Arizona ranked 31st out of 50 states in the health and well-being of seniors in a newly released report by the nonprofit United Health Foundation.

The state dropped eight spots from last year, when it was ranked 23rd in America’s Health Rankings Senior Report. This year’s report is based on the latest data from 2014 to 2017 that is compiled by state, federal and health agencies, along with national studies and surveys, said Dr. Rhonda Randall, senior adviser to the foundation.

“It is our goal with this report to help seniors, family caregivers and advocates better understand the specific health concerns in their own communities so we can all work together to address them,” Randall said.

The rankings are based on how each state compares to national averages in 34 measurements of senior health.

Among Arizona’s high marks in the national report were:

  • No. 1 (best) in the use of hospice care.
  • No. 2 for the second-lowest percentage of hospital deaths among chronically ill Medicare patients age 65 and older.
  • No. 8 in prescription-drug coverage, showing 87 percent of Medicare enrollees age 65 and older have a creditable prescription-drug plan.
  • No. 8 in preventable hospitalizations.
  • No. 10 in nursing-home quality, with four stars and five stars for facilities.
Importance of hospice care

In ranking No. 1 in use of hospice care, Agnes C. Poore, Casa de la Luz Hospice co-founder and chief clinical officer, said in an email interview, “We know Arizona has a bigger population of older residents, so you could say our demographics for hospice care is right. But, more than that, I attribute the top ranking to a statewide effort to educate the community — not only on hospice, but on the importance of making their wishes known for end-of-life care.

“As the report indicated, at end-of-life most people want to be in the comfort of their homes, surrounded by the people they love,” Poore said. “Hospice makes that happen. I’m incredibly proud of the work being done locally and across Arizona. At the end of the day, we’re empowering individuals to complete their mission on this earth in the ways, and in the places they want,” she said.

Poore said families are also becoming educated about Medicare hospice benefits, which cover expenses including medication, medical supplies and counseling.

Arizona’s success in educating families and caregivers about hospice care is the collaboration of social-services agencies, medical professionals and community groups, including churches, that work and support older adults in their end-of-life journey, Poore said.

In 2017, the Lovell Foundation and the Community Foundation for Southern Arizona partnered to award nearly $3 million to be given out over two to four years for end-of-life care and planning services to local organizations. The initial grants were awarded last summer to 10 projects, of which nine are in Pima County.

The No. 8 ranking in preventable hospitalizations is a success for Arizona, said Randall. It shows that seniors are receiving care through their primary-care doctors or in an outpatient setting such as a clinic or urgent-care facility.

Regarding the No. 8 rank in prescription-drug coverage, the Pima Council on Aging is the designated local office of the State Health Insurance Assistance Program for Pima County residents. “Our Medicare Counseling Office provides trained staff and volunteers who present non-biased information about Medicare plans marketed to adults age 65 and older,” said Adina Wingate, council spokeswoman. Last year, information specialists helped 3,748 individuals get accurate Medicare information.

The council also has volunteers and staff specialists who visit assisted-living and nursing-home residents to advocate for residents’ rights, said Wingate. Routine visits to long-term care facilities to monitor the conditions and talk to residents is also carried out under safe and confidential conditions, she said.

Where Arizona falls short

Among Arizona’s low marks were (out of 50 states):

  • No. 45 in enrollment of poor seniors in the Supplemental Nutrition Assistance Program, formerly the food stamps program.
  • No. 41 for home-delivered meals.
  • No. 47 in flu vaccination of those 65 and older.
  • No. 40 for seniors having a dedicated health-care provider.
  • No. 43 for seniors reporting frequent mental distress.

In response to dedicated health-care providers for older adults, the University of Arizona’s Dr. Mindy Fain, chief of geriatrics, general internal medicine and palliative medicine, and co-director of the UA Center on Aging, said, “We have a crisis when it comes to primary-care providers, including general internists, family doctors, geriatricians and nurse practitioners, and so many people have trouble finding a primary-care provider.” Increasing the number of practicing geriatricians in Arizona could happen if a school loan-forgiveness program for doctors would be established, said Fain.

To increase flu vaccinations, a public-awareness campaign could help, said Fain. People still need to be educated because there still is a “general fear about flu vaccines or a sense that they aren’t effective,” she said.

Wingate said influenza education campaigns aimed at older adults have been done in recent years, but much more health and safety information about the importance of vaccinations remains to be done.

Seniors need to understand that they “are at a higher risk of complications from flu and therefore need the highest level of protection we are able to offer,” said Marcy Flanagan, director of the Pima County Health Department.

“Along with good hand washing and a healthy lifestyle, vaccination can prevent older adults from becoming sick with the flu or make their symptoms less severe if they do get sick.”

There needs to be more funding and support services for elder programs, including food assistance for poor seniors, home-delivered meals and those experiencing mental distress, said Fain. “We don’t spend nearly enough time and resources on support services for older adults,” she said.

Pima Council on Aging’s Wingate agreed, saying, “Federal funding levels for home-delivered meals have not yet returned to pre-2009 recession levels.” She added that a “recent increase in Older Americans Act dollars are a step in the right direction.”

A community-needs assessment of older adults conducted by the council shows behavioral-health concerns, including depression and anxiety ranking among the top-20 concerns, Wingate said. Other concerns are social isolation and loneliness, and 48 percent of 2,269 people age 60 and older say they live alone.

The report’s analysis of national and state-by-state health for seniors, including a comprehensive study of environmental and socioeconomic data to determine benchmarks and rankings, needs to be discussed by primary-care doctors in conjunction with state health officials to improve care, Randall said.

The healthiest states for seniors in the nation, according to the report, are: Utah, No. 1; Hawaii, No. 2; New Hampshire, No. 3; Minnesota, No. 4; and Colorado, No. 5.

The states that have the most challenges are: Louisiana, No. 50; Mississippi, No. 49; Kentucky, No. 48; Arkansas, No. 47; and Oklahoma, No. 46.

Contact reporter Carmen Duarte at cduarte@tucson.com or 573-4104. On Twitter: @cduartestar