Widest gap
Arizona +68.5 index points
Combining the second-highest net 65+ migration rate with the second-lowest certified nursing-home bed rate.
Where America is growing older faster than its care is growing.
How ready is America to care for its aging population? Mirador Living compared five years of population change with the care and costs available in all 50 states and Washington, DC.
Arizona +68.5 index points
Combining the second-highest net 65+ migration rate with the second-lowest certified nursing-home bed rate.
South Dakota −75.0 index points
Where care readiness most exceeds demographic pressure. Iowa and Nebraska come next.
Idaho +12.66 per 1,000 aged 65+
The seven states gaining older residents fastest all rank among the ten widest care gaps.
Color shows where demographic pressure exceeds measured care readiness.
Use the arrow keys to move between states, and press Enter to open a state's full profile.
Gap values run from −75.0 (South Dakota) to +68.5 (Arizona).
Mirador Living compared how much demographic pressure each state faces with the care available there, across all 50 states and Washington, DC. Pressure combines 75+ population growth and net 65+ migration; readiness combines certified nursing-home beds, home-health agencies, hospitals and regional price levels. Every measure is ranked from 0 to 100 with equal weights, and the gap is pressure minus readiness, so larger positive gaps mean pressure exceeds measured readiness. It is a relative index, not a care-sufficiency, care-quality or best-place-to-retire ranking.
These rankings are estimates, not exact positions. For 21 states the migration figures could be zero, and nearby ranks are not clearly distinct.
A negative gap means measured readiness is ahead of demographic pressure in this index. It does not mean a state has spare care capacity.
Migration figures come from census records on individual movers. Where an origin is not recorded, the move is left out rather than counted as zero. Connecticut has the most of these (about 7,700 people), which makes its recorded net loss of 1,658 less certain.
Nursing-bed totals add up only the beds that nursing homes reported. Ten homes did not report a count (California 4, Montana 2, and one each in Georgia, Hawaii, Maryland and Mississippi), so the totals can slightly undercount. Home-health figures count agencies, not caregivers or visits.
The general price level reflects overall living costs, not the cost of care.
Some figures come from slightly different dates (nursing homes and hospitals: August 2026; home health: July 2026), and the population data covers the pandemic years. Growth and care-supply figures share the same 2024 population base, so their link is partly mathematical, not independent evidence that states fell behind on supply.
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