The quality of retirement in the United States has plummeted in the last decade, according to new global rankings.
The U.S. now ranks 24th out of 44 countries in retirement based on health, quality of life, material well-being, and finances, according to the 2026 Natixis Global Retirement Index.
That’s down three spots from last year and a plunge from 14th place in 2015.
“Healthcare costs remain a source of acute anxiety for Americans looking ahead, with one in three fearing going broke covering healthcare and long-term care costs in retirement,” the study said.
Nine of the top 10 countries for retirement were in Europe. Norway finished first, followed by Ireland, the Netherlands, Switzerland and Denmark.
Retirees in the U.S. are facing major headwinds - inflation is eating into retirement savings, healthcare spending remains the world’s highest, and income inequality continues to widen, Natixis said.
India ranked lowest among the 44 countries in the index, followed by Colombia, Turkey, Brazil and China.
The study uses countries that have advanced economies - all 44 come from Asia, Australia, Europe and North and South America.
Are golden years better across the pond?
The study’s results bring up an interesting question - do U.S. retirees have something to learn from how European countries approach retirement?
Yes, Mark Daamsgard, member of the advisory team at immigration consultancy Global Residence Index, said.
“One lesson Americans can take from Europe is that retirement planning shouldn't stop at the spreadsheet,” Daamsgard said.
“Where you live can have a major impact on your cost of living, healthcare access, transportation and quality of life. In Europe, there’s greater emphasis on things like walkability, community, public transportation, and even access to everyday services.”
Some soon-to-be retirees have caught on to these benefits, said Alex Razinkov, from residence and citizenship consultancy Immigrant Invest.
Of the around 100 consultations the company has done with soon-to-be-retired U.S. clients in 2026, almost 90 percent said they wanted to move to Europe for their golden years. Portugal was the top destination, he said.
Clients said that the ability to move freely between countries and access to healthcare were among the top reasons why they wanted to retire in Europe.
Healthcare hangups
Natixis’s rankings bear out the healthcare aspect. Among the top 25 countries for retirement, the U.S. tied for the fourth-lowest healthcare score.
Healthcare costs have played a major role in the number of American retirees living abroad, Natixis said. More than 700,000 Americans receive their Social Security benefits in a foreign country, up 60 percent from 20 years ago.
“This growth reflects more than just a lifestyle preference, with cost-of-living considerations front and center,” Natixis wrote. “For the United States, healthcare costs represent the largest gap between the cost of a domestic retirement and a foreign one.”
The typical U.S. retiree spends 29 percent of their Social Security income and 12 percent of their overall income on healthcare costs.
With experts predicting Social Security payments could fall by 22 percent in 2032, medical costs could take an even larger share of the average retiree’s benefits.
“With [out-of-pocket] health expenditures already eating away at retirement income, and the uncertainty from further health policy changes and Social Security drawing ever closer to trust fund depletion, it is understandable why many retirees feel that making ends meet is difficult,” Boston College’s Center for Retirement Research wrote in a February study.
Wealth potential
Despite the difficulties retirees face with healthcare costs, the U.S. retirement system has its strengths, bipartisan public policy think tank Economic Innovation Group wrote in a September post.
In particular, retirement accounts like 401(k)s and IRAs give individuals the chance to build wealth regardless of their employer.
“The tax-advantaged retirement savings system in the United States is one of the most effective wealth-building programs in the world,” Economic Innovation Group said.
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