This St. Louis suburb was named the most livable small city in the US 2 years running

Affordable housing, income equality and hospital density gave several St. Louis suburbs a leg up in the race for most livable small city.

For the second year running, SmartAsset named O’Fallon, Mo., the most livable small city in the U.S.

SmartAsset, an online organization providing practicable financial information, conducted the study with data on 286 cities with populations between 65,000 and 100,000 residents.

The methodology focused on home affordability, housing costs as a percentage of median income, poverty rate, unemployment rate, percentage of residents without health insurance, average commute time and concentration of entertainment establishments, restaurants, bars and health care facilities.

Nineteen of the top 25 cities were in the Midwest, and Missouri, Wisconsin, Indiana and Iowa did particularly well.

O’Fallon topped the list for the second year in a row. The city had the 11th lowest income inequality in the study, along with the 21st lowest poverty rate, at 4.6%.

St. Charles, Mo., wasn’t far behind, coming in 9th place. The area boasts low unemployment rates and affordable housing, with shelter costing 17.59% of the median household income. Health care establishments abound, with a concentration in the top 15th percentile in the nation.

Although St. Charles still made the top 10, it sunk two places down from 2021’s scores. Housing costs more compared to typical incomes than it did last year, and the poverty rate has risen by 1.5% year to year.

O’Fallon also saw conditions worsen, with housing prices rising more than 1% adjusted for income and a poverty rate increase of 0.6%.

Lee’s Summit, Mo., tied with Carmel, Ind., for 13th place. In the Kansas City suburb, housing costs 16.88% relative to median income, with a poverty rate of 4.6%. Carmel had a 15.21% housing cost, with a 3.1% poverty rate, but had a lower density of health care facilities than Lee’s Summit.

The highest ranking Illinois city was Bloomington, at 17th. Bloomington had a much higher poverty rate than most other cities that scored similarly, with 12.8% of residents living below the income line. The city came ahead with its entertainment district density, which was higher than the 16th place location’s.

How did other cities stack up?

Here are the top 20 most livable small cities, according to SmartAsset.

1. O’Fallon, Missouri

2. Oshkosh, Wisconsin

3. Eau Claire, Wisconsin

4. Flower Mound, Texas

5. Lafayette, Indiana

6. Fishers, Indiana

7. Sioux City, Iowa

8. Cheektowaga, New York

9. St. Charles, Missouri

10. Woodbury, Minnesota

11. Livonia, Michigan

12. Maple Grove, Minnesota

13. Tie: Carmel, Indiana and Lee’s Summit, Missouri

15. Duluth, Minnesota

16. Sammamish, Washington

17. Bloomington, Illinois

18. Casas Adobes, Arizona

19. Plymouth, Minnesota

20. Redmond, Washington