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Overview

According to the United States Census Bureau, adults aged 65 and older now comprise more than 15 percent of the total population. By 2030, that number will climb significantly to 20 percent. The growing number of seniors and the corresponding projected growth in the use of clinical and community services will only deepen their impact on the overall health status of the nation. As community leaders, policymakers and public health professionals prepare to address these population shifts, America’s Health Rankings® offers a suite of readily available health data to help inform important decisions and community health efforts.
The 2018 America’s Health Rankings Senior Report provides the latest check-up on the health and well-being of our nation’s seniors. Using 34 measures of senior health, the report highlights successes and challenges this population faces on a national and state-by-state basis. This year’s report highlights two supplemental measures — the suicide rate among seniors as well as a new measure to identify locations where seniors are at higher risk of social isolation.

Senior Report Spotlight Highlights Risk of Social Isolation Associated with Poor Health

With the senior population projected to grow rapidly over the next several decades, the impact of seniors’ health and aging on their quality of life is an expanding area of interest. Because of the association between social isolation and increased mortality, poor health status and greater use of health care resources, America’s Health Rankings Senior Report now includes a measure that evaluates the key risk factors for social isolation as identified by the AARP Foundation Isolation Framework Project.
America’s Health Rankings developed a new measure comprised of six factors to identify locations where adults aged 65 and older are at higher risk of social isolation. The new measure includes the following risk factors: divorce, separated or widowed, as well as seniors who never married, poverty, disability, independent living difficulty and living alone.
The analysis found social isolation risk among seniors is highest in Mississippi and Louisiana with a concentrated area of high risk from the mid-Southern region through the Appalachian Mountain states. Seniors have the lowest risk of social isolation in Utah and New Hampshire. Overall, seniors in states that are ranked healthier have a lower risk of social isolation than seniors living in states that face greater health challenges.
While risk of social isolation varies across states, large variation also occurs within states by county. The new measure identifies variation across the six risk factors of social isolation by comparing the top 20 percent of counties with the bottom 20 percent of counties in each state. Colorado has the largest variation, while the smallest variation exists in Iowa and Vermont.

Suicide Rates Have Increased Nationally Among Seniors

This year’s Senior Report also highlights an alarming increase in the suicide rate among seniors. Since the 2014 edition of the Senior Report, the suicide rate among seniors has increased 12 percent to 16.6 deaths per 100,000 aged 65 and older. The age-adjusted suicide rate for the general U.S. population has also risen over the past four years, increasing 10 percent to 13.7 deaths per 100,000 population. At the state level, Wyoming, New Mexico, Utah, West Virginia and Oklahoma have witnessed the largest suicide rate increases among seniors since 2014. Alaska experienced the greatest decrease in suicide among seniors during this time period.
Also striking is the wide variation in the suicide rate among seniors across states. For example, the rate is 3.9 times higher in Nevada than in Massachusetts (32.3 deaths versus 8.3 deaths per 100,000 adults aged 65 and older).

Seniors in Rural Areas Face Significant Health Challenges

The Senior Report found that seniors fare differently across key markers of health based on the communities where they live – whether rural, suburban or urban. Seniors who live in rural areas experience health disparities across a wide range of behavior and outcome measures:
  • More seniors are physically inactive in rural areas (34.3 percent compared to 30.4 percent in suburban and 30.1 percent in urban areas). This health disparity has persisted over the past five years.
  • High health status – seniors who consider their health status as “very good” or “excellent” – is lower in rural areas (36.8 percent compared to 42.0 percent in suburban areas and 41.4 percent in urban areas).
  • Significantly more seniors report falls in rural areas (32.4 percent compared to 28.5 percent in suburban areas and 29.5 percent in urban areas).
Receiving important preventive services related to their clinical care is less common among rural seniors than their urban counterparts. This year’s report highlights several health disparities, including:
  • A significant gap in flu vaccination coverage emerged over the past year, with rural seniors reporting a lower percentage of flu vaccination than urban seniors (57.2 percent versus 61.4 percent, respectively).
  • Rural seniors also receive health screenings at a lower rate compared with both suburban and urban seniors (66.4 percent versus 74.3 percent and 75.3 percent, respectively) – a disparity that has persisted for the past four years.

Encouraging Areas of Progress in Senior Health, Yet Disparities Persist

While the Senior Report highlights many pressing challenges facing our nation, it also reveals that at a national level, America’s seniors have experienced improvements across notable measures of health.
  • Food insecurity decreased 7 percent in the past year, indicating a smaller percentage of adults aged 60 and older faced the threat of hunger in the past 12 months;
  • Since the 2016 edition, oral health among seniors has improved, with dental visits among seniors significantly increasing and teeth extractions declining;
  • The number of home health care workers per 1,000 adults aged 75 and older increased 20 percent since the first Senior Report was published in 2013.
Importantly, wide gaps exist across states and within subpopulations, with some groups of seniors continuing to face challenges despite national improvements. For example, while food insecurity improved nationally in the past year, three states saw increases of three percentage points or more, with New Mexico increasing the most from 10.8 percent to 18.0 percent. Additionally, the prevalence of dental visits among seniors with less than a high school education is less than half the prevalence of seniors with a college degree.

Healthiest States for Seniors and Those Facing Greatest Challenges

Each year, America’s Health Rankings determines the healthiest states for seniors, considering 34 measures of health, including measures of behavior, community and environment, policy, clinical care and health outcomes.
Utah is the new healthiest state for seniors, followed by Hawaii (No. 2), New Hampshire (No. 3), Minnesota (No. 4) and Colorado (No. 5). All these states ranked in the top five in 2017, showing consistency in the healthiest cohort.
Louisiana ranks as the state with the most challenges for seniors, followed by Mississippi (No. 49), Kentucky (No. 48), Arkansas (No. 47) and Oklahoma (No. 46). These states have the greatest opportunities for improving senior health.
The report also recognizes states that have made the greatest movements since the first Senior Report was released in 2013. Rhode Island improved 22 ranks from No. 30 to No. 8. Rhode Island is followed by Alaska and Utah, which improved 17 and 9 ranks, respectively. Arizona has experienced the greatest decline, falling 13 ranks from No. 18 to No. 31 over the past five years. Vermont, Kansas and Nebraska have also had large ranking changes, declining 11, 9 and 9 ranks, respectively.



Continuing a Strong Commitment to Our Nation’s Seniors



Findings from this year’s Senior Report reveal that challenges facing seniors vary widely across and within states and that subpopulations experience disparities that are not always reflected in national averages. United Health Foundation supports efforts that help build healthier communities and address the unique health and wellness challenges present in the senior population. Policymakers, public health officials and community leaders are encouraged to use this report, along with the entire suite of America’s Health Rankings data, to support decision-making related to initiatives aimed at improving the overall health of the senior population.

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