SOCIAL AND ECONOMIC FACTORS

Community and Family Safety

Sum of weighted z-scores of ranked community and family safety measures
America's Health Rankings composite measure, 2021

Violent Crime

Number of murders, rapes, robberies and aggravated assaults per 100,000 population
U.S. Department of Justice, Federal Bureau of Investigation, 2019

Economic Resources

Sum of weighted z-scores of ranked economic resources measures
America's Health Rankings composite measure, 2021

Food Insecurity

Percentage of adults ages 60 and older who faced the threat of hunger in the past 12 months
Feeding America, The State of Senior Hunger in America, 2018

Poverty

Percentage of adults ages 65 and older who live below the poverty level
U.S. Census Bureau, American Community Survey, 2019

Poverty Racial Disparity*

Ratio of the racial or ethnic group with the highest poverty rate to the group with the non-Hispanic white rate among adults ages 65 and older
U.S. Census Bureau, American Community Survey, 2019

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
U.S. Department of Agriculture, Characteristics of Supplemental Nutrition Assistance Program Households, 2018

Education*

College Graduate*

Percentage of adults ages 65 and older who reported having a college degree
U.S. Census Bureau, American Community Survey, 2019

Social Support and Engagement

Sum of weighted z-scores of ranked social support and engagement measures
America's Health Rankings composite measure, 2021

Community Support Expenditures**

Dollars captured by the Administration on Aging per adult ages 60 and older
U.S. Department of Health and Human Services (HHS), Administration for Community Living, State Program Reports, 2018

High-speed Internet

Percentage of households with adults ages 65 and older that have a broadband internet subscription and a computer, smartphone or tablet
U.S. Census Bureau, American Community Survey, 2019

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
Brown University, Shaping Long-Term Care in America Project, 2017

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
U.S. Census Bureau, American Community Survey, 2015–2019

Volunteerism**

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

Voter Participation (Congressional)*,**

Percentage of U.S. citizens ages 65 and older who voted in the last congressional election
U.S. Census Bureau, Current Population Survey, Voting and Registration Supplement, 2018

PHYSICAL ENVIRONMENT

Air and Water Quality

Sum of weighted z-scores of ranked air and water quality measures
America's Health Rankings composite measure, 2021

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, 2017-2019

Drinking Water Violations

Percentage of population served by community water systems with a serious drinking water violation during the year
Environmental Protection Agency, Enforcement and Compliance History Online, Safe Drinking Water Information System, 2020

Non-smoking Regulation*

Percentage of population covered by 100% smokefree laws for restaurants, bars and non-hospitality workplaces
American Nonsmokers' Rights Foundation, 2021

Housing and Transit

Sum of weighted z-scores of ranked housing and transit measures
America's Health Rankings composite measure, 2021

Severe Housing Problems

Percentage of one- to two-person households with an adult ages 62 and older with at least one of the following problems: lack of complete kitchen facilities, lack of plumbing facilities, overcrowding or cost-burdened occupants
U.S. Department of Housing and Urban Development, Comprehensive Housing Affordability Strategy, 2013-2017

CLINICAL CARE

Access to Care

Sum of weighted z-scores of ranked access to care measures
America's Health Rankings composite measure, 2021

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
Centers for Disease Control and Prevention (CDC), Behavioral Risk Factor Surveillance System, 2019

Geriatric Providers

Number of family medicine and internal medicine geriatricians and geriatric nurse practitioners per 100,000 adults ages 65 and older
U.S. HHS, Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System, Sept. 2020

Home Health Care Workers

Number of personal care and home health aides per 1,000 adults ages 65 and older with a disability
U.S. Department of Labor, Bureau of Labor Statistics, 2019

Preventive Clinical Services

Sum of weighted z-scores of ranked preventive clinical services measures
America's Health Rankings composite measure, 2021

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
CDC, Behavioral Risk Factor Surveillance System, 2018

Immunizations

Sum of weighted z-scores of ranked immunizations measures
America's Health Rankings composite measure, 2021

Flu Vaccination

Percentage of adults ages 65 and older who reported receiving a seasonal flu vaccine in the past 12 months
CDC, Behavioral Risk Factor Surveillance System, 2019

Pneumonia Vaccination

Percentage of adults ages 65 and older who reported ever receiving a pneumonia vaccine
CDC, Behavioral Risk Factor Surveillance System, 2019

Quality of Care

Sum of weighted z-scores of ranked quality of care measures
America's Health Rankings composite measure, 2021

Dedicated Health Care Provider

Percentage of adults ages 65 and older who reported having a personal doctor or health care provider
CDC, Behavioral Risk Factor Surveillance System, 2019

Hospice Care

Percentage of Medicare decedents who were in hospice at time of death
National Hospice and Palliative Care Organization, NHPCO Facts and Figures, 2018

Hospital Readmissions

Percentage of Medicare beneficiaries ages 65-74 enrolled in the fee-for-service program readmitted within 30 days of hospital discharge
U.S. HHS, CMS, Office of Minority Health's Mapping Medicare Disparities Tool, 2018

Nursing Home Quality

Percentage of certified nursing home beds rated four or five stars over a three-month period
U.S. HHS, CMS, Nursing Home Compare, Sept. 2020 - Nov. 2020

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 beneficiaries ages 65-74 enrolled in the fee-for-service program
U.S. HHS, CMS, Office of Minority Health's Mapping Medicare Disparities Tool, 2018

BEHAVIORS

Nutrition and Physical Activity

Sum of weighted z-scores of ranked nutrition and physical activity measures
America's Health Rankings composite measure, 2021

Exercise

Percentage of adults ages 65 and older who met the federal physical activity guidelines (150 minutes of moderate or 75 minutes of vigorous aerobic activity and two days of muscle strengthening per week) in the past 30 days
CDC, Behavioral Risk Factor Surveillance System, 2019

Fruit and Vegetable Consumption

Percentage of adults ages 65 and older who reported consuming two or more fruits and three or more vegetables daily
CDC, Behavioral Risk Factor Surveillance System, 2019

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
CDC, Behavioral Risk Factor Surveillance System, 2019

Sleep Health

Sum of weighted z-scores of ranked sleep health measures
America's Health Rankings composite measure, 2021

Insufficient Sleep**

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

Tobacco Use

Sum of weighted z-scores of ranked tobacco use measures
America's Health Rankings composite measure, 2021

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
CDC, Behavioral Risk Factor Surveillance System, 2019

HEALTH OUTCOMES

Behavioral Health

Sum of weighted z-scores of ranked behavioral health measures
America's Health Rankings composite measure, 2021

Cognitive Difficulty*

Percentage of adults ages 65 and older who reported having physical, mental or emotional problems or difficulty remembering, concentrating or making decisions
U.S. Census Bureau, American Community Survey, 2019

Depression*

Percentage of adults ages 65 and older who reported being told by a health professional that they have a depressive disorder including depression, major depression, minor depression or dysthymia
CDC, Behavioral Risk Factor Surveillance System, 2019

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 heavy drinking (eight or more [females] or 15 or more [males] drinks per week)
CDC, Behavioral Risk Factor Surveillance System, 2019

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
CDC, Behavioral Risk Factor Surveillance System, 2019

Suicide

Deaths due to intentional self-harm per 100,000 adults ages 65 and older
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2017-2019

Mortality

Sum of weighted z-scores of ranked mortality measures
America's Health Rankings composite measure, 2021

Drug Deaths*

Deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 adults ages 65-74
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2017-2019

Early Death

Deaths per 100,000 adults ages 65-74
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2019

Early Death Racial Disparity*

Ratio of the racial or ethnic group with the highest early death rate to the non-Hispanic white rate among adults ages 65-74
CDC WONDER Online Database, Underlying Cause of Death, Multiple Cause of Death files, 2019

Physical Health

Sum of weighted z-scores of ranked physical health measures
America's Health Rankings composite measure, 2021

Able-bodied*

Percentage of adults ages 65 and older with no cognitive, visual, auditory, ambulatory, self-care and/or independent living difficulty disabilities
U.S. Census Bureau, American Community Survey, 2019

Falls**

Percentage of adults ages 65 and older who reported falling in the past 12 months
CDC, 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
CDC, Behavioral Risk Factor Surveillance System, 2019

High Health Status*

Percentage of adults ages 65 and older who reported their health is very good or excellent
CDC, Behavioral Risk Factor Surveillance System, 2019

Multiple Chronic Conditions

Percentage of Medicare fee-for-service beneficiaries ages 65 and older with four or more of 21 chronic conditions
U.S. HHS, CMS, Research, Statistics, Data & Systems, 2018

Obesity

Percentage of adults ages 65 and older with a body mass index of 30.0 or higher based on reported height and weight
CDC, Behavioral Risk Factor Surveillance System, 2019

Teeth Extractions**

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

DEMOGRAPHICS

Population Ages 65+

Percentage of population ages 65 and older
CDC WONDER Online Database, Single-Race Population Estimates, 2019

Rural Population

Percentage of a state’s total population estimated to live in a rural area
U.S. Census Bureau and U.S. Department of Agriculture, Economic Research Service, 2019
*Measure is not included in a state’s overall score. **Data appearing in this edition are the same that appeared in the Senior Data 2020 Update. Note: All Behavioral Risk Factor Surveillance System data for New Jersey are from 2018

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