• Feature

    The Best States in Which to Practice

    Every state has much to offer physical therapists and physical therapist assistants. It may be quality of life. Employment opportunities. Regulatory and business friendliness. Or any of dozens of other features. But to make it to the top of PT in Motion's third annual analysis of the best states in which to practice, states needed high rankings in multiple factors that health care professionals say are important.

    Best States in Which to Practice

    What's the best state in which to practice physical therapy?

    The answer of course depends in part on what you value. How important is salary? Quality of life? Future job prospects? Fewer regulatory restraints? The demographic characteristics (such as age and health) of the state's residents? And so on.

    Many rankings of "best states" use some combination of these factors. PT in Motion's analysis uses these 8 criteria:

    • Well-being and future livability. The quality of life—as it relates to physical therapists (PTs) and the general population—and the overall health of the population are included here, as are projections on future living conditions.
    • Literacy and health literacy. Both general literacy and health literacy, considered to be desirable population traits, reflect the ease and effectiveness with which health care providers can communicate with patients and clients.
    • Employment and employment projections. What's the job situation? This factor is based on state population and projections for the percentage growth in physical therapy jobs.
    • Business and practice friendliness. Most health care professionals say it's more desirable to practice in a state that is friendly toward business in general and physical therapists in particular.
    • Technology and innovation. Health information technology is becoming increasingly important in the practices of physical therapists and other health care providers with whom they interact. Which states lead in health care technology?
    • PT, PTA, and student engagement with APTA. These figures reflect PT, PTA, and student membership in APTA. A greater involvement suggests a stronger commitment in time and money to current and future professional development as well as involvement in state and national regulatory and legislative issues.
    • Compensation and cost of living. How much is a PT paid on an annual basis? And how far does the compensation stretch, as measured by that state's cost of living?
    • Health and financial disparities. New this year, these data consider the amount of financial and health care variation within a state regarding income, health, and women's health. States with less variation received higher scores than those with greater variation.

    In calculating the final state rankings, we weighted each of the 8 criteria equally. For example, "employment and employment projections" counted as much as "well-being and future livability."

    Other surveys and reader response to last year's survey suggest that all 8 factors are important. However, you personally might rank one higher than another, while your colleague might do the opposite. For that reason, we've provided the states' individual rankings for each of the 8 criteria so that you can adjust our rankings to your personal preferences.

    The average score for each of the 8 criteria was 10. An above-average state (for instance, higher-than-average anticipated growth rate) received more than 10 points while a below-average state received fewer than 10 points. Thus, the average cumulative score across all 8 measures is 80. Actual cumulative state scores range from 63.0 to 104.4.

    Many states received similar scores. For example, Iowa, ranked ninth, received an overall score of 90.875, while Vermont, ranked 10th, received 89.361 points. Does that make Iowa a far better state in which to practice than Vermont? Of course not. On the other hand, if you look at the individual components of the scores, you'll see that Iowa ranks higher than Vermont in business friendliness, while Vermont tops Iowa in well being and future livability.

    But when it comes down to including all 8 factors, 1 state was the clear leader. Again. And that state was...

    ... Utah.

    Utah scored 104.375 points, coming in above second-place Virginia, which itself turned in an impressive score of 98.385.

    What's the secret to Utah's success? It had consistently strong scores across the board, with a particularly high rating (third) in "well-being and future livability" and coming in first for its lack of health and financial disparities. Its lowest ranking was 17—still above average—in "compensation and cost of living."

    Similarly, Virginia demonstrated multiple strengths, ranking third in "employment and employment projections" and seventh in "technology."

    Rounding out the Top 5 were third-place Nebraska (98.3 points), fourth-place Colorado (95.7 points), and fifth-place Minnesota (95.5 points).

    It should be noted, though, that any state can have many desirable features. For instance, Texas is ranked 17th but came in second in employment and employment projections. Mississippi, Nevada, and Kentucky—none of which made the top 20 in the overall rankings—came in first, third, and fifth, respectively, in "compensation and cost of living," aided by a combination of above-average compensation and low cost of living.

    Ranking the States: Behind the Numbers

    What makes a state more or less desirable for practicing physical therapy? The answer can vary, based on each physical therapist's or physical therapist assistant's personal preferences. A PT seeking a state with good compensation and a low cost of living might place Mississippi or Texas—the 2 states with the strongest combination of pay and cost of living—at the top of his list. A PTA who is seeking a state with strong prospects for employment and overall growth in employment might choose that category's top-ranking California.

    Usually, though, the choice of the "best" state is based on multiple factors, many of which appear in different entities' rankings of "best states in which to practice" for a range of health care professions.

    For example, Physicians Practice magazine rates the best states for physicians.1 Factors in its calculations include cost of living, disciplinary actions taken against physicians, tax burden per capita, Medicare's Geographic Practice Cost Index, physician density, and malpractice award payouts per capita. Using those criteria, Physicians Practice ranked Mississippi, Alabama, Texas, and Nevada as the top states in which physicians practice.

    ValuePenguin, which compiles various "best" listings, ranked best cities for physical therapists based on income, cost of living, and concentration of physical therapists. Its top 2013 rankings included Sherman-Denison, Texas; Huntington, West Virginia, Ashland, Kentucky; and Jacksonville, Florida.2

    A ranking by Dentistry iQ (a division of PennWell) of best states in which to be a dental hygienist includes percent of the population without insurance, public health funding, smoking prevalence, recent dental visits, and the unemployment rate.3

    In constructing the initial PT in Motion "Best States" listing, we used these and other state rankings to identify 3 general areas:

    • Making a living as a PT; financial and employment factors
    • The health and other demographics of the population
    • Quality of life

    Based on suggestions from chapters and members, further research, and feedback from previous year's "Best States" listings, PT in Motion identified 8 criteria to inform its 2015 rankings:

    Well-Being and Future Livability

    Rationale: The quality of life—as it relates to both PTs and the general population—and the overall health of the population are important considerations. After identifying dozens of different data sources, PT in Motion settled on 4. Two—dealing specifically with well-being and future livability—are compiled by Gallup. Each, in turn, is based on multiple inputs. The other 2, both compiled by Kaiser Family Foundation, are life expectancy at birth—a measure of overall health and well-being—and the percent of adults who participate in activity.

    Well-Being Index
    The Gallup-Healthways Well-Being Index summarizes a range of well-being items in 5 categories.4 The data are based on daily surveys conducted from January through December 2014, including interviews with more than 176,000 Americans nationwide. The index is calculated on a scale of 0 to 100.

    The major categories are:

    • Physical
    • Purpose
    • Social
    • Financial
    • Community

    Future Livability
    The Gallup Future Livability Index uses 13 "forward-looking" metrics that it says might determine which states will be the best places to live in the future.5 Five of the 13 encompass economic, workplace, community, and personal choices. The remaining 8 metrics include evaluations of one's life 5 years from now, economic confidence, job creation, standard of living momentum, obesity, ease of finding a safe place to exercise, visits to the dentist, and the percentage of workers employed full time for an employer. The findings are based on the results of more than 530,000 interviews with US adults conducted from January 2011 through June 2012 as part of Gallup Daily Tracking and the Gallup-Healthways Well-Being Index.

    Literacy and Health Literacy

    Rationale: Both general literacy and health literacy are considered to be desirable population traits. They reflect the ease and effectiveness with which health care providers can communicate with patients and clients. For example, The Health Literacy of America's Adults, published by the National Center for Education Statistics of the Department of Education, states, "Health literacy is important for all adults. Adults may read an article in a magazine or a pamphlet in their doctor's office about preventive health practices; they may need to fill a prescription, select and buy an over-the-counter medication, or understand health insurance forms. Parents must manage their children's health care, including getting them immunized, taking them for physicals, and having their illnesses treated."6

    APTA supports health literacy. HPSO (Healthcare Providers Service Organization) explains: "Health literacy is integrated into key American Physical Therapy Association (APTA) core documents, including it as part of the evaluation criteria for accreditation of PT education programs. Health literacy is also implied in APTA's Statement of Practice for Physical Therapy."7

    Data Sources: PT in Motion's measures of general and health literacy had multiple inputs:

    • Percent of population in poverty (Source: Census Bureau8)
    • Literacy—level of basic prose literacy skills (Source: US Department of Education9)
    • Home access to the Internet (Source: Census Bureau10)
    • Percentage of population with graduate or professional degrees (Source: American Community Survey11)
    • High school graduation rate (Source: Department of Education12)

    Employment and Employment Projections

    Rationale: One nearly universal measure of "best states" in which to practice considers prospects for future employment and job demand. To determine this, PT in Motion began with the US Department of Labor employment projections for the percentage growth in physical therapy jobs by state from 2012 to 2022.13 We also factored in the percent of the US population in that state.14 For example, the Department of Labor projects similar demand growth for PTs in Texas and Iowa—approximately 32%. However, because Texas's population is nearly 9 times that of Iowa's, Texas ranks higher on our scale for employment opportunities.

    Business and Practice Friendliness

    Rationale: It's more desirable to practice in a state that is friendly toward business in general and physical therapists in particular. To measure these factors, PT in Motion used 3 sources.

    Small Business Friendliness
    The first is the 2014 Thumbtack.com Small Business Friendliness Survey, conducted in partnership with the Ewing Marion Kauffman Foundation.15 Rather than basing its results on publicly available statistics (such as unemployment rates, income per capita, and tax rates) as proxies for a state's friendliness toward business, this survey asked nearly 8,000 small business owners to rate their local and state environment across a variety of measures. According to Thumbtack, "we are able to capture nuances that are difficult or impossible to measure through other data sources." Components of the ratings included overall regulatory friendliness, friendliness of licensing regulations, friendliness of health and safety regulations, and availability of helpful training or networking programs. Ratings were expressed as grades, ranging from A+ to F.

    Business Competitiveness
    CNBC ranks of all states using more than 60 measures of competitiveness, developed using input from business groups, economic development experts, companies, and the states themselves.16 CNBC then separates those metrics into 10 broad categories, weighting the categories based on how frequently they are cited in state economic development marketing materials. CNBC explains, "That way, our study ranks the states based on the criteria they use to sell themselves."

    Direct Access to Physical Therapy Laws
    APTA's "A Summary of Direct Access Language in State Physical Therapy Practice Acts" and updates that occurred in 2015 were used to determine a state's direct access score.17 States with unlimited direct access scored the highest, followed by those with provisions. States with fewer limitations received more points than those with more limitations.

    Technology and Innovation

    Rationale: Health information technology is becoming increasingly important to the practices of physical therapists. APTA says: "As we move closer to a nationwide health information technology infrastructure, APTA is aggressively pursuing avenues to assist physical therapists select and implement health information technology (HIT). Additionally, APTA is working with federal policymakers to educate them as to the importance of including physical therapists in HIT initiatives moving forward.

    "While physicians and hospitals are the beneficiaries of many of the federal government's initial efforts to encourage HIT adoption, they will expect the other providers they work with, including physical therapists, to use it as well. Patients may also begin to expect their providers to use HIT to manage their care. Physical therapists should remain aware of and become educated on issues relating to health information technology particularly in this dynamic health care delivery environment."18

    The ranking of technology and innovation uses 5 different measures:

    • State Telehealth Laws and Reimbursement Policies. The 2015 report by the Center for Connected Health Policy is a summary guide describing how each of the 50 states defines, governs, and regulates the use of telehealth or telemedicine technologies in the delivery of health care services.19PT in Motion assigned points for 5 factors (reimbursement, live video, store and forward, remote patient monitoring, cross-state licensing) identified in the report.
    • Adoption of Basic EHRs: Overall Physician Practices. 20 This information is compiled by the Office of the National Coordinator for Health IT, US Department of Health and Human Services.
    • Overall Hospital Adoption of EHRs. 21 This information is compiled by the Office of the National Coordinator for Health IT, US Department of Health and Human Services.
    • State Technology and Science Index. 22 The Milken Institute collects nearly 80 factors from public and private sources that it assembles into 5 categories: human capital investment, risk capital and entrepreneurial infrastructure, research and development inputs, technology concentration and dynamism, and technology and science work force.
    • The "Technology and Innovation" component is taken from CNBC's "America's Top States for Business 2015."23

    APTA Engagement

    Rationale: These figures reflect PT, PTA, and student engagement with APTA. They are based on APTA data showing the percent of PTs, PTAs, and students within a state who are association members.24,25  

    Student engagement is determined by the percentage of CAPTE-accredited programs within a state that achieved at least 80% participation in APTA's Reach100 membership program.26 These figures may suggest a commitment in time and money to current and future professional development as well as involvement in state and national regulatory and legislative issues. A state with an active and engaged student body and professionals is likely to be more responsive to those interests and concerns.

    Scores were weighted, with 50% of the score based on PT membership, 33% based on PTA membership, and 17% based on student membership.

    Compensation and Cost of Living

    Rationale: The pay and benefits that a PT receives are important considerations in determining a state's desirability. However, a lower cost of living can offset lower compensation. This category looked at 2 elements: (1) annual rate of pay for physical therapists, and (2) the state's cost of living. States with high rates of compensation and low cost of living ranked highest.

    Data for annual rates of pay came from the Bureau of Labor Statistics.27 Cost of living data came from the Missouri Economic Research and Information Center.28

    Lack of Disparities

    Rationale: The preceding 7 factors compare states with one another. This measure—new for 2015—examines the variation within a state. APTA's Vision Statement—"Transforming society by optimizing movement to improve the human experience"—identifies "Access/Equity" as 1 of its guiding principles.29 It states:

    The physical therapy profession will recognize health inequities and disparities and work to ameliorate them through innovative models of service delivery, advocacy, attention to the influence of the social determinants of health on the consumer, collaboration with community entities to expand the benefit provided by physical therapy, serving as a point of entry to the health care system, and direct outreach to consumers to educate and increase awareness.

    Each state's disparity score comprises 3 elements. Two are health-related:

    • Obesity rates among non-Hispanic whites versus non-Hispanic blacks.30
    • Mammogram rates within the past 2 years among non-Hispanic whites versus non-Hispanic blacks.31

    The third is income-related:

    • The ratio of income of the top 5% of the population within a state versus the average income of the population in the lowest quintile. These ranged from a low (smallest disparity) of 6.27 in Alaska to a high (greatest disparity) of 11.88 in the District of Columbia.

    To calculate scores in each of the 8 categories, the average ranking nationwide was assigned a score of 10. An above-average state was awarded additional points; the more it exceeded the average, the more points it received. A below-average state received fewer than 10 points, based on how much below average it scored.

    Each state's 8 scores were added up. These scores were not weighted; each of the 8 counted equally. Each state's summary also shows how it ranks in each of the 8 contributing factors.

    Donald E. Tepper is editor of PT in Motion.

    References

    1. Sprey E. Best States to Practice 2014. Physicians Practice. September 24, 2014. http://www.physicianspractice.com/best-states-practice/best-states-to-practice-2014/page/0/1. Accessed August 17, 2015.
    2. Best Cities for Physical Therapists. Value Penguin. http://www.valuepenguin.com/2013/07/best-cities-physical-therapists. Accessed August 17, 2015.
    3. Best states to be a dental hygienist Dentistry iQ. http://www.dentistryiq.com/articles/2012/01/best-states-rdh-2012.html. Accessed August 8, 2014.
    4. State of American Well-being 2014. http://www.gallup.com/poll/181547/alaska-leads-states-first-time.aspx. Accessed August 16, 2015.
    5. Witters D. Utah Poised to Be the Best U.S. State to Live in. Gallup. August 7, 2012. http://www.gallup.com/poll/156449/utah-poised-best-state-live.aspx. Accessed August 6, 2013
    6. Kutner M, Greenberg E, Jin Y, et al. The Health Literacy of America's Adults—Results from the 2003 National Assessment of Adult Literacy (NCES 2006-483). National Center for Education Statistics, US Department of Education iii-iv.
    7. Improving health literacy improves patient outcomes. Healthcare Providers Service Organization Risk Advisor for Physical Therapists. 2012. http://www.hpso.com/pdfs/db/newsletters/2012-PhysicalTherapist-Risk-Advisor.pdf?fileName=2012-PhysicalTherapist-Risk-Advisor.pdf&folder=pdfs/db/newsletters&isLiveStr=Y
    8. National Assessment of Adult Literacy (NAAL) National Center for Education Statistics, Institute of Education Sciences. http://nces.ed.gov/naal/. Accessed August 16, 2015.
    9. DeNavas-Walt C, Proctor BD. Income and Poverty in the United Statates: 2013. September 16, 2014. United States Census Bureau. http://www.census.gov/library/publications/2014/demo/p60-249.html. Data: http://www.census.gov/hhes/www/poverty/data/incpovhlth/2013/state.xls. Accessed August 16, 2015.
    10. File T, Ryan C. Computer and Internet Use in the United States: 2013. US Department of Commerce. United States Census Bureau. http://www.census.gov/history/pdf/2013computeruse.pdf. Accessed August 16, 2015.
    11. Percent of People Who Have Completed an Advanced Degree by State." American Community Survey . Retrieved from https://www.census.gov/acs/www/. Accessed August 16, 2015.
    12. American Community Survey. https://www.census.gov/programs-surveys/acs/data/summary-file.html. Accessed August 16, 2015. https://www.census.gov/programs-surveys/acs/data/summary-file.html. Accessed August 6, 2013.
    13. Employment Trends by Occupation Across States. 2012-2022. Bureau of Labor Statistics, Department of Occupational Statistics and Employment Projections. http://www.bls.gov/emp. Accessed August 16, 2015.
    14. Annual Estimates of the Resident Population for the United States, Regions, States, and Puerto Rico: April 1, 2010 to July 1, 2014. US Census Bureau, Population Division. December 2014. http://www.census.gov/popest/. Accessed August 16, 2015.
    15. Allen N, Daniels S. 2013 Thumbtack.com small business friendliness survey: Methodology & Analysis. 2014. https://www.thumbtack.com/survey#/2014/1/states. Accessed August 17, 2015.
    16. America's Top States for Business 2015: A scorecard on state economic climate. CNBC. http://www.cnbc.com/2015/06/24/americas-top-states-for-business.html. Accessed August 17, 2015.
    17. A Summary of Direct Access Language in State Physical Therapy Practice Acts. January 2015. http://www.apta.org/uploadedFiles/APTAorg/Advocacy/State/Issues/Direct_Access/DirectAccessbyState.pdf. Updated with News and Briefs at http://www.apta.org/StateIssues/DirectAccess/. Accessed August 17, 2015.
    18. Health Information Technology. The American Physical Therapy Association. http://www.apta.org/FederalIssues/HIT/. Accessed August 20, 2015.
    19. State Telehealth Laws and Reimbursement Policies. The National Telehealth Policy Resource Center, Center for Connected Health Policy. February 2015. http://cchpca.org/state-telehealth-laws-and-reimbursement-policies-report. Accessed August 17, 2015.</p> <p>20. Percent of Physicians, NPs, and PAs that have Demonstrated Meaningful Use of Certified Health IT. CMS EHR Incentive Program data. April 2015. http://dashboard.healthit.gov/index.php. Accessed August 17, 2015.
    20. Percent of All Eligible and Critical Access Hospitals that have Demonstrated Meaningful Use of Certified Health IT. CMS EHR Incentive Program data. April 2015. http://dashboard.healthit.gov/index.php. Accessed August 17, 2015.
    21. Klowden K, Keough K, Barrett J. 2014 State Technology and Science Index. The Milken Institute. 2014. http://statetechandscience.org/state-tech-and-science-report-2014.pdf. Accessed August 17, 2015.
    22. America's Top States for Business 2015: A scorecard on state economic climate. CNBC. http://www.cnbc.com/2015/06/24/americas-top-states-for-business.html. Accessed August 17, 2015.
    23. 2012 PT/PTA Market Share by State. http://www.apta.org/MembershipDevelopment/Statistics/ChapterMarketShare/ Accessed August 6, 2013.
    24. http://www.apta.org/REACH100/.
    25. Platinum (100%), gold (90%), or silver (80%) levels in Reach 100. http://www.apta.org/REACH100/. Accessed August 17, 2015.
    26. Occupational Employment Statistics. Occupational Employment and Wages, May 2013. 29-1123 Physical Therapists. Bureau of Labor Statistics. http://www.bls.gov/oes/current/oes291123.htm. Accessed August 11, 2014.
    27. Cost of Living Data Series First Quarter 2014. Missouri Economic Research and Information Center. http://www.missourieconomy.org/indicators/cost_of_living/index.stm. Accessed August 11, 2014.
    28. Vision Statement for the Physical Therapy Profession and Guiding Principles to Achieve the Vision. APTA. http://www.apta.org/Vision/. Accessed August 17, 2015.
    29. Health Disparities Profiles: 2014 Edition. Washington, DC:DHHS Office on Women's Health. 2014. http://www.womenshealth.gov/quickhealthdata. Accessed August 17, 2015.
    30. Women's Health and Mortality Chartbook: 2014 Edition. Washington, DC: DHHS Office on Women's Health. 2014. http://www.womenshealth.gov/quickhealthdata. Accessed August 17, 2015.
    31. 2013 American Community Survey 1-Year Estimates. American FactFinder, US Census Bureau. http://factfinder.census.gov/faces/nav/jsf/pages/searchresults.xhtml. Accessed August 17, 2015.

    50 States (Plus DC) Ranked With Details

    Each shows the state's overall ranking (lower is better), its cumulative score (higher is better), and its ranking for each of the 8 criteria.

    Utah

    Overall Ranking: 1
    Score: 104.375
    Well-being and Future Livability: 3
    Literacy and Health Literacy: 13
    Employment and Employment Projections: 10
    Business and Practice Friendliness: 14
    Technology and Innovation: 12
    APTA Engagement: 8
    Compensation and Cost of Living: 17
    Lack of Health Disparities: 1

    Virginia

    Overall Ranking: 2
    Score: 98.385
    Well-being and Future Livability: 13
    Literacy and Health Literacy: 21
    Employment and Employment Projections: 3
    Business and Practice Friendliness: 12
    Technology and Innovation: 7
    APTA Engagement: 17
    Compensation and Cost of Living: 19
    Lack of Health Disparities: 27

    Nebraska

    Overall Ranking: 3
    Score: 98.280
    Well-being and Future Livability: 8
    Literacy and Health Literacy: 9
    Employment and Employment Projections: 30
    Business and Practice Friendliness: 3
    Technology and Innovation: 23
    APTA Engagement: 5
    Compensation and Cost of Living: 24
    Lack of Health Disparities: 13

    Colorado

    Overall Ranking: 4
    Score: 95.656
    Well-being and Future Livability: 2
    Literacy and Health Literacy: 19
    Employment and Employment Projections: 11
    Business and Practice Friendliness: 1
    Technology and Innovation: 5
    APTA Engagement: 35
    Compensation and Cost of Living: 34
    Lack of Health Disparities: 24

    Minnesota

    Overall Ranking: 5
    Score: 95.473
    Well-being and Future Livability: 4
    Literacy and Health Literacy: 4
    Employment and Employment Projections: 39
    Business and Practice Friendliness: 15
    Technology and Innovation: 1
    APTA Engagement: 20
    Compensation and Cost of Living: 31
    Lack of Health Disparities: 5

    North Dakota

    Overall Ranking: 6
    Score: 94.267
    Well-being and Future Livability: 21
    Literacy and Health Literacy: 3
    Employment and Employment Projections: 36
    Business and Practice Friendliness: 4
    Technology and Innovation: 24
    APTA Engagement: 4
    Compensation and Cost of Living: 35
    Lack of Health Disparities: 12

    South Dakota

    Overall Ranking: 7
    Score: 93.400
    Well-being and Future Livability: 12
    Literacy and Health Literacy: 17
    Employment and Employment Projections: 46
    Business and Practice Friendliness: 8
    Technology and Innovation: 29
    APTA Engagement: 3
    Compensation and Cost of Living: 36
    Lack of Health Disparities: 3

    Idaho

    Overall Ranking: 8
    Score: 92.596
    Well-being and Future Livability: 15
    Literacy and Health Literacy: 28
    Employment and Employment Projections: 22
    Business and Practice Friendliness: 2
    Technology and Innovation: 41
    APTA Engagement: 12
    Compensation and Cost of Living: 9
    Lack of Health Disparities: 6

    Iowa

    Overall Ranking: 9
    Score: 90.878
    Well-being and Future Livability: 19
    Literacy and Health Literacy: 6
    Employment and Employment Projections: 17
    Business and Practice Friendliness: 7
    Technology and Innovation: 31
    APTA Engagement: 14
    Compensation and Cost of Living: 22
    Lack of Health Disparities: 16

    Vermont

    Overall Ranking: 10
    Score: 89.361
    Well-being and Future Livability: 9
    Literacy and Health Literacy: 2
    Employment and Employment Projections: 37
    Business and Practice Friendliness: 20
    Technology and Innovation: 26
    APTA Engagement: 6
    Compensation and Cost of Living: 48
    Lack of Health Disparities: 9

    Washington

    Overall Ranking: 11
    Score: 88.863
    Well-being and Future Livability: 18
    Literacy and Health Literacy: 23
    Employment and Employment Projections: 19
    Business and Practice Friendliness: 32
    Technology and Innovation: 6
    APTA Engagement: 9
    Compensation and Cost of Living: 29
    Lack of Health Disparities: 22

    Alaska

    Overall Ranking: 12
    Score: 88.622
    Well-being and Future Livability: 7
    Literacy and Health Literacy: 26
    Employment and Employment Projections: 45
    Business and Practice Friendliness: 22
    Technology and Innovation: 28
    APTA Engagement: 2
    Compensation and Cost of Living: 43
    Lack of Health Disparities: 19

    Arizona

    Overall Ranking: 13
    Score: 88.348
    Well-being and Future Livability: 22
    Literacy and Health Literacy: 37
    Employment and Employment Projections: 9
    Business and Practice Friendliness: 13
    Technology and Innovation: 8
    APTA Engagement: 28
    Compensation and Cost of Living: 21
    Lack of Health Disparities: 28

    Wyoming

    Overall Ranking: 14
    Score: 86.815
    Well-being and Future Livability: 14
    Literacy and Health Literacy: 15
    Employment and Employment Projections: 27
    Business and Practice Friendliness: 41
    Technology and Innovation: 50
    APTA Engagement: 10
    Compensation and Cost of Living: 16
    Lack of Health Disparities: 2

    Oregon

    Overall Ranking: 15
    Score: 85.932
    Well-being and Future Livability: 20
    Literacy and Health Literacy: 20
    Employment and Employment Projections: 28
    Business and Practice Friendliness: 10
    Technology and Innovation: 3
    APTA Engagement: 24
    Compensation and Cost of Living: 47
    Lack of Health Disparities: 11

    Montana

    Overall Ranking: 16
    Score: 84.158
    Well-being and Future Livability: 16
    Literacy and Health Literacy: 25
    Employment and Employment Projections: 32
    Business and Practice Friendliness: 17
    Technology and Innovation: 37
    APTA Engagement: 15
    Compensation and Cost of Living: 37
    Lack of Health Disparities: 7

    Texas

    Overall Ranking: 17
    Score: 84.080
    Well-being and Future Livability: 28
    Literacy and Health Literacy: 49
    Employment and Employment Projections: 2
    Business and Practice Friendliness: 39
    Technology and Innovation: 14
    APTA Engagement: 32
    Compensation and Cost of Living: 2
    Lack of Health Disparities: 36

    Kansas

    Overall Ranking: 18
    Score: 83.475
    Well-being and Future Livability: 31
    Literacy and Health Literacy: 14
    Employment and Employment Projections: 35
    Business and Practice Friendliness: 28
    Technology and Innovation: 32
    APTA Engagement: 19
    Compensation and Cost of Living: 13
    Lack of Health Disparities: 15

    Wisconsin

    Overall Ranking: 19
    Score: 82.625
    Well-being and Future Livability: 10
    Literacy and Health Literacy: 8
    Employment and Employment Projections: 48
    Business and Practice Friendliness: 36
    Technology and Innovation: 19
    APTA Engagement: 18
    Compensation and Cost of Living: 27
    Lack of Health Disparities: 29

    New Hampshire

    Overall Ranking: 20
    Score: 82.397
    Well-being and Future Livability: 11
    Literacy and Health Literacy: 1
    Employment and Employment Projections: 23
    Business and Practice Friendliness: 23
    Technology and Innovation: 21
    APTA Engagement: 46
    Compensation and Cost of Living: 41
    Lack of Health Disparities: 10

    Massachusetts

    Overall Ranking: 21
    Score: 81.908
    Well-being and Future Livability: 6
    Literacy and Health Literacy: 10
    Employment and Employment Projections: 21
    Business and Practice Friendliness: 18
    Technology and Innovation: 9
    APTA Engagement: 47
    Compensation and Cost of Living: 44
    Lack of Health Disparities: 33

    Georgia

    Overall Ranking: 22
    Score: 81.825
    Well-being and Future Livability: 34
    Literacy and Health Literacy: 44
    Employment and Employment Projections: 8
    Business and Practice Friendliness: 6
    Technology and Innovation: 13
    APTA Engagement: 30
    Compensation and Cost of Living: 12
    Lack of Health Disparities: 46

    New Mexico

    Overall Ranking: 23
    Score: 81.347
    Well-being and Future Livability: 24
    Literacy and Health Literacy: 45
    Employment and Employment Projections: 34
    Business and Practice Friendliness: 31
    Technology and Innovation: 16
    APTA Engagement: 13
    Compensation and Cost of Living: 11
    Lack of Health Disparities: 23

    Michigan

    Overall Ranking: 24
    Score: 81.044
    Well-being and Future Livability: 38
    Literacy and Health Literacy: 18
    Employment and Employment Projections: 26
    Business and Practice Friendliness: 16
    Technology and Innovation: 15
    APTA Engagement: 48
    Compensation and Cost of Living: 10
    Lack of Health Disparities: 26

    Delaware

    Overall Ranking: 25
    Score: 80.391
    Well-being and Future Livability: 40
    Literacy and Health Literacy: 26
    Employment and Employment Projections: 43
    Business and Practice Friendliness: 30
    Technology and Innovation: 11
    APTA Engagement: 7
    Compensation and Cost of Living: 30
    Lack of Health Disparities: 32

    Illinois

    Overall Ranking: 26
    Score: 80.328
    Well-being and Future Livability: 32
    Literacy and Health Literacy: 30
    Employment and Employment Projections: 6
    Business and Practice Friendliness: 34
    Technology and Innovation: 4
    APTA Engagement: 43
    Compensation and Cost of Living: 23
    Lack of Health Disparities: 44

    Indiana

    Overall Ranking: 27
    Score: 80.120
    Well-being and Future Livability: 43
    Literacy and Health Literacy: 24
    Employment and Employment Projections: 29
    Business and Practice Friendliness: 11
    Technology and Innovation: 18
    APTA Engagement: 45
    Compensation and Cost of Living: 7
    Lack of Health Disparities: 17

    California

    Overall Ranking: 28
    Score: 79.365
    Well-being and Future Livability: 5
    Literacy and Health Literacy: 51
    Employment and Employment Projections: 1
    Business and Practice Friendliness: 51
    Technology and Innovation: 2
    APTA Engagement: 36
    Compensation and Cost of Living: 45
    Lack of Health Disparities: 48

    Florida

    Overall Ranking: 29
    Score: 77.328
    Well-being and Future Livability: 30
    Literacy and Health Literacy: 48
    Employment and Employment Projections: 4
    Business and Practice Friendliness: 29
    Technology and Innovation: 27
    APTA Engagement: 39
    Compensation and Cost of Living: 28
    Lack of Health Disparities: 20

    North Carolina

    Overall Ranking: 30
    Score: 76.497
    Well-being and Future Livability: 33
    Literacy and Health Literacy: 39
    Employment and Employment Projections: 14
    Business and Practice Friendliness: 27
    Technology and Innovation: 17
    APTA Engagement: 41
    Compensation and Cost of Living: 26
    Lack of Health Disparities: 30

    Nevada

    Overall Ranking: 31
    Score: 75.610
    Well-being and Future Livability: 37
    Literacy and Health Literacy: 43
    Employment and Employment Projections: 38
    Business and Practice Friendliness: 26
    Technology and Innovation: 49
    APTA Engagement: 22
    Compensation and Cost of Living: 3
    Lack of Health Disparities: 8

    Kentucky

    Overall Ranking: 32
    Score: 75.559
    Well-being and Future Livability: 48
    Literacy and Health Literacy: 32
    Employment and Employment Projections: 7
    Business and Practice Friendliness: 9
    Technology and Innovation: 44
    APTA Engagement: 23
    Compensation and Cost of Living: 5
    Lack of Health Disparities: 49

    Hawaii

    Overall Ranking: 33
    Score: 75.212
    Well-being and Future Livability: 1
    Literacy and Health Literacy: 31
    Employment and Employment Projections: 47
    Business and Practice Friendliness: 37
    Technology and Innovation: 39
    APTA Engagement: 11
    Compensation and Cost of Living: 51
    Lack of Health Disparities: 25

    District of Columbia

    Overall Ranking: 34
    Score: 73.942
    Well-being and Future Livability: 29
    Literacy and Health Literacy: 38
    Employment and Employment Projections: 51
    Business and Practice Friendliness: 5
    Technology and Innovation: 35
    APTA Engagement: 1
    Compensation and Cost of Living: 50
    Lack of Health Disparities: 51

    Rhode Island

    Overall Ranking: 35
    Score: 72.861
    Well-being and Future Livability: 36
    Literacy and Health Literacy: 5
    Employment and Employment Projections: 42
    Business and Practice Friendliness: 46
    Technology and Innovation: 38
    APTA Engagement: 16
    Compensation and Cost of Living: 42
    Lack of Health Disparities: 14

    Ohio

    Overall Ranking: 36
    Score: 72.114
    Well-being and Future Livability: 42
    Literacy and Health Literacy: 22
    Employment and Employment Projections: 16
    Business and Practice Friendliness: 35
    Technology and Innovation: 30
    APTA Engagement: 49
    Compensation and Cost of Living: 15
    Lack of Health Disparities: 42

    South Carolina

    Overall Ranking: 37
    Score: 72.079
    Well-being and Future Livability: 35
    Literacy and Health Literacy: 41
    Employment and Employment Projections: 12
    Business and Practice Friendliness: 33
    Technology and Innovation: 46
    APTA Engagement: 27
    Compensation and Cost of Living: 25
    Lack of Health Disparities: 45

    Maryland

    Overall Ranking: 38
    Score: 72.044
    Well-being and Future Livability: 26
    Literacy and Health Literacy: 16
    Employment and Employment Projections: 50
    Business and Practice Friendliness: 19
    Technology and Innovation: 10
    APTA Engagement: 38
    Compensation and Cost of Living: 38
    Lack of Health Disparities: 37

    Connecticut

    Overall Ranking: 39
    Score: 71.935
    Well-being and Future Livability: 17
    Literacy and Health Literacy: 11
    Employment and Employment Projections: 20
    Business and Practice Friendliness: 43
    Technology and Innovation: 33
    APTA Engagement: 50
    Compensation and Cost of Living: 46
    Lack of Health Disparities: 31

    Missouri

    Overall Ranking: 40
    Score: 71.262
    Well-being and Future Livability: 41
    Literacy and Health Literacy: 12
    Employment and Employment Projections: 44
    Business and Practice Friendliness: 40
    Technology and Innovation: 25
    APTA Engagement: 26
    Compensation and Cost of Living: 20
    Lack of Health Disparities: 50

    Maine

    Overall Ranking: 41
    Score: 71.149
    Well-being and Future Livability: 23
    Literacy and Health Literacy: 7
    Employment and Employment Projections: 49
    Business and Practice Friendliness: 48
    Technology and Innovation: 34
    APTA Engagement: 44
    Compensation and Cost of Living: 40
    Lack of Health Disparities: 4

    Tennessee

    Overall Ranking: 42
    Score: 70.792
    Well-being and Future Livability: 47
    Literacy and Health Literacy: 33
    Employment and Employment Projections: 33
    Business and Practice Friendliness: 24
    Technology and Innovation: 40
    APTA Engagement: 29
    Compensation and Cost of Living: 8
    Lack of Health Disparities: 34

    Pennsylvania

    Overall Ranking: 43
    Score: 70.521
    Well-being and Future Livability: 39
    Literacy and Health Literacy: 29
    Employment and Employment Projections: 25
    Business and Practice Friendliness: 49
    Technology and Innovation: 22
    APTA Engagement: 25
    Compensation and Cost of Living: 33
    Lack of Health Disparities: 38

    Oklahoma

    Overall Ranking: 44
    Score: 69.768
    Well-being and Future Livability: 44
    Literacy and Health Literacy: 36
    Employment and Employment Projections: 18
    Business and Practice Friendliness: 50
    Technology and Innovation: 45
    APTA Engagement: 31
    Compensation and Cost of Living: 4
    Lack of Health Disparities: 21

    New York

    Overall Ranking: 45
    Score: 68.663
    Well-being and Future Livability: 27
    Literacy and Health Literacy: 46
    Employment and Employment Projections: 5
    Business and Practice Friendliness: 44
    Technology and Innovation: 20
    APTA Engagement: 40
    Compensation and Cost of Living: 49
    Lack of Health Disparities: 39

    New Jersey

    Overall Ranking: 46
    Score: 68.198
    Well-being and Future Livability: 25
    Literacy and Health Literacy: 34
    Employment and Employment Projections: 15
    Business and Practice Friendliness: 47
    Technology and Innovation: 42
    APTA Engagement: 34
    Compensation and Cost of Living: 39
    Lack of Health Disparities: 41

    Alabama

    Overall Ranking: 47
    Score: 65.265
    Well-being and Future Livability: 49
    Literacy and Health Literacy: 42
    Employment and Employment Projections: 13
    Business and Practice Friendliness: 42
    Technology and Innovation: 48
    APTA Engagement: 37
    Compensation and Cost of Living: 6
    Lack of Health Disparities: 40

    Mississippi

    Overall Ranking: 48
    Score: 64.97
    Well-being and Future Livability: 50
    Literacy and Health Literacy: 50
    Employment and Employment Projections: 24
    Business and Practice Friendliness: 45
    Technology and Innovation: 47
    APTA Engagement: 42
    Compensation and Cost of Living: 1
    Lack of Health Disparities: 35

    West Virginia

    Overall Ranking: 49
    Score: 63.663
    Well-being and Future Livability: 51
    Literacy and Health Literacy: 35
    Employment and Employment Projections: 41
    Business and Practice Friendliness: 25
    Technology and Innovation: 51
    APTA Engagement: 21
    Compensation and Cost of Living: 32
    Lack of Health Disparities: 18

    Louisiana

    Overall Ranking: 50
    Score: 63.257
    Well-being and Future Livability: 46
    Literacy and Health Literacy: 47
    Employment and Employment Projections: 31
    Business and Practice Friendliness: 38
    Technology and Innovation: 36
    APTA Engagement: 33
    Compensation and Cost of Living: 18
    Lack of Health Disparities: 47

    Arkansas

    Overall Ranking: 51
    Score: 62.983
    Well-being and Future Livability: 45
    Literacy and Health Literacy: 40
    Employment and Employment Projections: 40
    Business and Practice Friendliness: 21
    Technology and Innovation: 43
    APTA Engagement: 51
    Compensation and Cost of Living: 14
    Lack of Health Disparities: 43


    Comments

    So, which state scored 1 for Employment and Employment Projections? They didn't make it to the top 20.
    Posted by Louie Puentedura on 9/29/2015 11:54:37 AM
    Would love to see where the rest of the states fall within this ranking system. Do you have this information available? Thanks.
    Posted by Meryl Alappattu on 9/29/2015 12:03:27 PM
    Where can I see the detailed list for all 50 states? Thanks
    Posted by M.Silva on 9/29/2015 12:29:59 PM
    Why did you not include PTAs? Something like this for PTAs would have been helpful.
    Posted by Timothy Spoleti on 9/30/2015 9:33:41 AM
    Good questions: Louie: California scored highest for "Employment and Employment Projections." It did fairly well on projected physical therapist job growth, and came in first due to the state's large population. (Both job growth as a percentage and population were considered in this calculation.) Timothy: The results should be generally applicable to PTAs as well. Some of the factors--for instance, "Literacy and Health Literacy," "Well-being and Future Livability," and "Technology and Innovation"--are equally applicable to both PTs and PTAs. In some cases, we were able to distinguish among PTs, PTAs, and students--as in "APTA Engagement." There are several categories ("Employment and Employment Projections" and "Compensation and Cost of Living") where we might be able to separate PTA factors from those of PTs. While I don't think it would have changed the rankings, I'll definitely try it next year. Question: Are there any other factors that you can suggest that would distinguish between PTs and PTAs? If so, I'll be glad to consider them.
    Posted by Don Tepper on 10/2/2015 1:21:15 PM

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