RALEIGH, N.C. (WNCN) — How healthy are North Carolina’s seniors? 

A new report says our state has some work to do to improve the health of its oldest residents. 

North Carolina ranks 34th nationally and trails the national average in 23 of the 41 measures in which states are ranked, according to the 10th annual state-by-state breakdown from a research foundation backed by UnitedHealthcare.

Utah was the healthiest state for seniors, followed by Vermont and Minnesota. Mississippi was the least-healthy, with No. 48 Kentucky and No. 49 Louisiana only slightly better.

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“We have a decade’s worth of data to look at the health of seniors in our nation and each of our states,” said Dr. Rhonda Randall, the chief medical officer for the employer and individual segment of UnitedHealthcare.

It’s not all gloom for our state. The study finds we are doing a few things well.

North Carolina ranks in the top five nationally when it comes to cancer screenings for people between 65 and 75, and in flu vaccinations for those older than 65. The state also is in the top 20 in vaccinating seniors for pneumonia.

But there is plenty of room for improvement.

Drug deaths rose 85 percent during the past decade in North Carolina, with more than six out of every 100,000 seniors in the state dying, mostly due to overdoses of non-prescribed opioids with some also attributed to accidents and mistakes with prescription drugs.

“It mirrors the national trend, but I think what is enlightening here is a lot of people might not expect to see that trend in seniors,” Randall said. “We were seeing those trends going in the wrong direction for all populations, including seniors, prior to the pandemic. But we did see some worsening over the last several years.”

The report also dings North Carolina for the quality of its nursing homes (only 30 percent are rated four or five stars), the rate of seniors facing food insecurity (15 percent) and that 1 in 6 seniors is dealing with frequent physical distress.

But there is a common thread in some other aspects where North Carolina falls short: For the most part, they’re behaviors that people can do something about.

— Less than 20 percent get enough exercise, putting the state 42nd.

— North Carolina’s smoking rate ranks 38th, with more than 1 in 10 seniors saying they smoke.

— And the state is 32nd when it comes to eating enough fruits and vegetables.

“Those are things that are in our individual control — so that’s the good news,” Randall said.

“Maybe the call to action here for seniors in North Carolina, who had one of the lowest rates of exercise in the nation, where less than one in five seniors get any more exercise than just their activities of daily living. … There’s an opportunity not only to do that for yourself, but to bring a friend or somebody in your community along with you and see what you can do there.”

Because of the lag the collecting and reporting of the data, this report is the first to include the impact the COVID-19 pandemic has had on seniors. It’s long been known that seniors were particularly vulnerable to COVID — which is why they were among the first in line when the vaccine rollout started in December 2020.

Randall says the “most sobering” statistic at a national level was the 17 percent increase in early deaths on a per capita basis — nearly 120,000 more early deaths across the U.S. in 2020, according to the report.

COVID was the third-leading cause of death among older adults in 2020, contributing to more than 76,000 of them, the report says.

“We also saw some really serious concerns of other causes of death (and) about two-thirds of that is attributed to COVID,” Randall said.