These are the best U.S. cities to grow old in

As Americans live longer and longer, the question of where they will spend their retirement years has become increasingly more difficult to answer. A couple of decades ago, moving somewhere sunny, warm and relatively affordable may have been all that mattered to a retiree looking to kick back in a hammock for a few years.

But the average 65-year-old woman and man today can expect to live until age 88.8 and 86.4 years old, respectively — two years longer than people their age could expect in 2000. With a longer retirement time horizon to plan for than ever before, many workers aren’t content with taking a 20-year vacation, even if they could afford it. Some people are planning to work well into their 70s. And in the face of rapidly rising health care costs, a lot of retirees may decide to stay close to home and to their family.  

With these factors in mind, the Milken Institute, a nonpartisan, nonprofit think tank, has come up with a comprehensive new ranking of U.S. cities that offer the best quality of life for retirees, specifically those who would rather “age in place” than uproot themselves during their golden years. The report is a follow-up to is 2012 index, but the methodology has changed significantly, Milken says.

“With the demographic shift proceeding across America, enabling successful aging could not be more important for our future,” says Paul Irving, president of the Milken Institute. “We hope our findings spark national discussion and, at the local level, generate virtuous competition among cities to galvanize improvement in the social structures that serve and empower older adults.”

Milken’s “Best Cities for Successful Aging” index ranks 352 U.S. cities based on 84 individual factors that affect the quality of life for older adults. Like most “Best Places to Retire” lists, Milken took into consideration factors like weather trends, crime rates and good medical facilities, but it also homed in on areas with the best rates of employment for older workers, education offerings, long-term health care options, and the overall financial well-being of older residents.

We highlighted the top 10 large cities below. For detailed rankings of the top 20 large and small cities in the U.S., check out Milken’s full index here.

#1 Madison, Wis.

The pros: Great hospitals; active lifestyle; solid employment opportunities

The cons: Expensive housing; costly inpatient medical care; too many fast food outlets may beget bad health choices

Madison was ranked the No. 1 best city to grow old in by Milken, largely due to its excellent health care offerings (11 hospitals all scored high marks from the Joint Commission on Accreditation of Healthcare Organizations) and its high employment rate and low poverty rates for adults over age 65. For retirees looking to stay active, Madison offers plenty of public transportation options, as well as opportunities to get around on foot.

#2  Omaha, Neb.

The pros: Great work opportunities; moderate cost of living; short commutes

The cons: High crime rate; lack of long-term care hospitals; short on public transportation options

Older workers in Omaha will find more opportunities for employment and volunteerism than other cities, Milken found (the city ranked #1 overall for community engagement). Short commute times mean fewer headaches while stuck in traffic, and the wealth of health care facilities is very convenient. Unfortunately, the city lacks many long-term care hospitals and residents indulge a little too heavily in sugary drinks and smoking, which can worsen their health.

 #3 Provo, Utah

The pros: Low smoking and binge drinking rates; fewest diabetes cases reported out of all 100 large metros; low rate of injuries in older adults

The cons: It’s expensive to live there; not very many hospitals offer Alzheimer's treatments; too few doctors and nurses

Provo residents are healthier overall than in many other large metro areas, Milken found. They’re more likely not to smoke, avoid drinking, and keep healthy food in their kitchens. The economy is relatively stable and Milken found high employment growth among older adults. Crime rates are low, too, and it’s one of the top metros for community engagement. But the area falls short on cost of living and health care offerings, especially for people with special needs, like Alzheimer’s.

#4 Boston, Mass.

Pros: Culture lovers will be thrilled with the city’s museum and arts offerings; plenty of health care options; great nursing homes; active population

Cons: It’s pricey to live there; long emergency room wait times; wide income disparity

If you’ve got the funds for it, Boston can be one of the best cities for older workers looking to age gracefully, Milken found. Despite it’s high income disparity and cost of living, residents enjoy a wide variety of health and wellness options, great entertainment opportunities (the young college crowds make sure of that) and plenty of people work long after age 65.

#5 Salt Lake City, Utah

Pros: Strong economy; high employment rates among workers 65 and over; accessible amenities like grocery stores and banks

Cons: Lack of special needs transportation and funding for community programs; few households with residents 65 and over; high rate of reverse mortgages among older homeowners signals financial vulnerability.

Salt Lake City was among the highest-ranking cities for employment opportunities for older workers, most likely owing to the city’s robust economy, according to Milken. Researchers found older residents often led active lifestyles. And there’s no shortage of home-health-care providers, which could be a boon to older adults looking to live out their final years at home, rather than in an assisted living or nursing home facility.

Rounding out the top 10 best cities for aging Americans...

#6  Jackson, Miss.

#7  Des Moines, Iowa

#8  Toledo, Ohio

#9  Austin, Texas

#10  Bridgeport, Conn.

For detailed rankings of the top 20 large and small cities in the U.S., check out Milken’s full index here.

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