Louisiana has been named the worst state for senior care in the country, according to a new report from RetirementLiving.com. The study compared all 50 states on factors such as health care access, nursing home quality, social support, and environmental conditions that affect older adults.
Researchers found that Louisiana lags in nearly every measure, with high rates of preventable hospitalizations, poor facility ratings, and environmental drawbacks that make aging more difficult. The findings highlight stark differences in senior care depending on where Americans live.
Why Louisiana is the state ranking last
Louisiana’s health care system shows some of the weakest outcomes in the nation. Nursing homes scored poorly for quality, raising concerns about the standard of care available to older residents. On top of that, the state reports some of the highest rates of preventable hospitalizations in the U.S., a signal that seniors aren’t getting enough support through primary or long-term care before conditions become emergencies.
The study noted that Louisiana has below-average air quality and limited access to parks and green spaces, both of which are linked to seniors’ physical and mental health. Drinking water quality is another red flag. Louisiana ranked near the bottom nationally, with the second-worst water safety scores in the country. For older adults, who are often more vulnerable to contaminants, this poses an added health and safety risk.
Social conditions weigh heavily, too. Louisiana struggles with high senior poverty rates and elevated levels of social isolation. Without reliable financial resources or strong community ties, many older residents face compounded challenges: poor access to health care, fewer social supports, and increased stress that can accelerate health decline.
The best states for seniors
The report also highlights states that have built stronger systems for their aging populations. Hawaii ranked first overall, earning praise for high-quality nursing homes, low preventable hospitalization rates, and a clean, accessible environment. Researchers described Hawaii as the “gold standard” for senior care in the U.S.
Minnesota took second place, boosted by strong health care accessibility, a robust network of geriatric specialists, and low levels of food insecurity among older residents. Utah placed third, with affordability, lower rates of isolation, and an environment that encourages healthy, active aging.
Other states in the top tier included New Hampshire, Colorado, Idaho, Massachusetts, Vermont, Delaware, and Wyoming. The Northeast and Upper Midwest often fare better because they invest more heavily in senior services and maintain higher-quality nursing facilities. They also benefit from a stronger base of geriatric clinicians.
By contrast, many Southern states rank lower because they face steeper challenges—higher poverty, food insecurity, weaker health care systems, and fewer providers. These gaps often translate into worse outcomes for seniors, including more preventable hospitalizations and higher mortality from manageable conditions.
The analysis also pointed to different trends that are worth watching. Access to geriatric clinicians has improved nationwide, and community support spending is holding steady, suggesting there is progress in some areas. However, nursing home quality, senior poverty, and hospitalization rates have worsened since 2024, underscoring ongoing challenges.