Most working Americans spend roughly five decades in the labor force, supporting themselves, their families, and saving for retirement. For many, financial stability is the foremost concern for a comfortable retirement. However, the opportunities that open up in retirement and the quality of life in old age depend a great deal on one thing: health.

The health of older Americans varies considerably across the country and between states. 24/7 Wall St. used 17 health indicators from the Centers for Disease Control and Prevention’s “Healthy Aging Program” to assess the health of Americans 65 and older in each state. These health indicators are grouped into three categories: preventive care, behaviors, and health outcomes.

Staying up-to-date on key preventive care services, as well as maintaining healthy behaviors such as eating a nutritious diet, engaging in regular physical activity, and refraining from tobacco use, all help reduce the risk of adverse health outcomes in old age. These healthy habits are common among older residents of the states at the top of this list.

Life expectancy at birth also tends to be higher in the states with the healthiest 65 and older populations. While a long life is not necessarily a healthy one, longevity is one of the best indicators of health in a community as it usually results from health institutions functioning effectively. In old age, which is often characterized by more frequent doctor visits, the quality of an area’s health care system can matter a great deal.

Click here to see the best states for a healthy retirement.
Click here to read our detailed findings & methodology.

50. Louisiana
> Disability, 65+: 43.1% (2nd highest)
> Obesity rate, 65+: 35.3% (the highest)
> Flu vaccine in the past year, 65+: 51.6% (3rd lowest)
> Life expectancy at birth: 75.8 years (3rd lowest)

Seniors in Louisiana are more likely to struggle with significant health factors than those in any other state. Some 43.1% of the 65 and older population in the state has a disability, the second highest share of all states. Having a disability, especially a physical one, can hinder one’s ability to exercise. Nearly 39% of older Louisianans do not exercise, much more than the 32.3% of older adults nationwide who are physically inactive. Leading a sedentary lifestyle is one of the key causes of obesity, and in Louisiana, 35.3% of older adults are obese, the highest share nationwide.

Louisiana seniors also receive one of the lowest retirement incomes of any other state at just $22,534 per year, less than the comparable national income of $26,483. Insufficient income can impose significant stress on an individual, and in Louisiana 10% of older adults report frequent mental distress, the second largest share in the country.

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49. Arkansas
> Disability, 65+: 42.4% (3rd highest)
> Obesity rate, 65+: 27.6% (19th lowest)
> Flu vaccine in the past year, 65+: 53.8% (6th lowest)
> Life expectancy at birth: 76.2 years (6th lowest)

Arkansas ranks as the second worst state for a healthy retirement mostly because of the relatively poor physical and mental health of the senior population. One in 10 senior residents report regular mental distress, the second largest share of any state. In addition, Arkansas seniors report an average of 6.5 physically unhealthy days per month, the fourth highest number nationwide.

Leading a healthy lifestyle typically requires regular doctor visits and getting necessary screenings and other preventive care. Only 34.9% of older women in Arkansas are up-to-date on select clinical preventive services, and only 61.6% have had a mammogram in the past two years — both the third lowest shares nationwide.

48. Mississippi
> Disability, 65+: 41.4% (6th highest)
> Obesity rate, 65+: 31.0% (7th highest)
> Flu vaccine in the past year, 65+: 61.5% (16th highest)
> Life expectancy at birth: 74.9 years (the lowest)

Mississippi seniors are among the least healthy in the nation. Approximately 70% of older adults in this state have high blood pressure, which is one of the leading causes of health complications such as cardiovascular disease and stroke. Mississippi’s share of seniors with high blood pressure is the second highest among states and much higher than the 61.7% share of seniors with high blood pressure nationwide.

The average life expectancy at birth in Mississippi is 74.9 years, far less than the national average of 79 years and the lowest among all states. Low life expectancy at birth often reflects low quality health services and generally poor health in a population.

47. New Mexico
> Disability, 65+: 40.0% (11th highest)
> Obesity rate, 65+: 24.0% (4th lowest)
> Flu vaccine in the past year, 65+: 56.8% (16th lowest)
> Life expectancy at birth: 78.4 years (17th lowest)

Seniors in New Mexico are among the least likely to receive screening deemed essential by the CDC. For example, 34% of older adults do not receive regular screenings for colorectal cancer, and 40% of older women in the state have not had a mammogram in the past two years — both the highest shares in the country. In addition, older men and women in this state are less likely to be up-to-date on recommended clinical preventive services, which includes both screenings and vaccinations. Only 42.1% of senior men and 34.9% of senior women are up-to-date with such services, both of which fall below the respective national shares.

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46. Kentucky
> Disability, 65+: 39.3% (16th highest)
> Obesity rate, 65+: 31.0% (7th highest)
> Flu vaccine in the past year, 65+: 59.5% (21st highest)
> Life expectancy at birth: 76.3 years (7th lowest)

The senior population in Kentucky exhibits some of the least healthy behaviors of any state. The smoking rate among older Kentucky adults of 12.4% is the second highest share nationwide. In addition, over 40% of seniors in Kentucky do not exercise on a regular basis, the highest share of all states. Both of these unhealthy behaviors likely contribute to state seniors reporting feeling physically unhealthy during nearly 7 days per month, more than any other state.

Mental health is just as significant as physical health and can greatly affect one’s day-to-day routine. In Kentucky, 18.5% of seniors have had or are currently struggling with depression, the highest share of any state.

45. Nevada
> Disability, 65+: 34.3% (10th lowest)
> Obesity rate, 65+: 25.7% (11th lowest)
> Flu vaccine in the past year, 65+: 54.0% (8th lowest)
> Life expectancy at birth: 78.1 years (15th lowest)

Preventive care is essential for detecting and treating health problems. Only 39.5% of men and 34.4% of women are up-to-date on select clinical preventive services, the fifth lowest and lowest shares, respectively, nationwide. In addition, only 61.1% of senior women in Nevada received a screening for breast cancer in the past two years, the second lowest share of all states.

Another form of preventive care is receiving an annual influenza vaccination. It is of paramount importance for older adults to get a flu shot because contracting the flu can be life-threatening for older individuals. Only 54% of seniors in Nevada received a flu shot last year, the eighth lowest share among states.

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44. Texas
> Disability, 65+: 36.4% (24th lowest)
> Obesity rate, 65+: 30.0% (16th highest)
> Flu vaccine in the past year, 65+: 57.3% (21st lowest)
> Life expectancy at birth: 78.5 years (19th lowest)

Seniors in Texas are among the least likely in the country to receive their recommended preventive care. Only 39.0% of senior men and 38.6% of senior women are up-to-date on the CDC’s recommended set of clinical preventive services. Both rates are among the lowest in the country. In addition, only 65.6% of senior women in the state received a mammogram in the past two years, and only 72.2% of all senior adults receive regular tests for colorectal cancer. Each of these shares falls below the national averages of 68.8% and 76.2%.

43. Alaska
> Disability, 65+: 41.3% (7th highest)
> Obesity rate, 65+: 35.3% (the highest)
> Flu vaccine in the past year, 65+: 53.9% (7th lowest)
> Life expectancy at birth: 78.4 years (18th lowest)

Perhaps the most alarming health complication among seniors in Alaska is the obesity rate. More than 35% of adults are obese, the highest share of any state. Obesity is more prevalent among disabled individuals than among non-disabled individuals. Some 41.3% of elderly adults in the state have a disability, the seventh highest share among states.

Another concern among seniors in Alaska is dental health, which often becomes more of an issue with age. Of seniors in the state, 68.8% reported having lost several teeth from decay or gum disease compared with the national share of 63.8%.

42. Oklahoma
> Disability, 65+: 42.3% (4th highest)
> Obesity rate, 65+: 30.4% (14th highest)
> Flu vaccine in the past year, 65+: 64.3% (7th highest)
> Life expectancy at birth: 76.1 years (5th lowest)

Seniors in Oklahoma are some of the least healthy in the nation, partially because of their poor dietary habits. Only 27.6% of older adults eat two or more servings of fruit on a daily basis, and only 11.4% eat three or more servings of vegetables every day. Each of these rates are among the lowest of any state and well below the national averages of 38.5% for fruit and 18.8% for vegetable consumption.

Seniors in Oklahoma are also less likely to engage in regular physical activity than seniors in almost any other state. Some 40.4% lead sedentary lifestyles, the second highest share of all states. Poor nutrition, coupled with minimal-to-no-exercise, can lead to many health complications, including obesity, diabetes, and high blood pressure. In Oklahoma, nearly two-thirds of older adults have high blood pressure, the ninth highest share in the nation.

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41. Idaho
> Disability, 65+: 36.5% (25th highest)
> Obesity rate, 65+: 25.2% (10th lowest)
> Flu vaccine in the past year, 65+: 53.5% (5th lowest)
> Life expectancy at birth: 79.5 years (20th highest)

Seniors in Idaho are far less likely to receive preventive screenings than seniors in most other states. For example, only 39.7% of men and 39.8% of women are up-to-date with the recommended preventive services, each of which are among the 10 lowest shares nationwide. Additionally, only 61.9% of women 65 and over have had a mammogram within the past two years, the fourth lowest share nationwide. Receiving a flu shot annually is also considered preventive care, and only 53.5% of seniors in Idaho got one last year, less than all but a handful of states.

40. Tennessee
> Disability, 65+: 37.1% (20th highest)
> Obesity rate, 65+: 28.6% (25th highest)
> Flu vaccine in the past year, 65+: 56.8% (16th lowest)
> Life expectancy at birth: 76.3 years (8th lowest)

According to the CDC, nearly 1 in 5 deaths in the United States are caused by smoking cigarettes, and in Tennessee, 13.2% of seniors smoke often or every day, the highest share of any state. Smoking can also lead to high blood pressure, which increases the risk of developing coronary heart disease and stroke. Some 68% of seniors in the state have high blood pressure, the sixth highest share of any state.

Poor mental health can significantly hinder quality of life. In Tennessee. 8.3% of older adults report frequent mental distress, or at least 14 mentally unhealthy days in a given month. For perspective, only 7.3% of seniors nationwide report the same.

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39. Alabama
> Disability, 65+: 43.6% (the highest)
> Obesity rate, 65+: 29.6% (20th highest)
> Flu vaccine in the past year, 65+: 59.8% (20th highest)
> Life expectancy at birth: 75.7 years (2nd lowest)

A nutritious diet can contribute to a healthy and long life, and seniors in Alabama are less likely to consume the daily recommended servings of fruits and vegetables. Only 23.5% of seniors in the state eat two or more servings of fruit and only 12.0% eat three or more servings of vegetables every day, the lowest and fourth lowest shares of all states, respectively. Seniors in Alabama also report the fifth highest share of high blood pressure incidence.

Alabama’s life expectancy at birth is 75.7 years, the second lowest of any state. Low life expectancy often reflects low quality health services and generally poor health in a population.

38. Indiana
> Disability, 65+: 34.0% (9th lowest)
> Obesity rate, 65+: 30.6% (12th highest)
> Flu vaccine in the past year, 65+: 55.2% (11th lowest)
> Life expectancy at birth: 77.7 years (11th lowest)

Adults 65 and over in Indiana exhibit a handful of unhealthy behaviors. Despite it being one of the main killers in the United States, smoking remains a serious health issue across the country. In Indiana, older state residents are more likely to smoke than seniors in most other states. Some 11.6% smoke often or every day, the fourth highest share in the nation. And Indiana seniors are less likely to exercise and more likely to be obese compared with older residents of other states.

Access to preventive care for Indiana’s older population may also be a problem in the state. Residents 65 and over are some of the least likely older Americans to get a flu shot, and receive screenings for colorectal cancer.

37. Arizona
> Disability, 65+: 34.0% (9th lowest)
> Obesity rate, 65+: 25.9% (15th lowest)
> Flu vaccine in the past year, 65+: 53.1% (4th lowest)
> Life expectancy at birth: 79.6 years (17th highest)

Seniors in Arizona are more likely to experience frequent mental distress than seniors across the United States. Approximately 8.4% of older Arizonans report at least 14 mentally unhealthy per month, the seventh highest percentage nationwide. Relatedly, the percentage of older state residents who have had or are currently struggling with depression is higher than the national average.

Seniors in the state are also not as likely to get the preventive care they need to avoid illnesses and diseases. For example, only 53.1% of seniors received their flu shot last year, the fourth lowest share among all states. Additionally, only 38.1% of older women are up-to-date with the recommended clinical preventive services, the fifth lowest share in the nation.

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36. Wyoming
> Disability, 65+: 37.5% (18th highest)
> Obesity rate, 65+: 25.8% (13th lowest)
> Flu vaccine in the past year, 65+: 57.3% (21st lowest)
> Life expectancy at birth: 78.6 years (20th lowest)

Like in many states with poor health among older residents, seniors in Wyoming are less likely than the average older American to receive the preventive care and screenings they need. For example, only 69.6% of seniors participate in regular screenings for colorectal cancer, the third lowest share nationwide.

Seniors in Wyoming are slightly more likely than older residents of other states to incur injuries from falling. Nearly 12% of the 65 and older population in the state received an injury from falling, the eighth largest share of all states. Nationwide, 10.9% of seniors were injured due to a fall.

35. New Jersey
> Disability, 65+: 32.2% (3rd lowest)
> Obesity rate, 65+: 27.9% (22nd lowest)
> Flu vaccine in the past year, 65+: 60.9% (18th highest)
> Life expectancy at birth: 80.0 years (10th highest)

New Jersey has one of the highest life expectancies at birth in the nation. Someone born in New Jersey today is projected to live 80 years, the 10th longest life expectancy among states.

In general, this is a strong indication of good health across the population and reflects well on the health care system in New Jersey.

Still, seniors in the state are more likely to lead sedentary lifestyles than those in other states — 38.2% of seniors are physically inactive, the eighth highest share nationwide. Regular exercise is beneficial for both physical and mental health. It is possible that the higher share of older state residents who are not active may be associated with the above-average share of those who experience frequent mental distress. Some 8.3% report feeling mentally unhealthy at least 14 days of the month, one of the highest shares in the nation.

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34. Georgia
> Disability, 65+: 36.8% (23rd highest)
> Obesity rate, 65+: 31.0% (7th highest)
> Flu vaccine in the past year, 65+: 58.1% (24th lowest)
> Life expectancy at birth: 77.4 years (10th lowest)

Georgia seniors are more likely than the average senior in the United States to engage in some behaviors that can be detrimental to health. More than 39% of the 65 and older population in the state leads a sedentary lifestyle, and nearly 11% of older adults smoke often or every day. Both rates are among the highest in the nation.

Lack of exercise has likely contributed to Georgia’s high older adult obesity rate of 31.0%, which is much greater than the national rate of 27.9%. Together, the lack of exercise and smoking may explain why Georgia seniors are more prone to having high blood pressure. Nearly 70% of older adults in the state have high blood pressure, the third highest share nationwide.

33. Illinois
> Disability, 65+: 34.6% (16th lowest)
> Obesity rate, 65+: 30.8% (11th highest)
> Flu vaccine in the past year, 65+: 56.5% (13th lowest)
> Life expectancy at birth: 79.0 years (25th lowest)

Access to preventive care such as screenings necessary to detect cancer in Illinois is only slightly worse than it is across the country. Approximately 41.4% of men and 40.4% of women are up-to-date on recommended preventive care procedures, each of which fall just below the national averages of 43.1% and 43.0%. This age group is considerably less likely than older Americans nationwide to participate in regular screenings for colorectal cancer — only 71.9% of older Americans in Illinois participate, compared with the 76.2% of those who do nationwide.

Older Illinois residents were injured more from falls than older Americans in other states. Some 12% of seniors in the state sustained an injury from a fall in 2016, the seventh highest share nationwide.

32. West Virginia
> Disability, 65+: 41.7% (5th highest)
> Obesity rate, 65+: 32.4% (4th highest)
> Flu vaccine in the past year, 65+: 67.5% (the highest)
> Life expectancy at birth: 76.0 years (4th lowest)

Older West Virginia residents have some of the nation’s better access to recommended preventive care, with both men and women reporting up-to-date status in most preventive treatments. More than two in three West Virginia seniors received their influenza vaccination in 2016, the highest proportion out of all states.

However, when it comes to eating healthy, seniors in the state fail to incorporate enough fruits and vegetables in their diet. Some 24.5% of seniors eat at least two servings of fruit per day, and 11.3% eat at least three servings of vegetables each day — each some of the lowest shares in the nation. The alternative is often a diet consisting of more processed and packaged foods, which can lead to excess weight gain overtime. As in many other states reporting such poor diets, West Virginia’s older adult obesity rate of 32.4% is the fourth highest rate nationwide.

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31. South Carolina
> Disability, 65+: 39.5% (13th highest)
> Obesity rate, 65+: 28.7% (23rd highest)
> Flu vaccine in the past year, 65+: 61.9% (12th highest)
> Life expectancy at birth: 76.9 years (9th lowest)

Seniors may be up-to-date on their screenings and vaccinations in South Carolina, but they do not report the best health outcomes. For example, 67% of seniors in the state have high blood pressure, the seventh highest share nationwide. Mental health is just as important as physical health when it comes to living a long healthy life, and nearly 18% of South Carolina seniors have had or currently struggle with depression, far greater than the 13.5% of seniors who have depression nationwide.

A person born today in South Carolina is projected to live approximately 77 years, one of the lowest life expectancies compared with other states. In general, this is an indication of a relatively ineffective health care system and reflects poorly on the health of the state’s population.

30. Kansas
> Disability, 65+: 37.4% (19th highest)
> Obesity rate, 65+: 28.9% (22nd highest)
> Flu vaccine in the past year, 65+: 54.7% (9th lowest)
> Life expectancy at birth: 78.7 years (22nd lowest)

Getting the flu at an older age can be life-threatening, and in Kansas, only 54.7% of older adults got their flu shot in 2016, well below the national share of 58.6%. Seniors in Kansas are also more likely to smoke than those in other states. Nearly 10% of adults 65 and over smoke often if not every day, which exceeds the national older adult smoking rate of 8.6%.

Dental health also becomes more of a concern as one ages. Nearly 69% of adults 65 and older in Kansas have lost teeth from decay or gum disease, the 11th highest percentage of all states.

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29. Michigan
> Disability, 65+: 38.1% (17th highest)
> Obesity rate, 65+: 32.2% (5th highest)
> Flu vaccine in the past year, 65+: 56.0% (12th lowest)
> Life expectancy at birth: 78.3 years (16th lowest)

An individual born in Michigan today is projected to live about 78 years, just below the national average life expectancy at birth of about 79 years. As in other states with relatively low life expectancies, in Michigan it coincides with several other poor health outcomes.

Seniors in Michigan are more likely to be obese and have high blood pressure than seniors in most other states. Over 32% of seniors in the state are obese, the fifth highest share among all states, and 62.4% of seniors have high blood pressure, the 16th highest share in the nation.

Older women in Michigan appear to be proactive about their health when it comes to getting screened for breast cancer. The likelihood of getting breast cancer increases with age, and an impressive 72.3% of women 65 and over in the state have received a mammogram in the past two years, the 10th highest share of all states.

28. Montana
> Disability, 65+: 39.5% (13th highest)
> Obesity rate, 65+: 24.3% (5th lowest)
> Flu vaccine in the past year, 65+: 57.1% (18th lowest)
> Life expectancy at birth: 78.9 years (24th lowest)

Seniors in Montana are some of the least obese in the nation, with only 24.3% considered obese compared to the 27.9% of seniors who are obese nationwide. Older Montana residents are also much less likely to have high blood pressure than seniors in a majority of states. Only 54% have high blood pressure, the lowest share in all but two states.

Montana’s 65 and older population likely needs to get screened for colorectal cancer more frequently. The chances of developing colorectal cancers increases goes up with age, and only 69.6% of adults 65 and over in Montana have been screened for it, the third lowest share of all states.

27. Ohio
> Disability, 65+: 35.2% (19th lowest)
> Obesity rate, 65+: 29.7% (19th highest)
> Flu vaccine in the past year, 65+: 57.3% (21st lowest)
> Life expectancy at birth: 77.9 years (14th lowest)

Disability in old age is about as likely in Ohio as it is in most other states. Approximately 35.2% of those 65 and older have a disability, compared to 36.3% of seniors nationwide.

Ohio seniors do not exhibit the healthiest behaviors. Some 10.6% of seniors in the state smoke often if not every day, the ninth highest share in the nation. Older adults the state are also more likely than older residents of other states to be obese. Ohio’s older adult obesity rate is 29.7%, versus national rate for 65 and over Americans of 27.9%.

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26. Oregon
> Disability, 65+: 41.1% (8th highest)
> Obesity rate, 65+: 27.7% (20th lowest)
> Flu vaccine in the past year, 65+: 51.4% (2nd lowest)
> Life expectancy at birth: 79.4 years (22nd highest)

Older residents of Oregon are among the most likely to eat healthily and exercise. Some 22.5% of Oregonians age 65 and over eat three or more servings of vegetables a day, one of the higher percentages of all states. Just 18.8% of elderly Americans eat at least that many vegetables each day. Elderly Oregon residents are also the second most likely to report regular exercise routines. In the last month, 77.6% reported regular physical activity, about 10 percentage points greater than the national average.

Yet that same population is among the worst in the country at staying up-to-date with preventive screenings. For example, just 63.8% of older women in the state had a mammogram in the past two years, one of the lowest rates in the nation. Older men in Oregon are the second most likely to be behind on recommended clinical preventive care.

25. Utah
> Disability, 65+: 37.1% (20th highest)
> Obesity rate, 65+: 26.8% (17th lowest)
> Flu vaccine in the past year, 65+: 54.9% (10th lowest)
> Life expectancy at birth: 79.9 years (13th highest)

Utah is one of the healthiest places to retire, partially because of seniors’ healthy habits. Seniors in this western state are less likely to be obese, more likely to exercise regularly, and less likely to smoke compared to most states. In fact, only 3.7% of seniors in Utah smoke, the lowest share of any state. These healthy behaviors have likely contributed to the senior population’s low prevalence of high blood pressure. Only 56.4% of those 65 and older in Utah have high blood pressure, much less than the 61.7% of seniors nationwide.

While over 90% of older residents of all states receive regular cholesterol screenings, the frequency of checks among Utah’s older population has room for improvement. The 91.7% of seniors who received a cholesterol screening in the past five years is the lowest share of all states.

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24. Wisconsin
> Disability, 65+: 34.6% (16th lowest)
> Obesity rate, 65+: 34.6% (3rd highest)
> Flu vaccine in the past year, 65+: 49.5% (the lowest)
> Life expectancy at birth: 79.8 years (14th highest)

Wisconsin’s elderly residents are among the most likely to be obese. Nearly 35% of the state’s older adults are obese, the third highest proportion of all states and well over the nationwide obesity rate for the age group of less than 28%. Accessing critical preventive care may also be a problem in the state. Only 49.5% of Wisconsin older population received an influenza vaccine in the past year, the lowest share among states.

On the positive side, Wisconsin’s elderly population is one of the least likely to smoke. Some 7.3% of older adults in the state are smokers, well below the comparable national rate of 8.6%.

23. Missouri
> Disability, 65+: 39.9% (12th highest)
> Obesity rate, 65+: 30.0% (16th highest)
> Flu vaccine in the past year, 65+: 64.8% (4th highest)
> Life expectancy at birth: 77.7 years (12th lowest)

Older residents of Missouri appear to have better access to preventive health care than older populations of other states. Both older men and older women are among the most likely to be up-to-date with clinical preventive services, such as cancer screenings and vaccinations. Some 64.8% of older adults in the state were vaccinated against the influenza virus in 2016, the fourth highest rate in the country.

A relatively large share of Missouri’s older population struggles with mental health issues. The percentage of residents 65 and over who have had or currently struggle with depression, at 16.9%, is the 10th highest share nationwide. Nationwide, 13.5% of older Americans have been diagnosed with depression.

22. Nebraska
> Disability, 65+: 36.6% (24th highest)
> Obesity rate, 65+: 29.9% (18th highest)
> Flu vaccine in the past year, 65+: 62.6% (11th highest)
> Life expectancy at birth: 79.6 years (17th highest)

Seniors in Nebraska are proactive about receiving preventive care. Both elderly men and women are more likely to be up-to-date with their core clinical preventive services than seniors in most other states. Seniors in the state are also more likely to get their flu shot. Some 62.6% received their vaccination in the last year, more than the 58.6% of seniors who did nationwide.

However, older adults in the state are not healthy by all measures. Adults 65 and over in Nebraska are more likely to be obese, have depression, and smoke than in other states.

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21. New York
> Disability, 65+: 37.1% (20th highest)
> Obesity rate, 65+: 24.6% (6th lowest)
> Flu vaccine in the past year, 65+: 59.5% (21st highest)
> Life expectancy at birth: 80.4 years (6th highest)

Seniors in New York state exhibit relatively healthy behaviors. For example, compared with older residents of most states, they are more likely to eat at least two servings of fruit and at least three servings of vegetables every day, exercise regularly, and are less likely to smoke. As in most states where older residents report such healthy behaviors, New York’s senior population’s low obesity rate, at just 24.6%, is among the lowest shares nationwide.

Seniors in this East Coast state also report one of the lowest rates of depression in the nation. Only 10% of older New York residents have struggled with depression, the fifth lowest share of any state.

20. Florida
> Disability, 65+: 33.6% (7th lowest)
> Obesity rate, 65+: 25.8% (13th lowest)
> Flu vaccine in the past year, 65+: 57.4% (22nd lowest)
> Life expectancy at birth: 79.5 years (21st highest)

With by far the largest proportion of residents 65 and over, Florida is one of the country’s most popular retirement destinations. But the state’s senior population is far from the healthiest. Older Americans in Florida are less likely to get a flu vaccination and are less likely to regularly engage in physical activity than is typical nationwide.

The elderly population in Florida is ahead of most other states when it comes to receiving cancer screenings. Some 72.8% of women 65 and older had a mammogram screening within the past two years, the sixth largest share of all states. In addition, 78% of seniors get screened regularly for colorectal cancer, versus the 76.2% of older Americans nationwide who do. Compared with older populations of other states, seniors in Florida are also less likely to be obese and have high blood pressure.

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19. North Dakota
> Disability, 65+: 35.9% (21st lowest)
> Obesity rate, 65+: 32.1% (6th highest)
> Flu vaccine in the past year, 65+: 58.6% (25th lowest)
> Life expectancy at birth: 80.0 years (12th highest)

Seniors in North Dakota are the least likely to struggle with mental health issues than older Americans in any other state. Only 4.2% of seniors say they experience mental distress frequently, the lowest share of all states and well below the comparable 7.3% share nationwide. Mental distress and depression are often related, and only 9.2% of seniors have depression in North Dakota, the second lowest share in the nation.

Life expectancy is also high in North Dakota. An individual born today in North Dakota is expected to live 80 years, one of the highest life expectancies in the country.

18. Washington
> Disability, 65+: 40.2% (9th highest)
> Obesity rate, 65+: 28.3% (23rd lowest)
> Flu vaccine in the past year, 65+: 59.1% (24th highest)
> Life expectancy at birth: 80.0 years (11th highest)

Seniors in Washington state are more likely to lead healthy lifestyles than those in much of the rest of the country. For example, adults 65 and over are more likely to eat their daily recommended servings of fruits and vegetables than seniors in most other states. Washington seniors also tend to be physically active. Some 77% of seniors exercise, the third largest share nationwide. Eating a healthful diet and exercising regularly can help reduce the likelihood of developing high blood pressure. Less than 60% of the older adult population in Washington has high blood pressure, below the national average of 61.7%.

17. Hawaii
> Disability, 65+: 26.3% (the lowest)
> Obesity rate, 65+: 16.0% (the lowest)
> Flu vaccine in the past year, 65+: 56.8% (16th lowest)
> Life expectancy at birth: 81.2 years (the highest)

Seniors in Hawaii rank are relatively healthy, due to their habits and way of life. Some 28.9% of seniors in the state report eating at least three servings of vegetables every day, the highest share of any state. Eating a diet full of fresh produce and minimal processed foods can help keep excess weight off. With such a high vegetable consumption, it is not surprising that seniors in Hawaii are also the least likely to be obese than seniors in any other state. Only 16.0% of state seniors are obese, well below the comparable national rate of 27.9%.

Seniors in Hawaii are also the least likely to be depressed and have a disability than seniors in any other state.

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16. Vermont
> Disability, 65+: 34.5% (12th lowest)
> Obesity rate, 65+: 25.9% (15th lowest)
> Flu vaccine in the past year, 65+: 59.0% (25th highest)
> Life expectancy at birth: 80.2 years (7th highest)

Seniors in Vermont are much more likely to eat the recommended servings of fruit and vegetables each day than seniors in most other states. Seniors in the state are also more likely to be physically active and are less likely to smoke. Due in part to these healthy habits, seniors in Vermont report relatively good health outcomes. For example, only 25.9% of the 65 and over population is obese, less than the 27.9% of seniors who are obese nationwide. Seniors in Vermont are also less likely to have high blood pressure. Some 57.4% have high blood pressure, much less than the national average of 61.7%.

15. North Carolina
> Disability, 65+: 40.2% (9th highest)
> Obesity rate, 65+: 28.6% (25th highest)
> Flu vaccine in the past year, 65+: 64.7% (5th highest)
> Life expectancy at birth: 77.9 years (13th lowest)

Seniors in North Carolina are ahead of most states when it comes to preventive care and treatment. For example, nearly 49% of men are up-to-date on their core clinical preventive services such as specific vaccinations and screenings, the fifth highest share in the nation. Some 48.2% of women are up-to-date on their core clinical preventive services as well, the eighth highest share of any state.

Seniors in the state are more likely to get screened regularly for colorectal cancer, cholesterol, and get their flu shot, and they are less likely to lose teeth from decay or gum disease. Senior women in North Carolina are also more likely to have mammograms every two years.

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14. California
> Disability, 65+: 36.2% (22nd lowest)
> Obesity rate, 65+: 23.5% (3rd lowest)
> Flu vaccine in the past year, 65+: 58.1% (24th lowest)
> Life expectancy at birth: 80.8 years (3rd highest)

California seniors are much less likely to be obese than the average American 65 and older. The 23.5% obesity rate among senior citizens in the state is the third lowest among states and well below the 27.9% comparable U.S. rate.

Seniors in the state are also less likely than most to struggle financially during retirement. The average retirement income is $33,712 a year. Only one other state has a higher mean retirement income and the U.S. mean retirement income is $26,483 annually.

13. South Dakota
> Disability, 65+: 39.4% (15th highest)
> Obesity rate, 65+: 27.3% (18th lowest)
> Flu vaccine in the past year, 65+: 63.3% (8th highest)
> Life expectancy at birth: 79.6 years (19th highest)

Older women in South Dakota are among the most likely Americans to get preventive screenings to ensure they are healthy. Approximately half of women 65 and older, 50.8%, are up-to-date with preventive services like vaccinations and cancer screenings. Some 72.9% of South Dakota’s older women received a mammogram in the past two years, the fourth largest share of all states.

Retirement age South Dakota residents may be more likely than most to struggle financially. The state’s average annual retirement income among households 65 and older is just $19,696, well below the $26,483 average retirement income nationwide.

12. Virginia
> Disability, 65+: 32.5% (6th lowest)
> Obesity rate, 65+: 27.8% (21st lowest)
> Flu vaccine in the past year, 65+: 63.0% (9th highest)
> Life expectancy at birth: 79.2 years (24th highest)

Wealthier individuals are more likely to make regular doctor visits and receive preventive care, and older Virginia residents tend to be relatively financially secure. The average retirement income among households 65 and older is $32,146 a year, well above the comparable $26,483 average income nationwide.

Seniors in Virginia are much more likely to receive preventive screenings than seniors in most other states. For example, 48.8% of older men and 47.3% of older women in the state are up-to-date on recommended clinical preventive services, the sixth and 11th highest shares nationwide, respectively.

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11. Massachusetts
> Disability, 65+: 34.9% (18th lowest)
> Obesity rate, 65+: 25.1% (8th lowest)
> Flu vaccine in the past year, 65+: 57.0% (17th lowest)
> Life expectancy at birth: 80.4 years (5th highest)

Retirement age adults in Massachusetts tend to have relatively healthy diets. Some 22.8% of older adults in the state eat three or more servings of vegetables each day, compared to 18.8% of older adults nationwide. Also, 49.0% of elderly state residents eat two or more servings of fruit daily, the largest share among states. Healthy eating habits may are a factor in the state’s lower than average 25.1% senior obesity rate. For reference, 27.9% of elderly Americans are obese.

Exercising regularly is an important component of a healthy lifestyle. Nearly 72% of Massachusetts seniors are physically active, well above the 67.7% of seniors who do exercise nationwide.

10. Pennsylvania
> Disability, 65+: 34.6% (16th lowest)
> Obesity rate, 65+: 30.5% (13th highest)
> Flu vaccine in the past year, 65+: 65.3% (3rd highest)
> Life expectancy at birth: 78.8 years (23rd lowest)

Some 52.5% of men 65 and older in Pennsylvania are up-to-date on core preventive care screening tests and vaccinations recommended for seniors, the largest share of all states. These clinical preventive services can help stave off illnesses and catch minor ones before they become life threatening. Some 96.1% of seniors had a cholesterol screening in the past five years, and 65.3% were vaccinated against the flu in the last year. Both rates are among the top 10 in the country.

Pennsylvania seniors are also among the least likely in the country to report frequent mental distress. Only 5.9% of older state residents report at least 14 mentally unhealthy days in a given month, well below the national share of 7.3%.

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9. Rhode Island
> Disability, 65+: 34.7% (17th lowest)
> Obesity rate, 65+: 25.2% (10th lowest)
> Flu vaccine in the past year, 65+: 60.4% (19th highest)
> Life expectancy at birth: 79.8 years (15th highest)

The American Cancer Society recommends that women 50 and over should get a mammogram every two years. In Rhode Island, 76.6% of women 65 and older have been screened for breast cancer over the past two years, the second largest share in the country. Adults 65 and over in Rhode Island are more likely to be up-to-date with cholesterol screenings — 96.4% of seniors were tested in the past five years, the fifth highest share nationwide.

Outcomes in the state are also generally positive. Just over a quarter of Rhode Island’s older residents are obese compared to 27.9% of older Americans nationwide. The state’s seniors also reported an average of 4.7 physically unhealthy days in the last month, less than the 5.2 day average the senior population reported nationwide.

8. Delaware
> Disability, 65+: 32.5% (6th lowest)
> Obesity rate, 65+: 30.4% (14th highest)
> Flu vaccine in the past year, 65+: 61.7% (14th highest)
> Life expectancy at birth: 78.7 years (21st lowest)

Higher income Americans are more likely to make regular doctor visits and receive preventive care. In Delaware, the average retirement income among households 65 and older is $29,540, about $3,000 more than the comparable national average. An impressive 78.7% of older women in Delaware received a mammogram in the past two years, the largest share among all states and nearly 10 percentage points above the national average. Older state residents are also more likely to receive regular screenings for colorectal cancer — some 80.5% of residents 65 and over in Delaware participate in such screenings, the third highest share nationwide.

Seniors in Delaware also appear to be in relatively good physical health. The state’s older population as a whole averaged 4.3 days of poor physical health in the last month, nearly a full day below the national average.

7. Connecticut
> Disability, 65+: 36.5% (25th highest)
> Obesity rate, 65+: 24.9% (7th lowest)
> Flu vaccine in the past year, 65+: 59.2% (23rd highest)
> Life expectancy at birth: 80.6 years (4th highest)

Older Connecticut residents are more likely to report positive mental and physical health, in comparison with all other states. Connecticut seniors report an average of 4.2 physically unhealthy days in a given month, tied for the least amount of days in the nation. Only 5.6% of state residents 65 and over reported feeling frequent mental distress, well below the national average of 7.3%.

Wealth and health are often closely linked, and few states have seniors who are as financially well-off as Connecticut. Only 6.5% of state residents 65 and over live below the poverty level, the third lowest percentage nationwide. For households 65 and older, the mean retirement income in Connecticut is $29,931 a year, about $3,500 more than the national average.

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6. Maryland
> Disability, 65+: 34.6% (16th lowest)
> Obesity rate, 65+: 29.2% (21st highest)
> Flu vaccine in the past year, 65+: 61.2% (17th highest)
> Life expectancy at birth: 79.2 years (25th highest)

Maryland’s elderly population tends to exhibit relatively healthy lifestyles. For example, 41.0% of state residents 65 and older eat two or more servings of fruit a day and 20.0% eat three or more servings of vegetables a day — each a larger than the average share. Additionally, 97.5% of state seniors have received a cholesterol screening within the past five years, the largest share of any state.

Wealthier Americans can afford a wider range of healthy options related to diet and lifestyle. In Maryland, the average retirement income is $34,918 a year, higher than any other state and well above the $26,483 national average.

5. Iowa
> Disability, 65+: 34.5% (12th lowest)
> Obesity rate, 65+: 30.9% (10th highest)
> Flu vaccine in the past year, 65+: 66.8% (2nd highest)
> Life expectancy at birth: 79.7 years (16th highest)

Iowa seniors report feeling better, both mentally and physically, than elderly residents of almost every other state. Just 5.1% of older Iowans report frequent mental distress in a given month. This is one of the lowest shares in the country and well below the 7.3% national average. The age group also reports an average of 4.2 physically unhealthy days per month, a full day below the national average and tied for the lowest rate among states.

These positive health outcomes could be due to the high level of preventive care in the state. Some 51.0% of senior women are up-to-date on important immunizations and cancer screenings, the largest share among states. Men are not far behind, as 49.7% are up-to-date with recommended clinical preventive services, one of the largest shares in the country.

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4. Maine
> Disability, 65+: 35.7% (20th lowest)
> Obesity rate, 65+: 28.7% (23rd highest)
> Flu vaccine in the past year, 65+: 61.7% (14th highest)
> Life expectancy at birth: 79.3 years (23rd highest)

Seniors in Maine tend to eat fruit and vegetables more frequently than seniors in other states. Some 46.2% of residents 65 and older eat two or more servings of fruit per day, well above the 38.5% of seniors nationwide. Also, 21.8% of the 65 and older population eats three or more servings of vegetables daily, more than the national average of 18.8%.

Maine’s elderly residents also tend to seek out preventive care much more frequently than those in most other states. Some 50.5% of men 65 and over in Maine are up-to-date with recommended clinical preventive services; 72.6% of older women in the state have had a mammogram in the past two years; and 96.3% of Maine seniors have received a cholesterol screening in the past five years. Each of these are among the top 10 shares nationwide.

3. Colorado
> Disability, 65+: 36.4% (24th lowest)
> Obesity rate, 65+: 21.0% (2nd lowest)
> Flu vaccine in the past year, 65+: 64.7% (5th highest)
> Life expectancy at birth: 80.2 years (8th highest)

Colorado seniors are the most active in the country. Just 21.5% of state residents age 65 and over lead sedentary lifestyles — well below the 32.3% of seniors who don’t exercise nationwide. This is likely one reason why Colorado’s senior obesity rate is so low. Only 21.0% of state residents 65 and over are obese, the second lowest share of all states, and well below the national rate of 27.9%.

Elderly residents in Colorado are the least likely to have high blood pressure. Only 53.0% of state residents 65 and over have been diagnosed with high blood pressure, compared to the 61.7% of elderly Americans nationwide. Colorado seniors are generally in good physical health. State seniors report an average of 4.4 physically unhealthy days in a given month, compared with the 5.2 unhealthy days reported by seniors nationwide.

2. Minnesota
> Disability, 65+: 32.5% (6th lowest)
> Obesity rate, 65+: 28.6% (25th highest)
> Flu vaccine in the past year, 65+: 62.9% (10th highest)
> Life expectancy at birth: 80.9 years (2nd highest)

As people age, they are more likely to be injured from falling. Minnesota seniors are among the least likely older Americans to be injured from a fall. Just 8.8% of Minnesota seniors were injured in a fall in the last year, one of the lowest rates of any state and well below the national rate of 10.9%.

A much lower share of Minnesota seniors report frequent mental distress than in most other states. Just 5.1% of Minnesotans 65 and over report feeling frequent mental distress, much less than the 7.3% of seniors who report the same nationwide. Minnesota also has the second highest life expectancy in the U.S, which is reflective of effective health care in the state and overall good health among residents. A baby born today is projected to live to nearly 81 years old, which exceeds the national average of 79 years.

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1. New Hampshire
> Disability, 65+: 31.4% (2nd lowest)
> Obesity rate, 65+: 26.5% (16th lowest)
> Flu vaccine in the past year, 65+: 61.9% (12th highest)
> Life expectancy at birth: 80.2 years (9th highest)

Senior citizens in New Hampshire are healthier than those anywhere else in the country. A large share of state residents 65 and older seek preventive care measures. Some 48.7% of men 65 and older and 49.2% of women in the same age group are up-to-date on important clinical services such as influenza and pneumococcal vaccinations as well as certain cancer screenings. Both rates are among the highest in the nation. Older New Hampshire residents are also some of the least likely to have a disability — only 31.4% of adults 65 and over live with a disability, much less than the 36.3% who do among all states.

New Hampshire seniors also exhibit healthy habits. Only 6.2% smoke often or every day, well below the 8.6% of seniors nationwide. Also, just 27.0% of seniors in New Hampshire do not engage in physical activity, far less than the 32.3% of seniors who don’t exercise nationwide.

Detailed Findings & Methodology

Preventive care can be essential for longevity, especially for the 65 and older population. The risk of disease, infection, and other chronic ailments becomes much higher with age. The effects certain illnesses have on a person also intensify with age. Viruses such as the flu, for example, can typically make a young adult ill for all but a few days, depending on the severity of the strand, but for a senior it can be life threatening.

It is critical for seniors to be vaccinated and get checkups regularly so that health conditions do not go unnoticed or untreated, and in the healthiest states, seniors are generally more likely to be up-to-date on their vaccinations and be screened regularly for different diseases, including colorectal and breast cancer.

Eating a well-balanced diet full of fruits and vegetables and getting regular exercise can also help maintain better health. As a result, physical activity rates and diet were factored into our ranking. The healthiest states for retirement tend to have physically active elderly populations that are more likely to consume at least two servings of fruit and three servings of vegetables every day.

Both diet and exercise work help maintain healthy weight, especially among seniors whose metabolisms have slowed down — and the healthier states tend to have lower obesity rates.

Obesity can lead to a slew of health complications such as cardiovascular disease, diabetes, high cholesterol, and high blood pressure.

Another behavior that can cause blood pressure to rise is smoking, and the prevalence of seniors who smoke is much higher in the in least healthy states to retire. In nine of the 10 healthiest states to retire in, the smoking rate among the 65 and older population falls below the 8.6% national average. In eight of the 10 least healthy states for retirement, the elderly smoking rate is higher than average.

In order to determine the best states for a healthy retirement, 24/7 Wall St. used 17 health indicators for Americans 65 and older from the Centers for Disease Control and Prevention’s “Healthy Aging Program.” We created an index using 17 measures and then ranked states based on their index score from least healthy to most healthy. Those 17 selected measures closely mirror the CDC’s 15 key indicators of older adult health. The health indicators were grouped into three categories: preventive care, behaviors, and health outcomes.

Preventive care includes data on whether seniors are up-to-date on their influenza and pneumococcal vaccines, screenings like mammograms, colorectal cancer tests, and for cholesterol levels. Behavioral indicators include senior’s reporting physical activity in their leisure, eating the recommended amount of fruits and vegetables, cigarette use, and the senior obesity rate. Health outcomes include the number of unhealthy days per month, how prone seniors are to frequent mental distress, whether they retained their natural teeth, the percentage of seniors who are disabled, and the percentage of those injured by falling.

We also considered average life expectancy at birth with data from the Global Health Data Exchange. Average retirement income is only among households 65 and older with retirement income and came from the Census Bureau’s 2016 American Community Survey.

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