uniform Crime Report and the share of workers who walk or use public transportation from the ACS. In addition, this category includes data on the number of social establishments — restaurants, libraries, civic organizations, among others — as well as the number of hospitals in the state. Both numbers are adjusted for population.

Click here to see the best (and worst) states to grow old.

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