Highest Paying States for Nursing Professionals in 2021

by Jennifer L. Gaskin and The Senior List Team | Last Updated, May 24, 2021

Over the next decade, the U.S. is poised to add about 2.4 million healthcare jobs, the most of any occupational group, according to data from the U.S. Bureau of Labor Statistics. While physicians and surgeons get a lot of the glory, nursing-related occupations account for a great deal of the expected growth.

Nursing professionals are vital to the entire healthcare system, as they provide most of the care in hospitals and long-term care settings, both of which are vitally important to older Americans. As the Baby Boomer generation continues to age, it’s expected that nursing shortages will continue and intensify in many places.

We wanted a better idea of how this landscape might shift over the next several years, so we studied salary, wage, employment, and housing data for each state to determine which ones are the best for nursing professionals in 2021 — and beyond.

Best States for Nursing Professionals: Overall Rankings

New York is the best state overall for nursing professionals, with Maryland in a distant second. Three Western states — California, Colorado, and Oregon — round out the rest of the top five. The bottom six states are all in the South, while Alabama had the lowest overall ranking.

Which Nursing Jobs Get Paid the Most?

Generally, the more educated the nursing care provider, the more money they can expect to earn. The average nurse practitioner (NP) in the U.S. makes more than $110,000 per year, which is more than four times higher than the median national wage for home health and personal care aides. In most states, NPs are required to have at least a master’s degree, while all other jobs require a bachelor’s degree or less.

Each of these jobs has seen wages grow over the past decade, but in one case, the increase hasn’t kept up with the rate of inflation. Ten years ago, none of these jobs came with a median national wage over $100,000, and the typical NP made just under $90,000. The cumulative inflation rate since 2011 is about 15 percent, which means that nationally, RNs have basically taken a pay cut since their median wage has only gone up by 14 percent.

And while the four jobs combined have seen employment rise by nearly 30 percent, the most skilled (NPs) and least skilled (home health/personal care aides) have seen the biggest increases. Jobs for nursing assistants have declined over the past 10 years, according to our analysis.

All the jobs we analyzed are expected to become more common over the next few years and through the end of the decade. Long-term growth rates are quite high, but some jobs will see rapid expansion through the end of next year.

Nursing Salaries Are Highest in California, Lowest in Alabama

As we mentioned, NPs have the best chance of earning a high wage, while home health/personal care aides tend to have the lowest wages. In many states, the median wage for registered nurses (RNs) is in six figures, while the lowest RN wage is Alabama’s $58,630. The lowest-paid of all four nursing jobs we studied was home health/personal care aides in Louisiana; these individuals earn a median wage of just under $19,000 per year.

Overall, California offers the best wages for nursing professionals, coming in first for both NPs and RNs, while Alabama’s wage offerings were all in the bottom three. The national average annual median wage for the four jobs is just under $60,000, but as we’ve already seen, there’s a ton of variation depending on the job.

High income only goes so far in places like California where housing costs are high. So, while the Golden State offers the nation’s highest average wage for nursing professionals, almost one-quarter of their income is eaten by housing costs, putting California in 40th. West Virginia, which has the second-lowest average wage, is the most affordable for nursing care providers.

Utah has the lowest combined employment rate and scored the lowest for current job opportunities, but there’s reason for optimism in the Beehive State. That’s because nurse jobs are expected to grow by almost 40 percent over the next decade, one of the most rapid growth rates in the country.

Most states did not have data available when it comes to the short-term growth rates projected for nursing assistants, and many were missing data for home health/personal care aides. For this reason, short-term growth projections were excluded from our final tally; that said, looking at the near-term reveals a few interesting findings.

Over the next year, many states are expected to see rapid growth in nursing professional employment. New Hampshire is projected to see NP jobs expand by more than 24 percent between 2020 and 2022, and 14 other states are expected to see NP employment rise by double digits. Every state should see nurse practitioner jobs increase, according to the government’s projections.

Forty-two states are expected to see jobs for registered nurses rise through the end of next year, while six are projected to have a net job loss for RNs. South Carolina’s is the biggest projected decline, about two percent.

Massachusetts should have the highest increase in home health/personal care aides with employment in that role rising about 17 percent through 2022; these jobs will decline by about two percent in Michigan.