Introduction

This year’s report highlights improvements in preventive health behaviors, growth in the workforce caring for older adults and a continued decrease in the early death rate. Despite these successes, older adults continued to face challenges such as increases in drug deaths, excessive drinking, suicide and food insecurity.

Between 2023 and 2024, the population of adults age 65 and older in the United States increased by more than 1.9 million individuals. In 2024, there were more than 61 million adults age 65 and older in the U.S., making up 18.0% of the population. The proportion of older adults will continue to rise as 2030

approaches and the last of the baby boomers turn 65 years old.¹ As the older American population grows, it remains important to strengthen and expand initiatives that promote their health and well-being while working collaboratively to address the complex challenges they face.

This year’s report highlights important differences in the health of older adults by metropolitan status. On average, residents of rural areas are older

than their urban counterparts, and older adults living in rural areas face unique challenges

to staying healthy.^2,3 Rural populations vary significantly by state, meaning that these factors impact communities across the U.S. differently. These differences highlight how geographic location and access to resources can shape health. 

• Fifty-six measures. These include 36 ranking and 20 unweighted measures (not included in a state’s overall rank). For a complete list of measures, definitions and source details, see the Measures Table.
• Five categories of health. These are comprised of Health Outcomes and four categories of health drivers: Social and Economic Factors, Physical Environment, Behaviors and Clinical Care.
• Twenty-five sources. Data are from many sources, including the Centers for Disease Control and Prevention’s (CDC’s) Behavioral Risk Factor Surveillance System (BRFSS) and the U.S. Census Bureau’s American Community Survey.

• Presenting a holistic view of health. This report goes beyond measures of clinical care and health behaviors by considering social, economic and physical environment measures, reflecting the impact of social drivers of health.
• Providing a benchmark for states. Since 2013, the report has presented strengths, challenges and key findings for every state and the District of Columbia. Public health advocates can monitor health trends over time and compare their state with other states and the nation. State Summaries are available on the America’s Health Rankings website as separate downloads.
• Highlighting differences. The report shows differences in health between states and among demographic groups at state and national levels, with groupings based on race/ethnicity, gender, age, education, income, metropolitan status, disability status, sexual orientation and veteran status where data are available.
• Stimulating action. The report aims to drive change and improve health by drawing attention to trends and promoting data-driven discussions among individuals, community leaders, public health workers, policymakers and the media. States can incorporate population insights into their annual review of programs, and many organizations use the report as a reference when assigning goals for health improvement plans.

America’s Health Rankings is built upon the World Health Organization’s definition of health:

“Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”⁴

The model was developed under the guidance of the America’s Health Rankings Advisory Council and Committees, with insights from other rankings and health models, particularly County Health Rankings & Roadmaps

and Healthy People.

The model serves as a framework across all America’s Health Rankings reports for identifying and quantifying the drivers and outcomes that impact state and national population health.

Definitions, Limitations and Methodology 
For details on demographic group definitions and limitations, data sources and methodology, please refer to the Appendix.