As America's population grays, choosing the best place to grow old is an important decision that can shape finances, comfort, health, and quality of life in later years. Access to abundant high-quality healthcare at affordable rates is even more important with every year that passes as 14% of adults aged 65 and older say that it is “somewhat” or “very” difficult to access the healthcare services they need.
With that in mind, the experts at healthcare staffing platform Nursa created the Aging Well in America Index, which ranks every US state on healthcare options, staffing pressures, nursing home care, life expectancy, healthcare costs, and environmental factors linked to longevity to reveal the best states to grow old in.
Study highlights:
- Hawaii is the best state to grow old in, scoring 8.56 out of 10 in the Aging Well in America Index
- Mississippi is the worst state to grow old in, scoring just 5.55 out of 10
- Nursing care costs the most in Alaska, with a $30,371 per month bill
- Rhode Island is the most walkable state in the US, scoring 7.7/10
- The best nursing homes are in Hawaii (3.59 rating out of 5) and the worst rated nursing homes are in Missouri (2.48/5)
The Best US States to Grow Old in
Hawaii is the best state to grow old in
According to Nursa, Hawaii is the best state to grow old in, with an Aging Well in America Index Score of 8.56 out of 10. Hawaiians have the longest life expectancy in the US, at 80 years, and the state is home to the second largest population aged 75+ at 9.95% of all Hawaiians. Hawaii is world-renowned for its natural beauty, with plenty of volcanoes, rainforests, and beaches offering endless outdoor activities, keeping its residents active and healthy. The state also has the second best air quality score at 27.3 out of 500 and second fewest number of days with unhealthy air at 25, with the state boasting fresh ocean air, low population density, and many environmental regulations, all keeping pollution at bay.
Hawaii also has the most sun exposure at 4,593 kilojoules per square meter (KJ/m2) helping residents get vitamin D. Research has found that vitamin D3 which you get primarily through sunlight exposure could help balance people’s immune systems and protect against viral infections such as COVID-19. Approximately 35% of Americans have vitamin D deficiency. There are 4,248 nursing home beds in the state, and with an average rating of 3.59 out of 5, they are the best-rated nursing homes in the US.
Florida is home to the largest state percentage of residents aged 75+
Florida follows in second with an 8.18 score out of 10. Florida is home to the largest percentage of residents aged 75+ with 10.03%, an ode to the long average life expectancy of 77.9 years. Florida’s warm climate, large volumes of retirement communities and favorable tax policies draw in the aging population, making it America’s retiree hotspot. Florida boasts the fourth most nursing homes, with 694, with 84,517 beds and an average rating of 3.28. Nursing home care costs on average $10,342 per month, roughly one-third of the cost in the US’ most expensive state, Alaska, at $30,371 - $364,452 over a year. Alaska is home to just 20 nursing homes and has a severe shortage of healthcare professionals, a small population, an extreme climate, and geographic isolation, all of which drive up costs. Many choose assisted living as an alternative, with costs at less than one-third ($9,882 per month).
New Jerseyans live the 3rd longest in the US
Third place goes to New Jersey, which scores 8.06 out of 10. New Jerseyans live the 3rd longest in the US at 79.6 years, with 7.65% of the population aged 75+. The state is the fourth most walkable, with a score of 7/10. Walking is incredibly valuable for your health, known to strengthen the heart, muscles, bones, and improve mental health. Research has found that those with multiple diseases who walk just 10 minutes a day can increase life expectancy by three years, and healthy adults over 40 who increase their activity could add at least 5 years. New Jersey has excellent resources for the aging population, with the 8th most nursing home beds at 50,981 spread across the state’s 348 nursing homes. Nursing homes in the state are the fourth best rated in the US, with 3.38 out of 5.
Massachusetts sits in fourth place with the second longest life expectancy at 79.8 and is the second least impacted by nursing shortages with a surplus of 9,540 nurses compared to demand. Massachusetts is also the sixth most walkable, scoring 6.70 out of 10. Following in fifth place is New York where residents live the fourth longest at 79.5 years, has the third most nursing home beds with 111,620 and is the fifth most walkable scoring 6.8/10.
Mississippi is the worst state to grow old in
On the flip side, Mississippi is the worst state to grow old in, scoring just 5.55 out of 10. Mississippians live the second shortest lives at 72.6 years and live in the least walkable state, scoring 1/10. Nursing homes in the state are the fifth worst rated, scoring just 2.69 out of 5.
Oklahoma ranks as the second worst state, scoring 6.14/10, followed by New Mexico (6.21/10), Georgia (6.22/10), and Michigan (6.29/10)
Methodology
- Nursa set out to determine the best US state to grow old in
- To do this, they ranked each state on 12 factors:
- Proportion of population over 75 years old sourced from the US Census
- Hospital beds per 10,000 population sourced from KFF
- Life expectancy at birth, sourced from the US Census
- Nurse shortage or surplus using demand vs supply sourced from HRSA
- Number of nursing homes sourced from the U.S Centers for Medicare & Medicaid Services
- Total number of nursing home beds sourced from the U.S Centers for Medicare & Medicaid Services
- Average nursing home rating sourced from U.S Centers for Medicare & Medicaid Services
- Cost of monthly semi-private nursing home care is sourced from CareScout
- Air quality index sourced from World Population Review
- Days with unhealthy air quality (2026 prediction), sourced from World Population Review
- Sunlight exposure sourced from the CDC
- Walkability index sourced from the EPA
- To calculate the final score, the percentrank method was used
- All data is correct as of 06/25/2026
*The walkability index was calculated by taking the scores for each walkability index section and normalizing them with the population of that section. This is further aggregated at the state level and normalized to give a score between 1 and 10.
** Hospital bed data includes staffed beds in community hospitals, which account for roughly 85% of all hospitals.
