No. 4: West Virginia
Weaknesses: Personal well-being, poor health care quality
If it weren't for a poor health care system, the Mountain State might be a good place to retire. Its residents enjoy a low cost of living and plethora of outdoor activities such as hiking, fishing and camping.
West Virginia, which has hot and humid summers, received the worst scores in the country for personal happiness by the Gallup-Healthways Well-Being Index. It was ranked last in five out of six categories, including emotional and physical health, as well as healthy behaviors.
The Agency for Healthcare Research and Quality, which monitors state health care systems, gave West Virginia its lowest rating in the country. The agency noted high rates of hospitalizations for conditions like asthma and diabetes and problems with hospital deaths from conditions considered to have low mortality rates.
Dr. Ernest Moy, who directs AHRQ's state snapshot report, says that West Virginia ranks consistently in the bottom 10, weighed down by poor marks for hospital care. Moy says that while West Virginia's health care system is better than it was two years ago, it's hard for the state to advance in the rankings because other states are recording improvement as well.