IntroductionThe Health of Tomorrow’s SeniorsFindingsTop and Bottom StatesChange in RankFuture PerspectiveCore MeasuresBehaviorsCommunity & Environment: MacroPolicyClinical CareOutcomesSupplemental MeasuresState SummariesAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingDistrict of ColumbiaAppendixDescription of Core MeasuresDescription of Supplemental MeasuresMethodology2016 Model Development2016 Senior Health Advisory GroupThe TeamExecutive SummaryConclusionAmerica’s Health Rankings® Expansion
Smoking is the leading cause of preventable death in the United States. On average, nonsmokers live 10 years longer than smokers. Smoking damages nearly every organ in the body and causes cataracts, respiratory disease, heart disease, stroke, and cancer. Smoking is also associated with accelerated cognitive decline; past smoking is a risk factor for dementia and premature impairment. Cessation, even in older smokers, can have profound benefits on current health status as well as improve long-term outcomes. Smoking is estimated to cost $300 billion yearly in direct health care expenditures and productivity losses.
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/smoking_sr
Excessive alcohol consumption is the United States’ third-leading cause of preventable death. The attributable death rate due to excessive alcohol among seniors is double the rate of the general population. Excessive alcohol consumption in seniors can lead to sleep disorders, depression, anxiety, suicide, liver disease, cardiovascular disease, and cancer. Heavy drinking can exacerbate health problems such as diabetes and high blood pressure. Alcoholism is also a significant risk factor for dementia. Acute impairment from heavy drinking can cause unintentional injuries and deaths. Bereavement, loneliness, and social isolation may contribute to excessive drinking. In 2010 excessive drinking cost $249 billion in the United States.
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/ExcessDrink_Seniors
Obesity is a leading cause of preventable death that contributes to cognitive decline, heart disease, diabetes, stroke, and certain cancers; it may also lead to disability due to excess weight on joints. The effect of obesity on mortality risk increases significantly with age. Obese seniors experience more hospitalizations, emergency department visits, and use of outpatient health services than non-obese seniors, leading to higher health care costs. Physical activity, healthy diet, supportive communities and social networks, and an environment that encourages exercise all play a role in reducing obesity in older adults.
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/obesity_sr
Underweight older adults may be frail, have more difficulties with activities of daily living, and need more caregiving assistance than older adults with healthy weight. They are at increased risk of acute illness and death. Poor nutrition is a main risk factor for being underweight. Social isolation, psychological disorders, poverty, physiological function, medications, and poor oral health are all factors that put older adults at an increased risk of being undernourished. Community meal services, education for adults at risk of being underweight, encouraging physical activity, and nutritional management training for care workers play a role in helping seniors maintain a healthy weight.
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/underweight_sr
Physical inactivity increases the risk of cardiovascular disease, cancer, diabetes, hypertension, obesity, and premature death. Aging causes muscle mass and strength to decrease which challenges older adults who want to remain active. Increasing physical activity prevents and helps manage numerous chronic diseases. Physical activity has also been shown to increase bone density, reduce falls, prevent memory loss, and decrease depression. Growing evidence illustrates the importance of environment and community design to promote physical activity for seniors. Inadequate levels of physical activity in American adults is associated with an estimated $117 billion in health care expenditures per year after adjusting for body mass index.
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/physical_inactivity_sr
Oral health naturally declines with age, and problems arise if routine care is not maintained. Poor oral health is associated with such chronic diseases as diabetes and cardiovascular disease, and can have a large impact on quality of life resulting in pain and affecting the ability to chew or speak. Gum disease affects nearly a quarter of adults aged 65 to 74 and more than 50,000 emergency department visits occur as a result of preventable dental conditions in adults aged 65 and older. Evidence indicates that older adults who use preventive dental care reduce their dental bills and out-of-pocket payments because they have fewer visits for expensive non-preventive procedures.
Data source: Behavioral Risk Factor Surveillance System, 2014 For details: www.americashealthrankings.org/ALL/dental_visit_sr
Osteoarthritis (OA), the most common form of arthritis, is a progressive degenerative joint disease more common in older, overweight individuals and those with a history of joint injury. It is associated with pain, aches, stiffness, and swelling. Many seniors believe that aches and pains are an inevitable part of aging, but risk factors can be prevented or modified to reduce pain caused by OA. Key factors that reduce risk include maintaining a healthy weight and regular physical activity, controlling blood sugar, and avoiding joint injuries. Physical activity can reduce pain and improve function, mobility, mood, and quality of life for many adults with arthritis.
Data source: Behavioral Risk Factor Surveillance System, 2013 For details: www.americashealthrankings.org/ALL/pain_management_sr