“Utah residents who look forward to retiring in their state just got some good news in a report that names the state as the best in which to grow old. Those who hope to age gracefully in Wyoming, North Dakota, and New York may face more of a challenge. Those states are ranked as the three worst”.

All 50 states were ranked by the elder care resource site Caring.com on 13 categories including quality, cost, and availability of health care for seniors. The calculations also incorporated a state-by-state well-being ranking for older Americans. Utah, No. 17 in well-being, had respectable scores across all the categories and was the only state to make it into the top 15 for both quality of life/health care (No. 7) and cost (No. 14). Here are the best and worst states for growing old, according to the report, followed by the median monthly cost of an assisted-living facility.

Best states

1. Utah/$2,950
2. Iowa/$3,518
3. South Carolina/$3,000
4. Washington/$4,500
5. Nebraska/$3,510

Worst states

1. Wyoming/$3,995
2. North Dakota/$3,340
3. New York/$4,136
4. Indiana/$3,528
5. West Virginia/$3,263

New York, No. 33 in the well-being ranking, was singled out by Caring.com for its extremes. The very high cost of the state’s health care doesn’t produce results close to commensurate with that spending, according to the report. While New York ranked 46th in cost (the lower the rank, the higher the cost), its life/health care quality rank was 34 (the lower the rank, the worse the quality). Massachusetts had a similar pattern; it ranked 49th in cost and 18th in quality. That’s reflective of a larger trend in the U.S.—high spending on health care isn’t translating into longer lives, as this interactive graphic demonstrates.