About the Senior Report

Highlights

Find out how state's seniors rank in physical inactivity, food insecurity, SNAP reach, and hospice care and see the ranking for overall senior health. Use dropdown menus to narrow or expand information.

State Rankings Obesity Physical Inactivity Food Insecurity Poverty

2016 Ranking

See how states stack up on overall senior health. Click on a state or use the dropdown menu to get more information on each state.

USA Obesity - Seniors (2013-2016) see more
  • Percentage of adults aged 65 and older estimated to be obese with a body mass index (BMI) of 30.0 or higher
USA Physical Inactivity - Seniors (2013-2016) see more
  • Percentage of adults aged 65 and older with fair or better health status who report doing no physical activity or exercise (such as running, calisthenics, golf, gardening, or walking) other than their regular job in the last 30 days
USA Food Insecurity (2013-2016) see more
  • Percentage of adults aged 60 and older who are marginally food insecure
USA Poverty - Seniors (2013-2016) see more
  • Percentage of adults aged 65 and older who live in households at or below 100% of the poverty threshold

Future Cohort

In 2011 the oldest of the baby boomer generation turned 65, marking the beginning of a tremendous demographic shift in the US population.[i] By 2056, the population of adults aged 65 and older is projected to surpass the population younger than 18 years.[ii] Each day through 2030, 10,000 baby boomers will turn 65, which will place a heavy burden on the health care system. Adults aged 65 and older are the largest consumers of health care as the process of aging brings upon the need for more frequent health care. [iii]

The tabs below describe the anticipated population change by 2030 and the differences in smoking, obesity, diabetes and health status for future seniors now and future seniors 15 years ago.

 

[i] “Baby Boomers Retire.” December 29, 2010. Pew Research Center. http://www.pewresearch.org/daily-number/baby-boomers-retire/. Accessed April 11, 2016.

[ii] Colby SL and Ortman JM. The Baby Boom Cohort in the United States: 2012 to 2060. Population Estimates and Projections. Current Population Reports. Issued May 2014.

[iii] Alemayehu B,Warner KE. The lifetime distribution of health care costs. Health Services Research. 39.3 (2004): 627-642.

Population Smoking Health Status Obesity Diabetes

Using population projections published by Woods and Poole in 2015, the senior US population is expected to increase by 49.5% between 2016 and 2030. This amounts to a projected annual growth rate of 3.5% in the 65 years and older population. In addition to projected increase in the aging population, the US population is expected to become more racially and ethnically diverse. The aggregate minority population in the United States is projected to become the majority by 2043. The projected growth of the senior population in the United States will pose challenges to policymakers, Medicare, Medicaid, and Social Security, not to mention the effect it will have on families, communities, businesses, and health care providers.

 

The pressure that this demographic shift places on the nation is not evenly distributed among the states (see table below), with some states expecting many more aging baby boomers than others.

The senior population is projected to increase by more than 50% in 25 states. The table includes estimates for all states annual growth rate in the 65 and older population from 2016 to 2030.

Projected Population Growth Among Adults Aged 65 and older from 2016 to 2030
State Annual Growth Rate 2016 to 2030 (%/14 years) Total increase from 2016 to 2030 (%)
United States 3.54 49.5
Alabama 2.97 41.6
Alaska 6.08 85.1
Arizona 4.2 58.8
Arkansas 3.05 42.7
California 3.81 53.4
Colorado 4.26 59.6
Connecticut 3.09 43.2
Delaware 3.39 47.5
District of Columbia 1.23 17.2
Florida 3.92 54.9
Georgia 4.38 61.4
Hawaii 3.25 45.5
Idaho 4.16 58.3
Illinois 2.86 40.0
Indiana 3.03 42.4
Iowa 2.65 37.1
Kansas 2.88 40.3
Kentucky 3.14 44.0
Louisiana 3.35 46.9
Maine 4.15 58.1
Maryland 3.69 51.7
Massachusetts 3.08 43.2
Michigan 3.03 42.4
Minnesota 4.22 59.0
Mississippi 3.13 43.8
Missouri 2.94 41.2
Montana 4.1 57.4
Nebraska 3.03 42.4
Nevada 4.67 65.4
New Hampshire 4.98 69.7
New Jersey 2.96 41.4
New Mexico 4.31 60.4
New York 2.39 33.4
North Carolina 3.85 53.9
North Dakota 4.32 60.4
Ohio 2.76 38.6
Oklahoma 2.82 39.4
Oregon 3.49 48.9
Pennsylvania 2.82 39.5
Rhode Island 3.07 42.9
South Carolina 3.82 53.5
South Dakota 3.65 51.0
Tennessee 3.37 47.2
Texas 4.74 66.3
Utah 4.23 59.2
Vermont 4.5 63.1
Virginia 4.12 57.7
Washington 4.08 57.1
West Virginia 2.42 33.9
Wisconsin 3.78 52.9
Wyoming 4.52 63.3
     
Data source: Woods and Poole 2015 Population Projections

 

[1] “Baby Boomers Retire.” December 29, 2010. Pew Research Center. http://www.pewresearch.org/daily-number/baby-boomers-retire/. Accessed April 11, 2016.

[2] Colby SL and Ortman JM. The Baby Boom Cohort in the United States: 2012 to 2060. Population Estimates and Projections. Current Population Reports. Issued May 2014.

[3] Alemayehu B,Warner KE. The lifetime distribution of health care costs. Health Services Research. 39.3 (2004): 627-642.

 

Nationally, the prevalence of smoking in the middle-aged population decreased 50% from 1999 to 2014. The public’s perception of the health risks associated with smoking have shifted over the past 15 years. Despite across the board decreases in smoking prevalence by state, there is some variation in the relative percentage change across states. Utah, Arizona, New Jersey, and Hawaii all achieved a percentage change decrease in smoking prevalence in the range of 61-67%. The relative change in the majority of other states fell somewhere between a 40-60% decrease in smoking prevalence. The smallest decrease occurred in Alabama where 31% fewer adults reported being current smokers in 2014 compared to 1999.

States with less steep declines and a higher prevalence of smokers compared to the national average can expect to face additional challenges over the coming years as the cost of chronic diseases associated with smoking are realized. 

 

Change in Smoking Prevalence among 50-64 years olds from 1999 to 2014
State 1999 (%) 2014 (%) Simple Difference (%) Relative Change (%)
United States 38.2 19.0 -19.2 -50.3
Alabama 34.3 23.7 -10.6 -30.9
Alaska 36.7 20.2 -16.5 -45.0
Arizona 50.6 17.6 -33.0 -65.2
Arkansas 43.6 26.8 -16.8 -38.5
California 33.4 15.0 -18.4 -55.1
Colorado 33.8 14.8 -19.0 -56.2
Connecticut 30.3 15.3 -15.0 -49.5
Delaware 36.2 20.3 -15.9 -43.9
District of Columbia 38.6 26.8 -11.8 -30.6
Florida 38.4 20.9 -17.5 -45.6
Georgia 42.1 20.2 -21.9 -52.0
Hawaii 40.1 15.0 -25.1 -62.6
Idaho 36.4 14.9 -21.5 -59.1
Illinois 38.1 18.8 -19.3 -50.7
Indiana 43.7 24.0 -19.7 -45.1
Iowa 37.2 19.4 -17.8 -47.8
Kansas 35.7 19.7 -16.0 -44.8
Kentucky 45.0 26.8 -18.2 -40.4
Louisiana 39.2 26.0 -13.2 -33.7
Maine 36.4 18.5 -17.9 -49.2
Maryland 35.3 17.5 -17.8 -50.4
Massachusetts 35.2 17.4 -17.8 -50.6
Michigan 37.9 21.3 -16.6 -43.8
Minnesota 40.7 16.5 -24.2 -59.5
Mississippi 46.2 24.6 -21.6 -46.8
Missouri 43.4 22.2 -21.2 -48.8
Montana 30.9 19.9 -11.0 -35.6
Nebraska 35.2 17.3 -17.9 -50.9
Nevada 43.5 18.6 -24.9 -57.2
New Hampshire 35.2 16.5 -18.7 -53.1
New Jersey 40.7 14.8 -25.9 -63.6
New Mexico 39.9 19.0 -20.9 -52.4
New York 37.6 15.4 -22.2 -59.0
North Carolina 35.5 20.6 -14.9 -42.0
North Dakota 39.6 20.4 -19.2 -48.5
Ohio 37.3 21.8 -15.5 -41.6
Oklahoma 50.2 22.4 -27.8 -55.4
Oregon 37.1 18.8 -18.3 -49.3
Pennsylvania 42.3 22.2 -20.1 -47.5
Rhode Island 35.0 16.6 -18.4 -52.6
South Carolina 45.8 23.3 -22.5 -49.1
South Dakota 36.1 20.5 -15.6 -43.2
Tennessee 44.7 24.3 -20.4 -45.6
Texas 37.8 15.6 -22.2 -58.7
Utah 31.8 10.4 -21.4 -67.3
Vermont 34.1 14.6 -19.5 -57.2
Virginia 33.2 19.5 -13.7 -41.3
Washington 35.1 16.8 -18.3 -52.1
West Virginia 47.0 26.9 -20.1 -42.8
Wisconsin 33.0 19.6 -13.4 -40.6
Wyoming 37.6 20.3 -17.3 -46.0
         
Percent difference and relative change were calculated prior to rounding the 1999 and 2014 values
Data Source: BRFSS 1999 and 2014      

Nationally, the percentage of adults aged 50 to 64 reporting very good or excellent health has decreased by 9.4% from 1999 to 2014. This drop in health status is far more dramatic in some states than others, with 18-19% fewer adults in Indiana, Kansas, New Mexico, Louisiana, and Oklahoma reporting very good or excellent health. A few states reported a modest increase in health status, with the largest percentage increase occurring in North Dakota where 2.2% more adults reported very good or excellent health. Missouri had no change in self-reported health status since 1999.

States with greater declines can expect to face additional challenges over the coming years as a less healthy cohort of adults ages. 

Change in High Health Status Prevalence among 50-64 years olds from 1999 to 2014
State 1999 (%) 2014 (%) Simple Difference (%) Relative Change (%)
United States 51.5 46.7 -4.8 -9.3
Alabama 41.2 36.5 -4.7 -11.4
Alaska 56.3 53.7 -2.6 -4.6
Arizona 52.2 46.1 -6.1 -11.7
Arkansas 40.6 34.7 -5.9 -14.5
California 52.8 47.9 -4.9 -9.3
Colorado 59.9 56.9 -3.0 -5.0
Connecticut 62.3 58.0 -4.3 -6.9
Delaware 53.7 48.9 -4.8 -8.9
District of Columbia 51.9 51.1 -0.8 -1.5
Florida 48.3 44.9 -3.4 -7.0
Georgia 48.4 43.6 -4.8 -9.9
Hawaii 47.4 45.7 -1.7 -3.6
Idaho 58.5 53.7 -4.8 -8.2
Illinois 50.8 46.4 -4.4 -8.7
Indiana 53.1 43.8 -9.3 -17.5
Iowa 54.7 49.8 -4.9 -9.0
Kansas 59.5 48.7 -10.8 -18.2
Kentucky 40.9 37.9 -3.0 -7.3
Louisiana 48.6 39.7 -8.9 -18.3
Maine 58.8 53.5 -5.3 -9.0
Maryland 53.6 53.7 0.1 0.2
Massachusetts 61.2 53.8 -7.4 -12.1
Michigan 55.0 47.8 -7.2 -13.1
Minnesota 62.4 55.8 -6.6 -10.6
Mississippi 37.7 32.3 -5.4 -14.3
Missouri 47.9 48.0 0.1 0.2
Montana 55.7 50.9 -4.8 -8.6
Nebraska 55.6 53.2 -2.4 -4.3
Nevada 55.6 46.1 -9.5 -17.1
New Hampshire 59.4 59.2 -0.2 -0.3
New Jersey 53.6 50.1 -3.5 -6.5
New Mexico 51.6 42.2 -9.4 -18.2
New York 51.9 47.4 -4.5 -8.7
North Carolina 46.6 43.7 -2.9 -6.2
North Dakota 50.0 51.0 1.0 2.0
Ohio 53.2 47.4 -5.8 -10.9
Oklahoma 51.8 41.9 -9.9 -19.1
Oregon 54.5 50.6 -3.9 -7.2
Pennsylvania 51.5 47.4 -4.1 -8.0
Rhode Island 58.4 53.8 -4.6 -7.9
South Carolina 48.6 43.1 -5.5 -11.3
South Dakota 54.4 50.4 -4.0 -7.4
Tennessee 40.6 38.8 -1.8 -4.4
Texas 46.9 40.7 -6.2 -13.2
Utah 59.0 54.8 -4.2 -7.1
Vermont 64.2 60.2 -4.0 -6.2
Virginia 55.9 49.2 -6.7 -12.0
Washington 58.8 49.3 -9.5 -16.2
West Virginia 38.8 35.4 -3.4 -8.8
Wisconsin 50.0 50.6 0.6 1.2
Wyoming 52.9 52.7 -0.2 -0.4
         
Percent difference and relative change were calculated prior to rounding the 1999 and 2014 values
Data Source: BRFSS 1999 and 2014      

The national obesity prevalence in the middle-aged population increased 25% from 1999 to 2014. While all but one state’s obesity rates have increased, they have not done so evenly. Idaho’s rate increased the least at only 2%, while obesity rates in Arizona rose by 96%. In Colorado, the obesity rate of middle-aged adults decreased by 3% over the 15-year period.

Obesity contributes to a variety of other serious chronic diseases. States with higher obesity rates may presume further health challenges are ahead. T 

 

Change in Obesity Prevalence among 50-64 years olds from 1999 to 2014
State 1999 (%) 2014 (%) Simple Difference (%) Relative Change (%)
United States 27.2 34.0 6.8 25.0
Alaska 31.1 34.7 3.6 11.6
Alabama 26.1 38.1 12.0 46.0
Arkansas 30.2 40.9 10.7 35.4
Arizona 17.6 34.6 17.0 96.6
California 24.4 28.9 4.5 18.4
Colorado 26.9 26.1 -0.8 -3.0
Connecticut 26.5 31.1 4.6 17.4
Delaware 29.0 36.3 7.3 25.2
District of Columbia 28.9 28.9 0.0 0.0
Florida 25.2 29.2 4.0 15.9
Georgia 29.1 36.3 7.2 24.7
Hawaii 19.4 24.9 5.5 28.4
Iowa 30.1 37.7 7.6 25.2
Idaho 31.8 32.4 0.6 1.9
Illinois 28.0 35.0 7.0 25.0
Indiana 31.2 38.5 7.3 23.4
Kansas 28.3 38.0 9.7 34.3
Kentucky 26.9 36.0 9.1 33.8
Louisiana 33.3 39.3 6.0 18.0
Massachusetts 24.1 29.3 5.2 21.6
Maryland 26.0 36.0 10.0 38.5
Maine 30.6 31.8 1.2 3.9
Michigan 31.4 35.4 4.0 12.7
Minnesota 23.1 32.7 9.6 41.6
Missouri 31.7 34.0 2.3 7.3
Mississippi 30.7 37.4 6.7 21.8
Montana 20.7 27.7 7.0 33.8
North Carolina 31.5 33.9 2.4 7.6
North Dakota 31.0 35.8 4.8 15.5
Nebraska 28.4 36.0 7.6 26.8
New Hampshire 23.7 30.5 6.8 28.7
New Jersey 23.2 31.3 8.1 34.9
New Mexico 20.8 31.6 10.8 51.9
Nevada 22.0 27.0 5.0 22.7
New York 20.9 32.5 11.6 55.5
Ohio 30.1 39.5 9.4 31.2
Oklahoma 31.0 39.1 8.1 26.1
Oregon 29.3 34.0 4.7 16.0
Pennsylvania 32.1 33.9 1.8 5.6
Rhode Island 24.7 30.2 5.5 22.3
South Carolina 28.7 38.8 10.1 35.2
South Dakota 31.3 37.2 5.9 18.8
Tennessee 28.3 38.5 10.2 36.0
Texas 28.4 40.2 11.8 41.5
Utah 27.4 32.4 5.0 18.2
Virginia 29.9 34.7 4.8 16.1
Vermont 26.8 29.0 2.2 8.2
Washington 28.5 32.1 3.6 12.6
Wisconsin 31.7 34.7 3.0 9.5
West Virginia 27.7 39.3 11.6 41.9
Wyoming 21.5 33.3 11.8 54.9
         
Percent difference and relative change were calculated prior to rounding the 1999 and 2014 values
Data Source: BRFSS 1999 and 2014    

Nationally, the prevalence of diabetes among the middle-aged population has increased dramatically from 1999 to 2014 with an almost 55% increase in the percentage of adults aged 50 to 64 who reported that a physician told them they had diabetes. This increase in diabetes prevalence is far more precipitous in some states than others, with nearly a 145% increase for middle-aged adults in Nebraska and a 138% increase in Colorado. Diabetes prevalence is estimated to double in six states. All states reported an increase in diabetes prevalence, with the smallest increase occurring in Montana with a single digit increase of 6%.


States with greater gains in diabetes prevalence can expect to face additional challenges over the coming years as a less healthy cohort of adults become seniors. 

 

Change in Diabetes Prevalence among 50-64 years olds from 1999 to 2014
State 1999 (%) 2014 (%) Simple Difference (%) Relative Change (%)
United States 10.1 15.6 5.5 54.5
Alabama 11.4 19.7 8.3 72.8
Alaska 7.2 11.5 4.3 59.7
Arizona 7.9 15.8 7.9 100.0
Arkansas 10.4 20.0 9.6 92.3
California 11.8 17.4 5.6 47.5
Colorado 4.7 11.2 6.5 138.3
Connecticut 7.7 13.0 5.3 68.8
Delaware 12.1 14.2 2.1 17.4
District of Columbia 10.6 16.2 5.6 52.8
Florida 10.6 14.5 3.9 36.8
Georgia 9.7 19.1 9.4 96.9
Hawaii 9.7 14.6 4.9 50.5
Idaho 7.0 10.0 3.0 42.9
Illinois 12.2 14.8 2.6 21.3
Indiana 8.9 16.0 7.1 79.8
Iowa 8.9 12.8 3.9 43.8
Kansas 7.2 15.2 8.0 111.1
Kentucky 10.1 17.0 6.9 68.3
Louisiana 11.5 17.8 6.3 54.8
Maine 7.9 12.3 4.4 55.7
Maryland 9.4 14.9 5.5 58.5
Massachusetts 7.6 13.3 5.7 75.0
Michigan 9.6 14.1 4.5 46.9
Minnesota 8.1 10.1 2.0 24.7
Mississippi 11.0 20.4 9.4 85.5
Missouri 8.6 14.6 6.0 69.8
Montana 11.0 11.7 0.7 6.4
Nebraska 5.8 14.3 8.5 146.6
Nevada 6.5 12.6 6.1 93.8
New Hampshire 10.1 12.5 2.4 23.8
New Jersey 8.4 12.1 3.7 44.0
New Mexico 8.8 16.4 7.6 86.4
New York 10.4 14.3 3.9 37.5
North Carolina 10.4 16.2 5.8 55.8
North Dakota 6.6 12.6 6.0 90.9
Ohio 9.1 16.7 7.6 83.5
Oklahoma 9.2 20.0 10.8 117.4
Oregon 9.2 11.4 2.2 23.9
Pennsylvania 10.1 15.7 5.6 55.4
Rhode Island 8.7 14.1 5.4 62.1
South Carolina 11.8 18.2 6.4 54.2
South Dakota 9.3 12.2 2.9 31.2
Tennessee 9.6 19.8 10.2 106.3
Texas 12.9 19.1 6.2 48.1
Utah 9.1 11.9 2.8 30.8
Vermont 6.1 9.3 3.2 52.5
Virginia 9.5 13.6 4.1 43.2
Washington 8.1 13.4 5.3 65.4
West Virginia 13.3 19.7 6.4 48.1
Wisconsin 9.8 12.7 2.9 29.6
Wyoming 9.0 11.4 2.4 26.7
         
Percent difference and relative change were calculated prior to rounding the 1999 and 2014 values
Data Source: BRFSS 1999 and 2014      

Senior Findings

Top and Bottom States

  • Massachusetts tops the list as healthiest state for older adults. Smoking decreased 20% since last year, which moves Massachusetts up 20 places in the ranking of that measure. Physical inactivity decreased 12%.  However, flu vaccination coverage decreased 13% in the last year.
  •  
  • The top six states (Massachusetts, Vermont, New Hampshire, Minnesota, Hawaii, and Utah) are a step above the other states and are virtually tied for the top place in the rankings. These states are uniformly high among the outcome measures but show variation in behaviors, community & environment, policy, and clinical care.

Louisiana is 50th again this year. The state’s strengths are high flu vaccination coverage, low prevalence of falls and ready availability of home health care workers. A high prevalence of smoking, obesity, and physical inactivity remain yearly challenges. In the past year, annual dental visits increased 12% and full mouth-teeth extractions decreased 29%.

  • Oklahoma, like Louisiana, is a step below the other bottom states. Kentucky, West Virginia, Arkansas, and Mississippi round out the bottom six states – these four states have similar overall scores and are comparable in their senior health.

Findings

Several items are noteworthy when reviewing the changes in senior health over the past year. The nation as a whole has experienced successes and challenges.

Successes include:

  • • A 9% decline in the rate of preventable hospitalizations from 59.3 to 53.8 discharges per 1,000 Medicare beneficiaries,
  • • A 8% reduction in the prevalence of full-mouth teeth extractions from 16.1% to 14.9% of adults aged 65 and older, and
  • • A 5% decrease in hip fractures from 6.2 to 5.9 hospitalizations per 1,000 Medicare beneficiaries.

Challenges include:

  • • A 7% decrease in community support from $873 to $811 per adult aged 65 and older in poverty,
  • • A 7% decrease in home-delivered meals from 20.6% to 19.1% of seniors in poverty,
  • • A 10% decrease in the reach of the Supplemental Nutrition Assistance Program (SNAP) from 75.2% to 67.4% of seniors in poverty, and
  • • A 5% increase in food insecurity from 14.8% to 15.5% of adults aged 60 and older.

Now in its fourth edition, successes and challenges can be examined over a three year time frame. Three year successes include:

  • • An 18% increase in home health care workers from 93.8 to 110.6 workers per 1,000 adults aged 75 and older,
  • • A 40% increase in hospice care use from 36.7% to 51.4% of decedents aged 65 and older,
  • • A 29% decrease in hospital deaths from 30.1% to 21.5% of decedents aged 65 and older, and
  • • A 7% increase in health status from 38.4% to 41.2% of adults aged 65 and older reporting very good or excellent health.

Looking at the changes over the last three years also accents a major challenge facing the senior population, a 9% increase in obesity from 25.3% to 27.5% of adults aged 65 and older. This compares to a 6% increase in obesity in the general population over the same time period.

Maintaining and improving the health of seniors is challenged by two factors; the rapidly increasing number of individuals in this age group and the healthiness of the individuals moving into this age group. By 2030, the number of seniors is projected to increase by 49.5% from approximately 49,360,000 in 2016 to 73,789,000 in 2030[1]. The future cohort of seniors (adults aged 50-64 years in 2014) differ from the current cohort of seniors (adults aged 50-64 years 15 years ago) compared with the current cohort of seniors. The prevalence of smoking is half among the future cohort, but the prevalence of obesity is 25% higher, the prevalence of diabetes is 55% higher, and the percentage reporting very good or excellent health is 9% less (Figure 3). Over the next 15 years, the health of this population will be challenged by large numbers of new people becoming seniors and the additional health challenges, such as diabetes that this groups brings with them.


[1] Woods & Poole Economics, Inc. The 2015 MSA Profile. Washington, D.C.

 

How to Use the Rankings®

America’s Health Rankings® Senior Report is about digging deeper, digesting data, and then doing something that will improve state health. The rankings are important, but they are only a starting point. Here are general guidelines about using the rankings if the state:

► Shows no change. Check the measures because it may be that there has been a notable change in one or more measures that has been offset by equally notable changes in the opposite direction by other measures. Or it may be that there have been changes, but relative to changes in other states, there’s no change in the overall ranking.

► Shows little change. Check the measures. A big shift in a measure or two may be masked by an abundance of smaller shifts with other measures.

► Shows big change. Again, investigate further to see what’s driving the change.

The strengths, challenges and highlights for each state are described on the state summary page in this book and on each state page on the website.

Once you have completed the investigation, use this information to take action. 

 

Downloads

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Senior Report downloads

Senior Report - May 2016
America's Health Rankings Senior Report for 2016.

2016 Senior Report Chart pack
Charts that illustrate the key findings of the 2016 Senior Report

2016 Senior Report Executive Summary
A brief summary of findings from the 2016 Senior Report.

2016 Senior Report -- Press Release
Press release describing the 2016 Senior Report from America's Health Rankings.

2016 Senior - Spanish
America's Health Rankings Senior Report, in Spanish