No. 2: West Virginia
The Mountain State puts pressure on its retirees in a number of ways. Its health care system, for example, is considered by the government to be one of America's worst, and its wellness score is at the bottom of the heap.
The Agency for Healthcare Research and Quality, which monitors state health care systems, gave West Virginia its second-lowest rating in the country. The agency noted such problems as high rates of "potentially avoidable" hospitalizations for chronic conditions and high rates of poor communication between patients and doctors.
Dr. Ernest Moy, who directs AHRQ's state snapshot report, says states with low-quality health care tend to fail at disease prevention and management. They may not have strong vaccination or anti-smoking programs, for example. Doctors in those states may not recommend as strongly as others that patients take steps to prevent disease. And patients may not be as interested in or capable of following their doctor's orders.
It's really a cultural problem that cuts into health care quality, Moy says, and retirees should consider that before they move.
"If you go into an environment where most people don't get preventive services, well, you might not want to get preventive services either," Moy says.