America's Health Rankings, United Health Foundation Logo

SOCIAL AND ECONOMIC FACTORS

Community and Family Safety

Violent Crime
Number of murders, rapes, robberies and aggravated assaults per 100,000 population.
FBI, 2020

Economic Resources

Food Insecurity
Percentage of adults ages 60 and older who faced the threat of hunger (i.e., marginally food insecure) in the past 12 months.
Feeding America, The State of Senior Hunger in America, 2018-2019 (states); 2019 (U.S.)
Poverty
Percentage of adults ages 65 and older living below the poverty level.
USCB, American Community Survey, 2019
Poverty Racial Disparity*‡
Ratio of the racial or ethnic group with the highest poverty rate to the non-Hispanic white rate among adults ages 65 and older.
USCB, American Community Survey, 2019
SNAP Reach
Number of adults ages 60 and older who participated in the SNAP per 100 adults ages 60 and older living in poverty.
USDA, Characteristics of Supplemental Nutrition Assistance Households, 2019

Education

College Graduate*‡
Percentage of adults ages 65 and older who reported having a college degree.
USCB, American Community Survey, 2019

Social Support and Engagement

Community Support Expenditures^
Dollars captured by the Administration on Aging per adult ages 60 and older.
ACL, State Program Reports, 2019
High-speed Internet
Percentage of households with adults ages 65 and older that had a broadband internet subscription and a computer, smartphone or tablet.
USCB, American Community Survey, 2019
Low-care Nursing Home Residents
Percentage of nursing home residents who did not require physical assistance for bed mobility, transferring, using the toilet and eating.
Brown University, Shaping Long-Term Care in America Project, 2020
Risk of Social Isolation^
Index of social isolation risk factors: poverty; living alone; divorced, separated or widowed; never married; disability; and independent living difficulty among adults ages 65 and older; normalized values are 1 to 100, with a higher value indicating greater risk.
USCB, American Community Survey, 2016-2020
Volunteerism
Percentage of adults ages 65 and older who reported volunteering in the past 12 months.
USCB, CPS, Volunteering and Civic Life Supplement, 2019
Voter Participation (Average)*^
Average of the percentage of U.S. citizens ages 65 and older who voted in the last presidential and the last midterm national elections.
USCB, CPS, Voting and Registration Supplement, 2018, 2020

PHYSICAL ENVIRONMENT

Air and Water Quality

Air Pollution
Average exposure of the general public to particulate matter of 2.5 microns or less measured in micrograms per cubic meter.
EPA, 2018-2020
Drinking Water Violations
Percentage of population served by community water systems with a serious drinking water violation during the year.
EPA, Safe Drinking Water Information System, 2021
Non-smoking Regulation*
Percentage of population covered by 100% smokefree laws for restaurants, bars and non-hospitality workplaces.
American Nonsmokers' Rights Foundation, 2022

Housing and Transit

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.
USHUD, Comprehensive Housing Affordability Strategy, 2014-2018

CLINICAL CARE

Access to Care

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.
CDC, Behavioral Risk Factor Surveillance System, 2020
Geriatric Providers
Number of family medicine and internal medicine geriatricians and nurse practitioners per 100,000 adults ages 65 and older.
CMS, National Plan and Provider Enumeration System, Sept. 2021
Home Health Care Workers
Number of personal care and home health aides per 1,000 adults ages 65 and older.
DOL, Bureau of Labor Statistics, 2020

Preventive Clinical Services

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, 2020

Immunizations

COVID-19 Vaccination*
Percentage of adults ages 65 and older who were fully vaccinated, defined as having received the second dose in a two-dose COVID-19 vaccine series or one dose of the single-shot J&J/Janssen COVID-19 vaccine.
CDC, COVID Data Tracker, Mar. 17, 2022
COVID-19 Vaccination - Booster Dose*
Percentage of fully vaccinated people ages 65 and older who later received another dose of any COVID-19 vaccine.
CDC, COVID Data Tracker, Mar. 17, 2022
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, 2020
Pneumonia Vaccination
Percentage of adults ages 65 and older who reported ever receiving a pneumonia vaccine.
CDC, Behavioral Risk Factor Surveillance System, 2020

Quality of Care

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, 2020
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
Risk-standardized rate of readmissions within 30 days per 100 admissions among Medicare beneficiaries ages 65-74 enrolled in the fee-for-service program
CMS, Mapping Medicare Disparities Tool, 2020
Nursing Home Quality
Percentage of certified nursing home beds rated four or five stars over a three-month period.
CMS, Care Compare, Sept.-Nov. 2021
Preventable Hospitalizations
Discharges following hospitalization for ambulatory-care sensitive conditions (PQI 90) per 100,000 Medicare beneficiaries ages 65-74 enrolled in the fee-for-service program.
CMS, Mapping Medicare Disparities Tool, 2020

BEHAVIORS

Nutrition and Physical Activity

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, 2020

Sleep Health

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, 2020

Smoking and Tobacco Use

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, 2020

HEALTH OUTCOMES

Behavioral Health

Cognitive Difficulty*‡
Percentage of adults ages 65 and older who reported having physical, mental or emotional problems or difficulty remembering, concentrating or making decisions.
USCB, 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, 2020
Drug Deaths*
Deaths due to drug injury (unintentional, suicide, homicide or undetermined) per 100,000 adults ages 65 and older.
CDC WONDER, Multiple Cause of Death Files, 2018-2020
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 heavy drinking (eight or more [females] or 15 or more [males] drinks per week).
CDC, Behavioral Risk Factor Surveillance System, 2020
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, 2020
Suicide
Deaths due to intentional self-harm per 100,000 adults ages 65 and older.
CDC WONDER, Multiple Cause of Death Files, 2018-2020

Mortality

Early Death
Deaths per 100,000 adults ages 65-74.
CDC WONDER, Multiple Cause of Death Files, 2020
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, Multiple Cause of Death Files, 2020

Physical Health

Able-bodied*‡
Percentage of adults ages 65 and older with no cognitive, visual, auditory, ambulatory, self-care and/or independent living difficulty disabilities.
USCB, 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, 2020
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, 2020
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, 2020
Multiple Chronic Conditions
Percentage of Medicare beneficiaries ages 65-74 enrolled in the fee-for-service program with three or more of the following chronic conditions: alcohol abuse, Alzheimer’s disease and related dementia, arthritis (osteoarthritis and rheumatoid), asthma, atrial fibrillation, autism spectrum disorders, cancer (breast, colorectal, lung and prostate), chronic kidney disease, chronic obstructive pulmonary disease, depression, diabetes, drug/substance abuse, heart failure, hepatitis (chronic viral B & C), HIV/AIDS, high cholesterol, high blood pressure, ischemic heart disease, osteoporosis, schizophrenia and other psychotic disorders, and stroke.
CMS, Mapping Medicare Disparities Tool, 2020
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, 2020
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, 2020

DEMOGRAPHICS

Population Ages 65+*
Percentage of population ages 65 and older.
CDC WONDER, Single-Race Population Estimates, 2020
Rural Population*
Percentage of a state’s total population estimated to live in a rural area.
USCB, 2020

‡ Data in this edition were repeated from the last edition. * Not included in the calculation of overall, model category or topic summation measures. ^ Data for each of the components are available in the Explore section.

Please tell us a little more about you

We appreciate you taking the time to help America’s Health Rankings better understand our audiences. Your feedback will allow us to optimize our website and provide you with additional resources in the future. Thank you.

Please select one option which best describes your profession or field of expertise

Journalist or media professional
Health Policy Professional
Public health professional (state, local, or community level)
Health care provider or administrator
Member of an advocacy group or trade organization
Academic, student, or researcher
Government administrator, legislator, or staffer
Concerned citizen
Other
Don't show me this again
Please take a quick survey.