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Highest Paying States for Nurses 2022

by Jennifer L. Gaskin and The Senior List Team | Published, May 31, 2022

Even before the COVID-19 pandemic unleashed chaos in the U.S. healthcare system, a shortage of qualified nursing professionals had long been predicted. With an aging population, led largely by the massive Baby Boomer generation, observers predicted a shortage of registered nurses, nursing instructors, and other nursing professionals that is now continuing to intensify.

Meanwhile, the pandemic has made matters worse. In January 2022, 34 percent of long-term care facilities in the U.S. reported a staffing shortage. Globally, as many as 180,000 healthcare workers have died from the virus.

Although nursing professionals nationwide are facing extremely difficult working environments, the situation on the ground in some states may be better than at the national level. For the past few years, we’ve conducted regular research into which states have the strongest job markets for nursing professionals, including wage, employment, and cost of living data.

Key findings

      • Nationally, inflation is taking a toll on nursing professionals’ wages. Compared to last year, none of the four jobs we analyzed had wage increases that outpaced the rate of inflation.
      • New York remains the best state for nursing professionals in terms of pay and employment figures, while Kansas is the worst state. Arizona vaulted from 10th to third place this year.

    • On average, nursing professionals in the western states of California, Washington, Alaska, and Hawaii are earning the highest salaries in the country.
    • Nurse practitioner employment will rise rapidly over the next year, surging by 10 percent through the end of 2023. Nurse practitioner jobs will grow most in Arizona, where employment will rise by 17 percent.

Best States for Nursing Professionals: Overall Rankings

To create the ranking of best states for nurses, we compared wages for registered nurses, nurse practitioners, nursing assistants, and home health/personal care aides to local housing costs and expected job growth in each state (see the bottom of the page for our full methodology).

For the second year in a row, New York remained the top state in our final ranking, followed by Delaware and Arizona, which were sixth and 10th, respectively, last year. Oregon and North Dakota round out the top five best states for nursing professionals. Kansas had the lowest score – just one point worse than Alabama – which was the bottom-scoring state last year.

Top 10 States for Nursing Professionals

#1 New York
#2 Delaware
#3 Arizona
#4 Oregon
#5 North Dakota
#6 Iowa
#7 Colorado
#8 New Mexico
#9 Indiana
#10 Minnesota

 

Wages and expected job growth were the most decisive factors when it comes to the best and worst states in our analysis. For example, Kansas was the worst-ranked state for nursing professionals given its relatively low wages and stagnant job growth projections. Conversely, while top-ranked New York has one of the least affordable housing markets, wages are high, and long-term job growth is among the best in the nation.

Comparing the most recent wage figures to the previous year shows that all four jobs have seen salaries rise slightly, though the single-year changes are quite modest. For each job, the changes do not keep up with the surge in inflation we’ve seen over the past year. For example, if their wages were to keep up with inflation, the average nurse practitioner should earn about $118,000 today, rather than the roughly $113,000 reported by the U.S. Bureau of Labor Statistics in March 2022. Nursing assistant wages come the closest to keeping up with year-over-year inflation rates.

Wage Increases Since 2012

Job 2021 wage Percent increase since 2012
Nursing assistant $32,500 30%
Nurse practitioner $112,843 28%
Home health & personal care aides $27,120 28%
Registered nurse $76,944 22%

 

Sources: U.S. Bureau of Labor Statistics and U.S. Department of Labor Projections Central

However, taking the longer view, wages for nursing professionals have stood up to inflation over the long term. Since 2012, they’ve risen by an average of 27 percent, which is higher than the cumulative 18 percent inflation rate that’s occurred in the same time frame. It’s worth noting, though, that while most of the job roles we examined are well ahead of inflation, wages for registered nurses are just four percentage points ahead.

As wages have risen, so have employment levels for nurse practitioners, home health aides, and registered nurses has increased since 2012. Even more growth is on the horizon, due to an aging population that may drive demand for medical services of all types.

Percentage Change in Total Employment, 2012-2021

Nurse practitioners 120%
Home health & personal care aides 84%
Registered nurses 15%
Nursing assistants -7%

 

Source: U.S. Bureau of Labor Statistic

Nurse practitioner employment jumped by 120 percent since 2012. State-level regulatory changes have provided more autonomy for nurse practitioners, which make this job very attractive for those interested in advancing their medical career. Depending on what degree they have, an RN can become a nurse practitioner in as little as two years.

Employment of nursing assistants dropped about seven percent since 2012. Though nursing assistants are in high demand, these roles often come with low pay, which may dissuade people from seeking certification and employment.

Our analysis also shows that total employment for nursing assistants should experience a small rebound by the end of 2023 and an even bigger one over the next several years. In fact, all four jobs are projected to experience healthy growth through 2028, led by employment of home health and personal care aides — a 29 percent jump over the next half-decade or so. As more and more older adults continue to age in place, these individuals will comprise an even more important plank in the senior healthcare system.

Projected Changes in Nursing Employment

Timeframe Home health/personal care aides Nursing assistants Registered nurses Nurse practitioners
Short-term growth (2021-2023) 5% 1% 2% 10%
Long-term growth (2018-2028) 29% 10% 14% 27%

Source: U.S. Department of Labor Projections Central

Want a High-Paying Nursing Job? Go West.

Of the five states with the highest average wages, four (California, Hawaii, Alaska, and Washington) are in the West, and California came in at the very top of the list. Across the four nursing jobs included in our analysis, California has the highest average annual wage at just under $86,000.

Jobs that require extensive training also come with better wages: In most states, nurse practitioners, who are licensed to provide many of the same medical services as physicians, can earn six-figure salaries.


Registered nurse salaries ranged most across the country, from a low of about $60,000 in Alabama to a high of about $125,000 in California. This is a 107 percent difference. Home health and personal care aides also had a similarly massive salary range, with a 99 percent difference between the lowest paying state (Louisiana) and the highest paying state (Washington).

Median Annual Wages By Occupation and State

State Home health/personal care aides Nursing assistants Registered nurses Nurse practitioners
Alabama $21,920 $24,300 $60,510 $99,750
Alaska $36,060 $41,410 $99,110 $123,140
Arizona $29,000 $36,090 $78,260 $121,070
Arkansas $23,540 $28,420 $61,530 $99,910
California $29,680 $37,450 $125,340 $149,910
Colorado $29,910 $36,590 $78,070 $102,370
Connecticut $29,740 $36,770 $83,860 $125,360
Delaware $24,420 $34,970 $75,380 $121,470
District of Columbia $31,280 $37,500 $95,220 $121,470
Florida $23,910 $29,070 $75,000 $101,110
Georgia $23,340 $28,560 $75,040 $101,690
Hawaii $29,470 $36,990 $111,070 $131,000
Idaho $23,910 $29,450 $75,560 $102,060
Illinois $29,340 $32,090 $77,580 $122,960
Indiana $24,070 $29,690 $62,400 $104,020
Iowa $28,900 $29,990 $61,790 $121,470
Kansas $23,210 $29,060 $61,790 $100,590
Kentucky $27,690 $29,060 $62,480 $100,260
Louisiana $18,210 $24,220 $64,450 $103,610
Maine $29,700 $36,040 $75,040 $119,550
Maryland $29,290 $31,570 $78,350 $104,550
Massachusetts $36,300 $37,370 $94,960 $128,160
Michigan $28,150 $35,580 $76,710 $102,060
Minnesota $29,320 $36,770 $79,100 $127,690
Mississippi $22,720 $23,780 $60,790 $101,840
Missouri $23,110 $28,680 $61,920 $101,180
Montana $28,760 $29,690 $75,000 $122,100
Nebraska $28,840 $29,960 $64,000 $103,340
Nevada $23,460 $36,580 $79,360 $127,620
New Hampshire $29,370 $36,770 $77,230 $121,070
New Jersey $29,500 $36,730 $94,690 $129,240
New Mexico $22,970 $29,600 $78,340 $121,070
New York $30,300 $38,130 $96,170 $128,220
North Carolina $23,150 $29,230 $72,220 $102,370
North Dakota $30,410 $36,770 $73,250 $103,550
Ohio $24,000 $29,840 $74,080 $103,310
Oklahoma $22,350 $28,820 $62,170 $109,660
Oregon $30,060 $37,460 $99,410 $127,690
Pennsylvania $28,390 $35,780 $76,940 $106,700
Rhode Island $29,300 $37,110 $78,900 $125,540
South Carolina $22,900 $28,900 $72,650 $100,020
South Dakota $28,950 $28,970 $60,550 $102,060
Tennessee $23,370 $29,130 $62,390 $99,630
Texas $22,500 $29,420 $77,320 $121,010
Utah $29,110 $29,690 $75,000 $105,220
Vermont $30,040 $36,590 $75,380 $101,790
Virginia $23,010 $29,690 $76,900 $102,860
Washington $36,300 $37,140 $96,980 $128,980
West Virginia $22,280 $28,910 $62,390 $100,020
Wisconsin $28,400 $34,760 $76,560 $121,310
Wyoming $29,250 $30,410 $75,000 $102,370

 

Source: U.S. Bureau of Labor Statistics

In some states, wage increases are helping offset the rising cost of housing, according to the federal data we analyzed. But there’s an important caveat — these figures are not available in real-time. Both home prices and rent costs have spiked in recent months, even in areas like New York City that have rent stabilization policies. And despite increased interest rates, the market for home purchases remains uber-competitive.

For the most part, housing is becoming more affordable for the average nursing professional, especially those with more advanced degrees. Though there has been improvement, housing is still not affordable for many home health aides or nursing assistants.

Average Annual Housing Cost as a Percentage of Annual Wages By Occupation and State

State Home health/personal care aides Nursing assistants Registered nurses Nurse practitioners
Alabama 43% 39% 16% 10%
Alaska 42% 36% 15% 12%
Arizona 41% 33% 15% 10%
Arkansas 38% 31% 14% 9%
California 62% 49% 15% 12%
Colorado 49% 40% 19% 14%
Connecticut 57% 46% 20% 13%
Delaware 53% 37% 17% 11%
District of Columbia 64% 54% 21% 17%
Florida 55% 45% 17% 13%
Georgia 50% 41% 16% 12%
Hawaii 63% 50% 17% 14%
Idaho 43% 35% 14% 10%
Illinois 46% 42% 18% 11%
Indiana 40% 33% 15% 9%
Iowa 36% 34% 17% 8%
Kansas 48% 38% 18% 11%
Kentucky 34% 32% 15% 9%
Louisiana 56% 42% 16% 10%
Maine 37% 31% 15% 9%
Maryland 56% 52% 21% 16%
Massachusetts 49% 47% 19% 14%
Michigan 38% 30% 14% 11%
Minnesota 43% 34% 16% 10%
Mississippi 41% 39% 15% 9%
Missouri 45% 36% 17% 10%
Montana 38% 37% 15% 9%
Nebraska 39% 37% 18% 11%
Nevada 54% 35% 16% 10%
New Hampshire 53% 43% 20% 13%
New Jersey 67% 53% 21% 15%
New Mexico 44% 34% 13% 8%
New York 56% 45% 18% 13%
North Carolina 46% 36% 15% 10%
North Dakota 36% 30% 15% 11%
Ohio 43% 35% 14% 10%
Oklahoma 44% 34% 16% 9%
Oregon 46% 37% 14% 11%
Pennsylvania 42% 34% 16% 11%
Rhode Island 50% 39% 19% 12%
South Carolina 45% 35% 14% 10%
South Dakota 36% 36% 17% 10%
Tennessee 44% 35% 16% 10%
Texas 58% 44% 17% 11%
Utah 43% 42% 17% 12%
Vermont 44% 36% 18% 13%
Virginia 62% 48% 19% 14%
Washington 43% 42% 16% 12%
West Virginia 38% 29% 14% 8%
Wisconsin 40% 33% 15% 9%
Wyoming 38% 36% 15% 11%

 

Sources: U.S. Bureau of Labor Statistics and U.S. Census Bureau

In every state, the average annual housing cost would be well below 25 percent of the average annual salary for registered nurses and nurse practitioners. For RNs, New Mexico has the best housing affordability ratio, with the average annual cost of housing accounting for just 13 percent of the average annual salary. But several states aren’t far behind — Arkansas, Idaho, Michigan, Ohio, Oregon, South Carolina, and West Virginia all sit at around 14 percent.

Meanwhile, home health assistants in some states could spend upwards of 50 percent of their income on housing. As the housing prices in many regions of the U.S. rise, even more home health assistants could be priced out of their homes or forced to find higher-paying jobs.

New York Has Strongest Current Job Market; Arizona’s Market Expected to Have Best Short-Term Growth

For today’s nursing professionals, New York has the highest combined employment rate, well ahead of second-place Minnesota. And as we’ve seen, for the most part, nursing jobs should become easier to come by over the next half-decade.

Combined Nursing Professional Employment Per 1,000 Jobs

New York 88.5
Minnesota 76.0
Pennsylvania 75.0
New Mexico 73.3
Massachusetts 71.4
California 69.8
West Virginia 67.8
Maine 67.7
North Dakota 67.0
Missouri 66.1
Rhode Island 62.3
Wisconsin 62.0
Connecticut 60.1
Mississippi 58.8
South Dakota 58.7
Delaware 58.4
Kansas 57.4
Louisiana 56.7
Ohio 56.4
Michigan 56.3
Vermont 56.0
Iowa 54.2
Arkansas 53.6
Idaho 52.7
Illinois 52.6
Arizona 51.0
North Carolina 50.7
Alaska 50.7
Texas 50.2
New Jersey 50.0
Montana 49.9
Nebraska 49.6
Kentucky 49.2
Alabama 48.5
Washington 48.4
Oregon 48.1
Indiana 47.9
South Carolina 46.3
New Hampshire 46.1
Wyoming 44.4
Colorado 44.2
Virginia 44.0
Oklahoma 43.6
Maryland 43.4
Tennessee 43.3
Hawaii 42.7
Florida 41.0
District of Columbia 39.7
Nevada 37.2
Georgia 36.2
Utah 34.6

 

Source: U.S. Bureau of Labor Statistics

An increase in nursing employment would be welcome news for states that are already struggling to keep up with demand for nurses. On a national level, the U.S. has about 24 nursing professionals for every 1,000 residents, but many states fall far short of that average. In Georgia, for example, there are only about 15 nursing professionals for every 1,000 people, while New York has the second-highest rate, behind only Washington, D.C.

These conditions were in place before COVID-19, which has undoubtedly worsened the situation. In Georgia, the state with the worst nurse-to-resident ratio, wave upon wave of the virus led experienced nurses to leave the profession as the toll of the job became too great. A 2021 survey by healthcare staffing agency Vivian found that 43 percent of nurses were considering leaving the industry.

Still, even in the short-term, nursing employment is projected to grow — rapidly in some cases. Because of their variability, we didn’t include short-term employment projections in our final tally, but they are worth considering.

For the most part, the next year-and-a-half should bring double-digit growth in most states for nurse practitioners, though Mississippi is expected to see employment for all four occupations fall through the end of 2023. Of the 635 occupations for which short-term growth rates were available in Mississippi, fewer than half will see employment expand over the next year.

Projected Change in Nursing Employment, 2021-2023 By Occupation and State

State Home health/personal care aides Nursing assistants Registered nurses Nurse practitioners
Alabama 4.6% 2.9% 3.4% 11.3%
Alaska 2.7% 2.9% 2.8%
Arizona 13.7% 8.1% 7.6% 17.3%
Arkansas -0.1% 0.4% 1.5% 10.5%
California 8% 3.2% 3.5% 15.4%
Colorado 6.3% 2.5% 3.7% 10.3%
Connecticut 5.9% 1.2% 3.6% 11.1%
Delaware 2.9% -1.1% 0.1% 7.8%
District of Columbia -0.6% -1.9% 0.2% 7.1%
Florida 3.2% 0.2% 3.3% 14%
Georgia 7.7% 6% 5.2% 12.9%
Hawaii 4.7% 1.4% 1.7% 7.3%
Idaho 4.5% 4.4% 4.2% 3.6%
Illinois 4.6% 1% 2.5% 10%
Indiana 4.7% 1.5% 2.2% 10.9%
Iowa 6.8% 2.4% 2.7% 10%
Kansas 2.3% -0.6% 0.9% 8.4%
Kentucky 4.9% 0.9% 1.9% 10%
Louisiana 6.7% 5.1% 2.9% 11.8%
Maine 6.1% 3.7% 3.2% 10.1%
Maryland 8.9% 3.3% 3% 10%
Massachusetts 8.1% 2.6% 3.4% 12.3%
Michigan 2.5% 0.7% 1.8% 8.9%
Minnesota 3.7% 1.6% 2.9% 10.2%
Mississippi -5.8% -12.6% -4.7% -0.3%
Missouri 5.2% -0.2% 1.8% 9.7%
Montana 6.6% 3.9% 3.6% 9%
Nebraska 6.2% 2.5% 2.5% 8%
Nevada 6.9% -0.8% -2.1% 9.9%
New Hampshire 6.8% 1.6% 2% 11.5%
New Mexico 0.9% -6.8% -3.5% 6.9%
New York 7.2% 2.5% 4.5% 11.4%
North Carolina 4.7% 1.8% 3.1% 10.4%
North Dakota 5.3% 2.9% 3.1% 11.3%
Ohio 0.6% -6.9% 0.1% 9.1%
Oklahoma 3.6% -0.1% 1% 6.7%
Oregon 4.8% 3.4% 3.2% 10.5%
Pennsylvania 3.3% 0.3% 1.3% 8.7%
Rhode Island 10.3% 6.4% 4.2% 10%
South Carolina 6.8% 1.9% 2.7% 11.7%
South Dakota 4.2% 1.3% 3.1% 9.7%
Tennessee 5.9% 4.4% 2.9% 13.3%
Texas 8.2% 4% 4.2% 7.9%
Utah 4.4% 3% 3.6% 11.7%
Vermont 8% 0.8% 1.6% 8%
Virginia 4.8% -2.3% 1.6% 12.2%
Washington 5.1% 3.1% 3% 4.4%
West Virginia 4.8% 3.1% 3.6% 12.1%
Wisconsin 4.3% -3.2% 1% 8.6%
Wyoming 5.2% 2.1% 2.7% 11.1%

 

Note: Projections not available for New Jersey

Source: U.S. Department of Labor Projections Central

As we mentioned, most healthcare jobs will continue to be in high demand in the near-term and the long-term due to the growing population of senior citizens and pandemic-driven turnover rates, but the robust growth in most healthcare jobs nationally is not necessarily reflected on the state level.

For example, all four occupations are expected to shed jobs over the next year in Mississippi. The overall population in the state has declined over the past 10 years, and many college graduates are leaving Mississippi once they get their degrees.

On the other hand, Arizona had the highest average growth rate in the four nursing jobs we analyzed, including double-digit growth in just the next couple of years for home health/personal care aides and nurse practitioners.

Arizona had one of the highest population growth rates over the past 10 years, expanding by 12 percent between the 2010 and 2020 censuses. And the state grew by almost 100,000 people between 2020 and 2021 alone. At the same time, the state has gotten older, going from about 14 percent of the population being 65 or older to about 18 percent, the 13th-fastest rate in the country since 2010.

Conclusion

About 90 percent of U.S. nurse practitioners are involved in primary patient care, and nursing professionals provide the bulk of care in long-term care centers. That makes nurses and related workers the backbone of the medical system. Though COVID-19 has certainly taken its toll, the employment outlook remains positive in most states for nursing care professionals.

Methodology

To create our analysis of which states are best for nursing professionals, we consulted several governmental data sources:

  • U.S. Bureau of Labor Statistics: Our analysis covered median wages and employment U.S. Census Bureaurates, which is a measure of jobs in a particular occupation compared to all jobs, for four nursing occupations — registered nurse, nurse practitioner, home health/personal care aide, and nursing assistant. This information was most recently updated in March 2022 and extends through May 2021.
  • Projections Central: We analyzed the percentage by which each of our nursing jobs is expected to expand in each state and the U.S. as a whole from 2018-2028 and 2021-2023. The long-term projections, which are included in our overall ranking, were most recently updated in July 2021, while short-term projections were updated in April 2022.
  • U.S. Census Bureau: To determine how affordable each state is for the average nursing professional, we compared annual housing costs to annual income. The housing figures we used covered median rent and median owner costs for both mortgaged and non-mortgaged housing units. This information was most recently updated in March 2022, covering the year 2020.

Every state was assigned a point value relative to its ranking in the category; the higher a state ranked, the more points it scored up to 51 per category across these 17 metrics.

  • Median annual wage for registered nurses
  • Median annual wage for nurse practitioners
  • Median annual wage for home health/personal care aides
  • Median annual wage for nursing assistants
  • Registered nurse employment per 1,000 jobs
  • Nurse practitioner employment per 1,000 jobs
  • Home health/personal care aide employment per 1,000 jobs
  • Nursing assistant employment per 1,000 jobs
  • Projected growth in registered nurse employment, 2018-2028
  • Projected growth in nurse practitioner employment, 2018-2028
  • Projected growth in home health and personal care aide employment, 2018-2028
  • Projected growth in nursing assistant employment, 2018-2028
  • Median annual rent
  • Median annual owner costs, housing units with a mortgage
  • Median annual owner costs, housing units without a mortgage
  • Average median housing cost (rent combined with mortgage costs) as percentage of average median annual income

Here is a complete list of states and their scores:

Highest possible score = 765

New York 571
Delaware 489
Arizona 486
Oregon 462
North Dakota 461
Iowa 457
Colorado 445
New Mexico 431
Indiana 429
Minnesota 428
Maryland 427
Pennsylvania 427
Washington 427
Arkansas 424
California 424
West Virginia 422
Nevada 420
Kentucky 414
Wyoming 409
New Hampshire 405
Missouri 404
Massachusetts 403
Utah 399
New Jersey 398
Maine 393
Connecticut 389
Ohio 388
Tennessee 386
Hawaii 379
Alaska 376
Montana 367
Rhode Island 365
Georgia 364
Wisconsin 355
Idaho 353
Vermont 353
Texas 344
Virginia 344
North Carolina 341
South Dakota 340
Illinois 338
Michigan 331
South Carolina 321
Florida 317
Nebraska 314
Louisiana 308
District of Columbia 306
Oklahoma 302
Mississippi 296
Alabama 278
Kansas 277
Highest possible score = 765