Most Age Friendly States.

Survey Says: The Most Age-Friendly States

  • Results from the first and largest of its kind ratings & reviews platform reveal the likelihood of older adults to recommend their communities to other older adults
  • States gain ability to measure results from their master plans for aging with ongoing sentiment data from older residents
  • Residents of “First State” Delaware rate it first in the country on “age-friendliness”

WALTHAM, MA, USA — March 7, 2023 — In the minds of older residents, how is your state faring when it comes to age-friendly living?  In a first-of-its-kind survey of older adult satisfaction regarding the community they live in, the Age Friendly Institute collected more than 60,000 submissions from older residents across America.  On the platform, a consumer reviews site that aggregates all things age-friendly, older residents rated their own town on a number of dimensions of “age-friendliness”, using a structure defined by the World Health Organization combined with net promoter score (NPS) survey methodology.

The survey is ongoing, giving visibility to how consumer sentiment changes over time, and enabling leaders to track future progress on key metrics, and set new targets.  The Age-Friendly Institute compiled responses at the state level.  Delaware earned the highest ratings by its older residents, followed (in order) by Idaho, Hawaii, Arkansas, New Jersey, Maine, Massachusetts, South Carolina, Alabama and Louisiana (see full list).  “We celebrate these states, their leadership and those older Americans contributing [to the survey] to make their places better places in which to live and to age,” said Alana Officer, Unit Head, Demographic Change and Healthy Ageing at World Health Organization. She continued: “Until now, there has been no option for older people to provide continuous feedback to local leaders about the age-friendliness of their cities and communities. So today, I want to join you to celebrate a local revolution led by the Age-Friendly Institute.”

State leaders are mobilizing to create master plans for their aging populations.  This, because by 2030, 73 million baby boomers in the U.S. will be 65 or older. Master plans are long-term roadmaps that include policies and initiatives to ensure that older adults can lead fulfilling and healthy lives. They typically cover several key areas, including healthcare, housing, transportation, social engagement, jobs and financial security.

Age-friendly health systems are integral to age-friendly communities. “It’s not possible to have an age-friendly community without age-friendly health care,” said Terry Fulmer, President of The John A. Hartford Foundation, which supports efforts to expand age-friendly health care and public health through support of the Institute for Healthcare Improvement, Trust for America’s Health, the Age-Friendly Institute and others.  “We welcome this ongoing feedback from older adults. As we age, we know what matters most to us and this survey’s information will help everyone understand which communities are truly age-friendly.”

The Age-Friendly Institute applied age-friendly rubrics in addition to net promoter score (NPS) survey methodology to collect and measure older adult satisfaction.  NPS methodology in this setting was applied with the premise that the likelihood of an older resident recommending a community to others is an indicator of their overall satisfaction with local living conditions for people over age 50.  On, additional detailed ratings and reviews are collected from older residents, and displayed, following 1) the domains of an age-friendly community developed by the World Health Organization, and 2) the 4Ms framework for an Age-Friendly Health System, rooted in four evidence-based elements of high-quality care: What Matters, Medication, Mentation, and Mobility.

“We’re pleased to give older adults this scalable way to be heard by state leaders and local community organizers,” said Tim Driver, President of the Age-Friendly Institute.  “As we harness the transformative power of the internet to amplify their voices, we look forward to joining with more state leaders on developing an increasingly respectful experience for their older adult citizens.”

The Age-Friendly Institute celebrates that Delaware has again lived up to the nickname “First State” which it originally earned due to the fact that on December 7, 1787, it became the first of the 13 original states to ratify the U.S. Constitution—and now it’s ratified by its older residents as the most age-friendly place to live in America.

See ratings methodology on

About The Age-Friendly Institute
The Age-Friendly Institute ( aggregates and elevates all things age-friendly. Its consumer website was created to simplify the confusing landscape for older adults and families as they navigate aging and to give voice to their experiences. brings together expert-developed systems for establishing what is age-friendly with reviews, ratings and insights from older adults and family caregivers. Through its research and events, the Institute encourages cross-sector collaboration among aging services organizations in pursuit of a comprehensive Age-Friendly Ecosystem. The Age-Friendly Institute is also the home of the Certified Age Friendly Employer (CAFE) program.

Media Contact for Age-Friendly Institute:
Emily Johnson

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