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The 10 Best Cities for Getting Older in the U.S.

The country's best big and small metro areas offer engaging activities, accessible health care and the opportunity to work and learn

By Jason Kane

This article first appeared on the PBS NewsHour website.

Great hospitals! Good public transportation! Booming economy! The best small city for seniors looking to age well is ... Sioux Falls, S.D.?

Forget palm trees and warm sea breezes. The health care facilities in this small Plains city "specialize in geriatric services, hospice and rehabilitation, and the metro has recreation and an active lifestyle," according to a recent study by the Milken Institute, a non-partisan think tank. It's enough to make Sioux Falls No. 1 of 259 small cities in the report.

Looking for a more major metropolitan vibe? Set your gaze to Provo, Utah, where a pro-business environment, a focus on wellness and high community engagement make it No. 1 on the institute's big cities list.

(MORE: 8 Things Your City Should Be Doing to Help You Age Well)

Not a single town in Arizona or Florida cracked the top 100 in the major metropolitan category and only the inland city of Gainesville, Fla., made the cut in the small metro category. Why? Probably because the notion of moving someplace in the desert or by the beach with "a nine-hole golf course, a shuffleboard court, a rec room and cafeteria" is outdated, says Paul Irving, president of the Milken Institute.

"That's not what people are looking for these days," he says. "People want a safe, affordable, engaging and connected community. They want to remain associated with former co-workers and with their families. They want quality health care, active lifestyles and access to education, transportation, employment, recreation and culture."

(MORE: The Best Cities for Boomers to Pre-Retire)

Nearly 90 percent of Americans over the age of 65 say they would prefer to "age in place" in their own homes as long as possible, according to AARP. In that age bracket, 4 out of 5 people believe their current home is where they will always live.

But to do that successfully in the long run, most need support from their communities – especially easy access to health care and wellness programs, affordable living arrangements, convenient transportation options and, often, employment.

On many of these fronts, cities throughout the United States just weren't cutting it, Irving says. That's why the Milken Institute decided to rank 359 metro areas, large and small, on their performances in "promoting and enabling successful aging." The study will be updated every other year, the idea being not just to shed some light on what is – and isn't – being done, but to fire up some healthy rivalries, or "virtuous competition," as Irving calls it, between mayors and city councils and civic leaders.

"We really wanted to cause them to question whether the policies and practices they adopt in their own metro areas are as advanced as they should be," he says. "We also wanted them to consider whether they were taking full advantage and creating adequate opportunity to benefit from their aging populations."

(MORE: Is Your Hometown a Place to Grow Old? Mine Is)

Below, check out the top five cities in the Large Metro and Small Metro categories from the think tank's "Best Cities for Successful Aging" report. The report will next be updated in the summer of 2014. Click here to read the full list and see how your hometown stacks up.

All slides courtesy of the Milken Institute.

Top 5 Large Metros for Successful Aging, According to the Milken Institute

Provo-Orem, Utah
The presence of Brigham Young University, one of the largest private universities in the United States, and a pro-business environment make Provo the No. 1 city on our list. It also boasts a low incidence of chronic disease, thanks to healthy lifestyles and a focus on wellness. Provo is an excellent location for seniors who are relocating or hoping to age in place, with safety, security, high community engagement, quality health care, a healthy lifestyle, and opportunities for second careers and entrepreneurships.


Madison, Wis.
Home to the respected University of Wisconsin, Madison is a hub of innovation and intellectual stimulation. A midsize city with its own quality health-care system and cultural events, Madison and its residents also benefit from being just 150 miles from Chicago and its amenities, services and consumer markets.

Omaha-Council Bluffs, Neb./Iowa
The greater Omaha area hosts the headquarters of five Fortune 50 companies, which contribute significantly to the area's financial well-being and are a testament to its low-cost environment. The metro area is becoming a health-care hub for the surrounding area and a popular place for holding conferences.

Boston-Cambridge-Quincy, Mass.-N.H.
It almost goes without saying: Few places are as innovative or offer as many opportunities for education and retraining as the greater Boston area, home to more than 100 colleges and universities. For culture vultures, the area is full of theaters, historic places, lively lectures and music venues.

New York-Northern New Jersey-Long Island, N.Y.-N.J.
Greater New York hosts two of the top 20 hospitals in the United States. Despite being the nation's financial capital, it did poorly in the financial category because of high taxes and many seniors facing financial distress. If you can afford to live there, the area has all the big-city amenities and the negatives, too.

Top 5 Small Metros for Successful Aging, According to the Milken Institute

Sioux Falls, S.D.
With a booming economy, low-unemployment and a rapidly growing financial infrastructure, Sioux Falls is a good place for seniors who want to work or start a second career. Its hospitals specialize in geriatric services, hospice and rehabilitation, and the metro has recreation and an active lifestyle.

Iowa City, Iowa
Home to the University of Iowa and its medical school, Iowa City has excellent health care, little crime and relatively few seniors below the poverty line. On the flip side, housing and rentals are pricier than the median for small metros. Although its population skews younger, the presence of a young working-age population implies a solid fiscal base.

Bismarck, N.D.
The capital city is reaping the benefits of North Dakota's oil and gas boom. It ranks high in senior employment, and the large service sector increases the chances of finding a job. If weather is not a high priority, Bismarck offers excellent opportunities for working seniors.

Columbia, Mo.
Thanks in part to a strong tax base, Columbia offers excellent educational facilities and health care. University-sponsored research is an incubator for innovation and new businesses, which gives seniors access to cutting-edge technology in health care and supports entrepreneurial activities. However, the metro is short on recreation and culture.

Rochester, Minn.
The Mayo Clinic, one of the best hospitals in the nation, is located here. Needless to say, this has attracted many health-care providers. Safe and secure neighborhoods offer a superior quality of life. But the sluggish economy and low college enrollment are definite weaknesses.

Learn more about the Milken Institute rankings from Next Avenue.

Jason Kane Read More
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