The 2025 America’s Health Rankings® Senior Report, released by the United Health Foundation, presents a comprehensive overview of the health and well-being of older adults across all 50 states. While the report highlights encouraging national trends — such as reduced early death rates and improved social connectedness — it also underscores persistent challenges, including rising behavioral health concerns and a critical shortage of direct care workers.

Florida ranks 29th in overall senior health, falling behind peer states such as North Carolina (18th), Texas (20th), and California (21st). The state lands in the bottom 10 for several workforce-related measures and continues to struggle to meet the needs of its rapidly aging population.

Critical Shortage of Home Health Workers

Despite having the second-largest population of adults aged 65 and older in the nation, Florida ranks 50th — dead last — in the availability of home health and personal care aides. In 2023, there were just 16.0 aides per 1,000 seniors in Florida, compared to the national average of 62.0. This alarming shortage has persisted since 2016 and raises serious concerns about the state’s ability to support aging in place.

This shortage directly threatens Florida’s aging population, which overwhelmingly prefers to age in place. Without enough workers to deliver critical services, seniors are at greater risk of avoidable hospitalizations, premature nursing home placement, and lower quality of life.

Wage Competitiveness Undermines Workforce Stability

Nationally, low pay remains a major barrier to recruiting and retaining direct care workers. In 2022, the median income for a U.S. direct care worker was just $25,015, with over one-third of the workforce living in or near poverty.

The report’s “Direct Care Worker Wage Competitiveness” indicator found that the wage shortfall — the gap between direct care wages and other entry-level jobs — worsened in 24 states between 2019 and 2021. Though Florida’s specific wage gap was not highlighted in this year’s data, it was notably absent from the list of improving states.

In contrast, states like Washington, New Hampshire, and North Dakota saw significant reductions in their wage shortfalls, reflecting targeted investments in their direct care workforces. Meanwhile, states such as Louisiana, Texas, and California had among the highest wage shortfalls, with direct care workers earning $4 or more less per hour than comparable jobs.

What Policymakers Should Know

As lawmakers and state agencies plan for the future of aging in Florida, this year’s Senior Report serves as a call to action:

• Close the workforce gap by raising Medicaid reimbursement rates and increasing compensation for home care workers.
• Incentivize career entry and retention by offering training, benefits, and career advancement opportunities.
• Look to successful states like Washington and New Hampshire for models of policy and wage reform.

Without targeted investments and reforms, Florida risks falling even further behind — leaving vulnerable seniors without the home care support they need to age with dignity and independence.

Click here to read the full report.