I wonder if Kentucky is such a bad state for retirement if you exclude the Appalachia region (at least as far as amenities and life expectancy goes). Most retirees may have a good life in the rest of the state. And perhaps the same for most states (avoid the parts that don’t have much for retirees but cling to an area that does).
My wife’s from KY. It’s an old tobacco state with a ton of smokers, so lung cancer and heart disease jack up the mortality rates. Land is dirt cheap. So is the cost of living. Problem is that the Democrats ran the state since the Civil War, so a welfare mentality has been stamped in the culture of some areas.