The nation’s elderly population is growing. The 2010 decennial census recorded the greatest number and proportion of Americans age 65 and older ever recorded, at 40.3 million people, or 13% of the U.S. population. Today, nearly 15% of the U.S. population is 65 or older, and that share is expected to continue to increase in coming years. According to the U.S. Census Bureau, Americans 65 and older will comprise over 20% of the population before 2050.

State officials, families, and elderly individuals will likely need to spend increasingly large resources and time considering the role of older community residents. Circumstantial factors such as weather preference and the presence of friends and family play a major role in the quality of life for elderly residents. Based on relatively material indicators, including health, labor markets, amenities, and access to medical facilities, elderly populations in some states are better off than in others.

23. Maryland
> Pct. of pop. age 65 and up: 14.1% (9th lowest)
> 65 and over poverty rate: 7.3% (15th lowest)
> 65 and over bachelor attainment: 32.6% (3rd highest)
> Life expectancy at birth: 79.3 years (22nd highest)

The national average retirement age is 63 years. One consequence of this is that millions of elderly residents are at risk of financial insecurity if Social Security proves insufficient and their savings are not sufficient to cover expenses through end of life. In Maryland, 56.7% of senior citizens have at least one supplemental form of retirement income in addition to Social Security, such as 401ks, pensions, and IRAs. This is higher than the 49.1% of American senior citizens with a supplemental retirement income. The median income of elderly households in the state of $53,401 a year is third highest in the country.

Further, while Americans of all ages face everyday economic, social, and medical challenges, low income, poverty, violent crime, medical expenses, and other such difficulties disproportionately affect older people. Most older Americans will require some level of support sooner or later, and many elderly individuals need long-term care and support services. The experience of growing old can also differ substantially between states.

Many, if not most, of America’s seniors rely heavily on a combination of Social Security, Medicare, and modest retirement income. Due to political changes, expenditures on these government programs are likely to decline rather than increase, leaving many elderly in a state of greater financial uncertainty. There are also few alternatives. Even for older Americans who supplement their income with wages, this income is unlikely to rise substantially. The typical elderly household earns $40,971 annually, and only about half of people 65 and over report having retirement income such as pension payments and 401k withdrawals in addition to Social Security. States where the elderly median household income and the share of seniors with supplemental retirement income were lower than average were considered worse off than other states.

The physical decline that comes with age means disabilities are considerably more likely among older individuals. While largely unavoidable, being disabled in old age is more likely in some states than in others. Nationwide, 35.4% of Americans 65 and over report having some form of disability. A state’s position in the ranking fell the more the elderly disability rate exceeded the national figure. Of the 25 states on the lower end of our list, 16 have above average disability rates among elderly residents. In seven states, all in the top 20, over 40% of seniors report a disability.

The crude annual mortality rate for elderly populations is another indication of health. Nationwide, there are 4,261 deaths per 100,000 people 65 and older a year When the mortality rate far exceeds the national incidence and that of other states, it is likely that adverse health leading to premature death is partially to blame.

Research has shown that elderly people — especially those in poor health and with disabilities — are at greater risk of abuse than other age cohorts. Low social support is among the many factors that significantly increases the odds of mistreatment. Nationwide, there are approximately 30 social establishments per 10,000 people. These include performing arts companies, sports stadiums, museums, historical sites, libraries, bars, casinos, golf course and country clubs, religious organizations, and many other venues. Because the concentration of such organizations in a state pushes up its ranking, they are relatively abundant in the best states to grow old in. The social establishment to 10,000 person ratio exceeds 40 in just six states, all in the top 15.

In addition to reducing the odds of mistreatment, isolation, exclusion, and neglect, the presence of these amenities can of course also be major positive forces for a community’s elderly residents.

Click here to see the best and worst states to grow old in.

Click here to read our methodology.