Senior care in the US looks very different depending on where you live. A new analysis compared every state and found huge gaps in health care, social support, and living environments for older adults. Some states provide strong systems for seniors, while others continue to struggle with poverty, isolation, and preventable hospitalizations.
According to RetirementLiving.com, which reviewed data from government sources and health nonprofits, Hawaii ranked first in the nation for senior care. The report graded states on health care accessibility, social factors such as poverty and isolation, and environmental conditions that can affect aging populations.
The top states for senior care
Hawaii earned the highest spot thanks to high-quality nursing homes, fewer preventable hospitalizations, and favorable environmental and social conditions. The state’s clean air, better access to parks, and supportive communities made it what researchers called the “gold standard” for eldercare in the US.
Minnesota followed in second place. Researchers noted its strong health care system, low levels of food insecurity, and reliable social support for older residents. Utah came in third, standing out for affordability, low rates of senior isolation, and what the study described as an environment that supports healthy senior living.
Other states that performed well include New Hampshire, Colorado, Idaho, Massachusetts, Vermont, Delaware, and Wyoming. Together, these states highlight how investments in senior services, access to geriatric specialists, and community support programs can make a measurable difference in quality of life.
The states falling behind
On the opposite end, Louisiana ranked last. The analysis found its nursing homes among the lowest quality in the country, paired with high rates of preventable hospitalizations. Researchers also flagged poor air quality, limited park access, and some of the worst drinking water in the US as added risks for seniors.
Mississippi came second to last, with the highest levels of senior poverty and social isolation. West Virginia ranked just above, facing the weakest senior health care access and the highest rate of preventable hospitalizations nationwide. Other states in the bottom tier included Oklahoma, Kentucky, Georgia, Arkansas, Tennessee, Illinois, Alabama, and Nevada.
Jailyn Rodriguez, who led the study, explained that Northeastern and Upper Midwestern states generally ranked higher because they devote more resources to senior services and maintain stronger bases of geriatric specialists. By contrast, Southern states face greater challenges like higher poverty, food insecurity, and fewer health care providers, all of which add up to poorer outcomes.
The findings also reflect national trends. Rodriguez noted that access to geriatric clinicians has improved since 2024, now reaching nearly 40 for every 100,000 seniors. Hospice use is also slightly up, showing more families turning to end-of-life care, but not all signs are positive, as preventable hospitalizations have risen, and both nursing home quality and senior poverty rates have worsened.
The report highlights a sharp divide in how seniors experience care across the country. While states like Hawaii and Minnesota demonstrate that strong systems can support older adults, many regions still fall behind. As the older US population continues to grow, these gaps will likely become more visible, making investment in senior health and social services even more urgent.