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The Best Big and Small Cities for Successful Aging

Why the Milken Institute Center for the Future of Aging chose them


By Richard Eisenberg

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Successful Aging

The Top Cities for Successful Aging

Where would you like to grow older? If you’re open to suggestions, I recommend reviewing the new Best Cities for Successful Aging rankings (http://successfulaging.milkeninstitute.org) from the Milken Institute Center for the Future of Aging. (Spoiler alert: This year’s No. 1 big and small cities are the college “towns” of Provo-Orem, Utah and Iowa City, Iowa. Click on the slideshow for more on them and the other winners.)

As the winning cities suggest, the 2017 Milken index is actually two lists: One ranking the 100 largest U.S. metro areas (the Big Cities list) and one ranking 281 small metros (the Small Cities). Combined, they include all U.S. Metropolitan Statistical Areas except Enid, Okla. (insufficient data — get on it, Enidites!).

Unlike anecdotal, subjective “best places to retire lists,” this one is all about the data, as were the 2012 and 2014 versions. “Our notion is: facts are stubborn things,” says Paul Irving, chairman of the Milken Institute Center for the Future of Aging.

For the 2017 rankings, the research team spent six months crunching numbers for 83 indicators in nine categories: General Livability, Health Care, Wellness, Financial Security, Education, Transportation and Convenience, Employment, Living Arrangements and Community Engagement.

The Top 10 Big Cities: Provo-Orem; Madison, Wis.; Durham-Chapel Hill, N.C.; Salt Lake City; Des Moines-West Des Moines, Iowa; Austin-Round Rock, Texas; Omaha, Neb.-Council Bluffs, Iowa; Jackson, Miss.; Boston-Cambridge-Newton, Mass. (which includes some N.H. towns) and San Francisco-Oakland-Hayward, Calif.

The Top 10 Small Cities: Iowa City; Manhattan, Kansas; Ames, Iowa; Columbia, Mo.; Sioux Falls, S.D.; Ann Arbor, Mich.; Ithaca, N.Y.; Lawrence, Kansas; Logan, Utah (which includes some Idaho towns) and Fairbanks, Alaska.

As you may have noticed, just over half of this year’s winners are college towns. “They’ve had a good amount of successful economic development recently,” says Liana Soll, associate director for the Center. Adds Irving: “College towns tend to be vital centers of employment and have a strong health infrastructure, with university hospitals, strong transit systems connected to universities and, in some cases, innovative housing options. So they touch many of the bases.”

None, you may have also noticed, are in sunny retirement havens in Florida or Arizona. “Weather is just one of many factors that could contribute to successful aging,” says Soll.

A good place for successful aging, Irving believes, “is a good place for all people.” That’s why the 2017 rankings report says the rankings offer “a broad focus on livability across the life course.” And it’s why the Center’s “Mayor’s Pledge,” signed by more than 140 U.S. mayors from Akron, Ohio to York, Pa., is about trying to make their cities “work better for older residents and young people as well.”

Irving believes America’s cities have made progress since his 2014 rankings. But “on the other hand, I feel we are not moving quickly enough,” he adds. “It’s a challenge for all of us.”

(Click or swipe the slideshow to see why each of the Top 10 big and small cities were winners.)

San Francisco

The Top 10 Big Cities for Successful Aging

In the 2017 rankings of best cities for successful aging from the Milken Institute Center for the Future of Aging, four of the Top 10 big cities are college towns. And all 10 have a high percentage of older residents with degrees. The best big cities, the Center says, also excel in general livability and well-being, economic strength and “opportunities for work and community engagement.” Many, however, have a high cost of living, including housing.

Successful Aging

No. 1 Big City: Provo-Orem, Utah

Provo-Orem was tops in the Milken Institute Center for the Future of Aging rankings both for people age 65 to 79 and for those 80 and older.

Provo Mayor John Curtis, 57, told Next Avenue the area “has strong fundamentals,” adding that “if you had to make up a town, this is what it would be.” Curtis also says “a lot of what you see in Provo is multigenerational — we like a family environment and we like to be around kids.”

Provo-Orem reclaimed the No. 1 perch from the Center’s 2012 rankings “on the strength of the services and support systems that make it an ideal home for older adults amid a youthful, family-oriented population,” the Center’s report says. This safe metro area, home to Brigham Young University, Utah’s five national parks and a low unemployment rate, also ranked No. 1 among all 100 big cities in the Wellness category. The Mormon influence accounts for the area’s low drinking and smoking rates.

Madison

No. 2 Big City: Madison, Wis.

Madison dropped a notch from being the best big city for successful aging in the Milken Institute Center for the Future of Aging’s 2014 rankings. But it’s still strong in many categories thanks, in part, to being home to the University of Wisconsin.

The Center gave Madison high marks for its “strong medical services, an educated, healthy population and an abundance of recreational activities” as well as for safety, entertainment and community engagement. Many here walk to work (when the weather allows).

Durham-Chapel Hill

No. 3 Big City: Durham-Chapel Hill, N.C.

Durham-Chapel Hill was new to this year’s Milken Institute Center for the Future of Aging big city rankings, due to its recent population growth. The Center says the Research Triangle, home to three world-class universities (Duke, UNC and North Carolina State), has “stellar age-friendliness” as well as cultural and employment options that “make it a strong choice for successful aging.”

The area also ranked No. 1 in the Health Care category among 100 big cities, partly due to “top-notch access to geriatric, Alzheimer’s, hospice and physical therapy services and many primary-care providers.”

Salt Lake City

No. 4 Big City: Salt Lake City, Utah

The Milken Institute Center for the Future of Aging report calls Salt Lake City “a draw for snow enthusiasts and a growing hub for finance and technology.” The area scores well for its “acclaimed Intermountain Healthcare and strong primary-care network” as well as a diverse job market and an older population “that’s enthusiastic about volunteering.”

Des Moines

No. 5 Big City: Des Moines-West Des Moines, Iowa

The Milken Institute Center for the Future of Aging ranked the Des Moines-West Des Moines metro area the best for community engagement among all of the nation’s 100 biggest cities. A few reasons: lots of older volunteers, many civic opportunities, strong funding for programs targeting older adults and loads of libraries and recreational facilities. This area also scored well for its economy, health services and relatively low cost of living.

One downside: sparse public transit.

Austin

No. 6 Big City: Austin-Round Rock, Texas

Home to the University of Texas, the South by Southwest music and film festival, a booming high-tech industry and more entertainment than you can shake a drumstick at, the Austin-Round Rock metro area is called “hip and youthful” in the Milken Institute Center for the Future of Aging report.

That said, the Center notes, the tax-friendly area “also facilitates enjoyable lifestyles for older residents” plus “high older-worker employment” and a “thriving small-business climate.” And it was ranked the second best big city in the Financial Security category, to boot.

Omaha

No. 7 Big City: Omaha, Neb.-Council Bluffs, Iowa

Since billionaire investor Warren Buffett has chosen to stay in the Omaha-Council Bluffs metro area, that might be reason enough to consider this a great place for successful aging. And the Milken Institute Center for the Future of Aging says the numbers don’t lie: Omaha scored well for a low cost of living, quality health care, recreational amenities and strong employment opportunities.

Jackson

No. 8 Big City: Jackson, Miss.

Although the economy could use improving, Jackson ranked well by the Milken Institute Center for the Future of Aging for other reasons: low living and housing costs, low taxes and a large health care sector. But few older adults have Internet access, the Center’s report says, and “fast food is a staple” here, making obesity common.

Boston

No. 9 Big City: Boston-Cambridge-Newton, Mass.

While this huge New England metro area, which includes parts of New Hampshire, might be too big to be called a “college town,” it’s well-known for many top colleges and universities. That, the Milken Institute Center for the Future of Aging says, is a strong reason the area scores so well in so many of its categories.

You’ll find high-quality hospitals, plenty of transit options, walkable neighborhoods and many 65+ workers here, the Center says.

If you can afford it: the Boston metro area is one of the most expensive, according to the study.

San Francisco

No. 10 Big City: San Francisco-Oakland-Hayward, Calif.

Talk about high-tech: the San Francisco metro area shot up from No. 17 in the Milken Institute Center for the Future of Aging’s 2014 ranking due to its tech companies’ economic strength. Also strong for the local older population: transit, cultural and educational offerings, health care, mild weather and many small businesses.

But San Francisco can be extremely expensive (housing and taxes, to name two examples), and the commute to work can be grueling.

Successful Aging

The Top 10 Small Cities for Successful Aging

The best small cities for successful aging, according to The Milken Institute Center for the Future of Aging, combine “moderate living costs, robust economies, quality health care, educational facilities and healthy and engaged populations.” Five are new to the Top 10 since the Center’s last rankings in 2014. As the rankings report notes: “Sometimes small-scale changes can make a big difference in people’s lives — and in metro rankings, too.”

Successful Aging

No. 1 Small City: Iowa City, Iowa

The Milken Institute Center for the Future of Aging ranked Iowa City — home to the University of Iowa— No. 1 for people ages 65 to 79 and ages 80+. (Ames, its Iowan rival, is ranked No. 3 among small cities.) The surprisingly diverse area was also No. 1 among small cities in the Center’s last ranking in 2014. And Iowa City scored No. 1 among all 281 small cities in the Health Care category (lots of primary-care physicians, strong specialty care, affordable hospitals and high-quality nursing homes). Other winning attributes: high employment, a business-friendly economic environment and accessible transit.

“I’m 72 and walk or bike to work virtually every day,” Iowa City Mayor Jim Throgmorton told Next Avenue. “I wouldn’t be able to do that were it not for the physical design of the city and the services of the city. There are safe, walkable streets, an increasingly robust network of biking facilities and a vibrant downtown.”

In decent weather, Throgmorton does his “Mayor’s Walk” around town once a month, knocking on doors to hear what residents do and don’t like about living in Iowa City. “Everybody who’s aging appreciates the high quality health care, the arts and culture and the educational opportunities that make Iowa City extraordinary,” Throgmorton said.

Access to decent quality, affordable housing within walking distance of the core of downtown is “a challenge,” though, the mayor added. But Iowa City has adopted an affordable housing plan to try to increase the availability of low-to-moderate income homes.

Manhattan Kansas

No. 2 Small City: Manhattan, Kansas

Credit: Manhattan Convention and Visitors Bureau

As the song goes: “I’ll take Manhattan,” and the Milken Institute Center for the Future of Aging calls Manhattan, Kansas the nation’s second best small city for successful aging. (Another Kansas community, Lawrence, is No. 8.) The very-affordable home to Kansas State University has “a college-town feel,” the Center’s report says. Of particular note: access to specialty medical care and job opportunities at KSU, Fort Riley and local small businesses. The commute to work is short, often done by walking.

Ames

No. 3 Small City: Ames, Iowa

Credit: Ames Main Street Cultural District

Just two rungs below the No. 1 small city for successful aging (Iowa City), Ames is also deemed by the Milken Institute Center for the Future of Aging to be the best small city in the Education category. Having Iowa State University in its pocket also makes Ames strong for health care and cultural amenities. Two bonuses: Ames has the lowest unemployment rate of all small metro areas and the smallest percentage of older adults in poverty.

Columbia

No. 4 Small City: Columbia, Mo.

Another college town (University of Missouri), Columbia scored well by the Milken Institute Center for the Future of Aging for several reasons. The Center said it has a “great selection” of primary care doctors and many med-school-affiliated hospitals; affordable assisted living and nursing homes plus many home health-care providers and a reliable economy with high levels of older-adult employment.

Sioux Falls

No. 5 Small City: Sioux Falls, S.D.

The No. 1 best small city for successful aging in the 2012 rankings from the Milken Institute Center for the Future of Aging, Sioux Falls is still a standout. In fact, the area ranked best of all small cities this year in the Financial Security category (high growth rates in incomes and small businesses) and tied as No. 1 for lowest hospital costs; it ranked second for Community Engagement.

But Sioux Falls is “somewhat geographically isolated,” according to the Center’s report, needs to improve its wellness status and could have more walkable streets.

Ann Arbor

No. 6 Small City: Ann Arbor, Mich.

The University of Michigan here powered Ann Arbor’s ranking from the Milken Institute Center for the Future of Aging, especially for health, transportation (public transit and walkability) and cultural and recreational amenities. Downsides, the Center says: costly housing and hospitals.

Ithaca

No. 7 Small City: Ithaca, N.Y.

Best known as home to Cornell University, Ithaca is a paradise for outdoorsy types who don’t mind cold winters, according to the Milken Institute Center for the Future of Aging rankings. The area rose dramatically from its No. 17 perch in the Center’s 2014 list, due to improvements in health, wellness, finances and community engagement.

Many 65+ adults are employed here, the data reports, and the area has walkable communities (snow notwithstanding) plus short commutes.

Lawrence

No. 8 Small City: Lawrence, Kansas

Credit: Doug Stremel / Andrea Johnson

Benefiting from having the University of Kansas here as well as recent improvements in health and wellness pushed Lawrence into the Top 10 of this year’s Milken Institute Center for the Future of Aging rankings. Health care is especially impressive, the Center says, with “ample primary care, short emergency room waits and affordable hospitals.”

The economy is strengthening, in part due to a growing tech community; Lawrence tied for the lowest older-adult unemployment among all the small cities. Taxes and housing are on the high side, though.

Logan

No. 9 Small City: Logan, Utah

Credit: Paul Hermans

This metro area (which includes some towns in neighboring Idaho) is deemed a “comparatively safe, community-minded city with a stable economy” by the Milken Institute Center for the Future of Aging. Commutes are short, the 65+ unemployment rate is low and residents stay active, sometimes on the slopes of the Bear River Mountains.

Fairbanks

No. 10 Small City: Fairbanks, Alaska

You might be surprised to see an Alaskan city showing up on a list of best cities for successful aging, given the weather. But the Milken Institute Center for the Future of Aging says Fairbanks “leads the nation in community engagement, with cultural amenities and social organizations.” And the weather is actually a plus in one way: locals love to fish, hike and engage in all manner of snow sports.

One more data point that might surprise you: Fairbanks has many primary-care clinicians, ample hospice care and easy access to diagnostic centers, according to the Center’s report.

But living costs, including long-term care services, are on the high side.

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Richard Eisenberg
By Richard Eisenberg
Richard Eisenberg is the Senior Web Editor of the Money & Security and Work & Purpose channels of Next Avenue and Managing Editor for the site. He is the author of How to Avoid a Mid-Life Financial Crisis and has been a personal finance editor at Money, Yahoo, Good Housekeeping, and CBS MoneyWatch.@richeis315

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