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Behaviors

Insufficient Sleep

Percentage of adults ages 65 and older who reported sleeping, on average, fewer than seven hours in a 24-hour period.
Behavioral Risk Factor Surveillance System, 2018

Physical Activity and Nutrition

Weighted sum of the z-scores for exercise, physical inactivity, fruit consumption and vegetable consumption.
America's Health Rankings composite measure, 2020

Exercise

Percentage of adults ages 65 and older who met the federal physical activity guidelines in the past 30 days.
Behavioral Risk Factor Surveillance System, 2017

Physical Inactivity

Percentage of adults ages 65 and older in fair or better health who reported doing no physical activity or exercise other than their regular job in the past 30 days.
Behavioral Risk Factor Surveillance System, 2018

Fruit Consumption

Percentage of adults ages 65 and older who reported eating two or more fruits daily.
Behavioral Risk Factor Surveillance System, 2017

Vegetable Consumption

Percentage of adults ages 65 and older who reported eating three or more vegetables daily.
Behavioral Risk Factor Surveillance System, 2017

Substance Use

Weighted sum of the z-scores for excessive drinking and smoking.
America's Health Rankings composite measure, 2020

Excessive Drinking

Percentage of adults ages 65 and older who reported binge drinking (four or more [females] or five or more [males] drinks on one occasion in the past 30 days) or chronic drinking (eight or more [females] or 15 or more [males] drinks per week).
Behavioral Risk Factor Surveillance System, 2018

Smoking

Percentage of adults ages 65 and older who reported smoking at least 100 cigarettes in their lifetime and currently smoke daily or some days.
Behavioral Risk Factor Surveillance System, 2018

Social & Economic Factors

Household Economics

Weighted sum of the z-scores for food insecurity, poverty and SNAP reach.
America's Health Rankings composite measure, 2020

Food Insecurity

Percentage of adults ages 60 and older who faced the threat of hunger in the past 12 months.
The State of Senior Hunger in America, 2017

Poverty

Percentage of adults ages 65 and older who live below the poverty level.
American Community Survey, 2018

SNAP Reach

Number of adults ages 60 and older who participate in the Supplemental Nutrition Assistance Program (SNAP) per 100 adults ages 60 and older living in poverty.
Characteristics of Supplemental Nutrition Assistance Program Households report Denominator: U.S. Census Bureau, American Community Survey, 2018

Social Support and Engagement

Weighted sum of the z-scores for community support expenditure, low-care nursing home residents, risk of social isolation, volunteerism and voter turnout.
America's Health Rankings composite measure, 2020

Community Support Expenditure

Dollars captured by the Administration on Aging per adult ages 60 and older.
Administration for Community Living, State Program Reports Denominator: CDC WONDER Single Race Population Estimates 2010-2018. 2018

Low-care Nursing Home Residents

Percentage of nursing home residents who do not require physical assistance for bed mobility, transferring, using the toilet and eating.
America's Health Rankings composite measure, 2020

Risk of Social Isolation

Percentile of the mean z-scores for the following risk factors in adults ages 65 and older: poverty; living alone; divorced, separated or widowed; never married; disability; and independent living difficulty.
American Community Survey, 2014-2018

Volunteerism

Percentage of adults ages 65 and older who reported volunteering in the past 12 months.
Corporation for National & Community Service, 2017

Voter Turnout

Percentage of U.S. citizens ages 65 and older who voted in the last biennial national election.
Current Population Survey, Voter Registration, 2018

Violent Crime

Number of murders, rapes, robberies and aggravated assaults per 100,000 population.
Federal Bureau of Investigation, 2018

Physical Environment

Air and Water Quality

Weighted sum of the z-scores for air pollution, non-smoking regulation and drinking water violations.
America's Health Rankings composite measure, 2020

Air Pollution

Average exposure of the general public to particulate matter of 2.5 microns or less measured in micrograms per cubic meter.
U.S. Environmental Protection Agency Denominator: U.S. Census Bureau, Annual Estimates of the Resident Population: April 1, 2010 to July 1, 2018, 2016-2018

Non-Smoking Regulation

Percentage of population covered by 100% smokefree laws for non-hospitality workplaces, restaurants and bars.
American Nonsmokers' Rights Foundation, 2020

Drinking Water Violations

Percentage of population served by community water systems with a serious drinking water violation during the year.
Enforcement and Compliance History Online, Safe Drinking Water Information System, 2019

Severe Housing Problems

Percentage of occupied housing units with at least one of the following problems: lack of complete kitchen facilities, lack of plumbing facilities, overcrowding or severely cost-burdened occupants.
Comprehensive Housing Affordability Strategy, 2012-2016

Clinical Care

Access to Care

Weighted sum of the z-scores for avoided care due to cost, dedicated health care provider, geriatricians and home health care workers.
America's Health Rankings composite measure, 2020

Avoided Care Due to Cost

Percentage of adults ages 65 and older who reported a time in the past 12 months when they needed to visit a doctor but could not because of cost.
Behavioral Risk Factor Surveillance System, 2018

Dedicated Health Care Provider

Percentage of adults ages 65 and older who reported having one or more people they think of as their personal doctor or health care provider.
Behavioral Risk Factor Surveillance System, 2018

Geriatricians

Number of family medicine and internal medicine geriatricians per 100,000 population ages 65 and older.
National Plan and Provider Enumeration System, Sept. 2019 Denominator: CDC WONDER Single Race Population Estimates 2010-2018, 2018

Home Health Care Workers

Number of personal care and home health aides per 1,000 adults ages 65 and older with a disability.
Bureau of Labor Statistics Denominator: U.S. Census Bureau, American Community Survey, 2018

Preventive Clinical Services

Weighted sum of the z-scores for cancer screenings, flu vaccination, pneumonia vaccination and shingles vaccination.
America's Health Rankings composite measure, 2020

Cancer Screenings

Percentage of women ages 65-74 who reported receiving a mammogram in the past two years and the percentage of adults ages 65-75 who reported receiving colorectal cancer screening within the recommended time period.
Behavioral Risk Factor Surveillance System, 2018

Immunizations

Weighted sum of the z-scores for flu vaccination, pneumococcal vaccination and shingles vaccination.
America's Health Rankings composite measure, 2020

Flu Vaccination

Percentage of adults ages 65 and older who reported receiving a seasonal flu vaccine in the past 12 months.
Behavioral Risk Factor Surveillance System, 2018

Pneumonia Vaccination

Percentage of adults ages 65 and older who reported receiving the pneumonia vaccine.
Behavioral Risk Factor Surveillance System, 2018

Shingles Vaccination

Percentage of adults ages 65 and older who reported receiving the shingles vaccine.
Behavioral Risk Factor Surveillance System, 2017

Quality of Care

Weighted sum of the z-scores for hospice care, hospital readmissions, nursing home quality and preventable hospitalizations.
America's Health Rankings composite measure, 2020

Hospice Care

Percentage of Medicare decedents who were in hospice at the time of death.
National Hospice and Palliative Care Organization, NHPCO Facts and Figures, 2017

Hospital Readmissions

Percentage of Medicare enrollees ages 65-74 readmitted within 30 days of hospital discharge.
Office of Minority Health's Mapping Medicare Disparities (MMD) Tool, 2017

Nursing Home Quality

Percentage of certified nursing home beds rated four- or five-stars over a three-month period.
Nursing Home Compare, December 2018 to February 2019

Preventable Hospitalizations

Discharges following hospitalization for diabetes with short- or long-term complications, uncontrolled diabetes without complications, diabetes with lower extremity amputation, chronic obstructive pulmonary disease, angina without a procedure, asthma, hypertension, heart failure, dehydration, bacterial pneumonia or urinary tract infection per 100,000 Medicare enrollees ages 65-74.
Office of Minority Health's Mapping Medicare Disparities (MMD) Tool, 2017

Health Outcomes

Health Status

Weighted sum of the z-scores for able-bodied, frequent mental distress, frequent physical distress and high health status.
America's Health Rankings composite measure, 2020

Able-Bodied

Percentage of adults ages 65 and older with no cognitive, visual, auditory, ambulatory, self-care and/or independent-living difficulty disabilities.
American Community Survey, 2018

Cognitive Difficulty*

Percentage of adults ages 65 and older who reported having physical, mental or emotional problems or difficulty remembering, concentrating or making decisions.
American Community Survey, 2018

Frequent Mental Distress

Percentage of adults ages 65 and older who reported their mental health was not good 14 or more days in the past 30 days.
Behavioral Risk Factor Surveillance System, 2018

Frequent Physical Distress

Percentage of adults ages 65 and older who reported their physical health was not good 14 or more days in the past 30 days.
Behavioral Risk Factor Surveillance System, 2018

High Health Status

Percentage of adults ages 65 and older who reported their health is very good or excellent.
Behavioral Risk Factor Surveillance System, 2018

Injury and Illness

Weighted sum of the z-scores for falls, multiple chronic conditions, obesity and teeth extractions.
America's Health Rankings composite measure, 2020

Falls

Percentage of adults ages 65 and older who reported falling in the past 12 months.
Behavioral Risk Factor Surveillance System, 2018

Multiple Chronic Conditions

Percentage of Medicare enrollees ages 65 and older with four or more of 21 chronic conditions.
Centers for Medicare & Medicaid Services, 2017

Obesity

Percentage of adults ages 65 and older with a body mass index of 30.0 or higher based on reported height and weight.
Behavioral Risk Factor Surveillance System, 2018

Teeth Extractions

Percentage of adults ages 65 and older who reported having all teeth removed due to decay or gum disease.
Behavioral Risk Factor Surveillance System, 2018

Mortality

Weighted sum of the z-scores for early death and suicide.
America's Health Rankings composite measure, 2020

Early Death

Deaths per 100,000 adults ages 65-74.
CDC WONDER Mortality data, 2018

Drug Deaths*

Deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 adults ages 65-74.
CDC WONDER Mortality data, 2016-2018

Suicide

Deaths due to intentional self-harm per 100,000 adults ages 65 and older.
CDC WONDER Mortality data, 2016-2018
*Supplemental measure.

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