Updated May 16, 2019, with quotes from United HealthCare.

BIRMINGHAM, Ala. (May 15, 2019)—Young seniors—those ages 65 to 74—are reporting better health than they were 15 years ago but are also engaging in higher rates of unhealthy behaviors, according to the United Health Foundation’s annual America’s Health Rankings Senior Report issued Wednesday.

This is the sixth year for a senior version of America’s Health Rankings, which is produced in partnership with the Gerontological Advance Practice Nurses Association. The report analyzes national health on a state-by-state basis by evaluating a historical and comprehensive set of health, environmental and socioeconomic data to determine national health benchmarks and state rankings. Data was obtained from more than a dozen sources, including the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System, the Administration on Aging’s State Program Reports, the U.S. Census Bureau’s American Community Survey and the Dartmouth Atlas of Health Care.

The 2019 Senior Report focused changes in the health of seniors aged 65 to 74 between 2002 to 2017. It found that there are 11 million more seniors age 65 to 74 than there were in 2002; that group represented 9.1% of the U.S. population in 2017, the most recent date in the data.

Young seniors are self-reporting better health status than in 2002, an increase of 11%, and rates of smoking are down 16%. Early death (before age 78 in the U.S.) for this age cohort has decreased 22% since 2002. However, rates of obesity have increased 36% and young seniors report excessive drinking at a 42% higher rate than in 2002. Also concerning in light of the decreased early death rate is an increased suicide rate of 16%.

"Having poor mental health days or feeling depressed is not a normal part of aging," said Rhonda Randall, D.O., chief medical officer of United HealthCare national markets, and an advisor to America's Health Rankings. "Seniors experiencing these challenges should seek help from their health care provider."  

"The United Health Foundation recognizes that risk factors for depression among older adults include physical illness, certain medication use, certain chronic diseases, heavy alcohol consumption, loss of a loved one and lack of social support. We have also seen better health among seniors who participate in civic activities and have strong engagement with others in their communities. The United Health Foundation recommends that seniors work with their health care providers and ask questions about how they can adjust their lifestyles and stay on a regular care schedule to be as healthy as possible, as well as learn about how they can be more engaged in their communities to improve their health holistically."

Home Health Growing

The report found that home health care workers increased 21% from 2018 to 2019, from 112 to 135 workers per 1000 adults 75 and older. The Bureau of Labor Statistics reports the need for long-term support and services is expected to increase 41% over the next decade to accommodate the growing senior population.

The number of home health workers varies across states. There are about 264 workers per 1,000 adults in Minnesota and just 32 workers per 1,000 adults in Florida.

"The United Health Foundation believes that most seniors want to remain in their homes and communities as long as possible, so it is important that they have access to the support they need to do so," said Randall. "Of the support services measured in the Senior Report, hospice use and the number of home health workers have increased in recent years ... These support services—along with others that America’s Health Rankings does not measure, such as transportation aid, support for drug costs, housing assistance, senior center programs, etc.—may help provide options for seniors to remain in their homes and improve their comfort and quality of life."

State Rankings

The report ranks states across 35 health measures from behavior, policy and outcomes. Some of the measures considered are obesity rates, state investment in community programs, senior volunteerism, nursing home quality and home health workers per 1,000 people.

Top 5

  1. Hawaii
  2. Utah
  3. Connecticut
  4. Minnesota
  5. Colorado

Bottom 5

  1. West Virginia
  2. Oklahoma
  3. Louisiana
  4. Kentucky
  5. Mississippi

Hawaii ranks first due a low prevalence of obesity among adults 65 and older (19.8%) and a high prevalence of arthritis management program at 60%. The state struggles with high rates of excessive drinking among young seniors and low volunteerism.

Mississippi struggles with low community support expenditures for seniors ($184/senior) and the highest prevalence of seniors living in poverty (13.7%). The state sees a high percentage of hospice care (54.8%) and a low percentage of ICU use among Medicare beneficiaries (12.3%).

The online version of the Senior Report has a web tool that allows users to see how improvements or declines in various measures can impact a state’s rank.

"Seniors are going to live longer, but will have more chronic illnesses for a longer period of time," said Randall. "As life expectancy grows, we want our seniors to know that they are never too old to make changes that can improve their health. Taking steps to stop smoking and excessive drinking, while also living a healthy lifestyle that reduces risk factors for obesity and diabetes can help them better enjoy their senior years."

The Senior Report’s purpose is to promote data-driven discussions among individuals, community leaders, the media, policymakers and public health officials that can drive positive change and improve the health of seniors.

Find the full report at americashealthrankings.org.