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2017 best cities for aging map

Location, Location, Location: Top 5 Largest (and Smallest) Cities for Successful Aging

Americans are living longer, and most of us want to stay in our own homes as long as possible.

But staying healthy, secure, and independent at home requires more than installing grab bars in the bathroom. It’s also about living in a community that can support you as you age.

According to new research by the Milken Institute’s Center for the Future of Aging, cities that are focused on successful aging offer far more than just good weather or affordable living. They are improving livability across all aspects of life—from transportation and employment to community engagement.

The Best Cities for Successful Aging™ 2017 report ranks more than 300 large and small metro areas, highlighting those that enable an optimal quality of life for older adults.

What determines an age-friendly environment?

Researchers looked at 83 factors in 9 main categories:

  • General Livability
  • Health Care
  • Wellness
  • Financial Security
  • Education
  • Transportation and Convenience
  • Employment
  • Living Arrangements
  • Community Engagement

Top 5 large metro areas

Number 1: Provo-Orem, UT

Provo-Orem ranks high for healthy and active lifestyles, education, and income. It has five national parks that promote outdoor recreation, low smoking and binge drinking rates, one of the smallest income inequality gaps, and 9 in 10 adults 65+ with high school diplomas.

What needs work? Affordability, as it has expensive hospitals and transportation and doesn’t receive a lot of funding for older adult programs.

Number 2: Madison, WI

Madison ranks high for medical care, healthy environments, and intellectual atmosphere. It boasts ample and diverse health care services for older adults, several hospitals and short emergency room waits, few fall injuries, great walkability, high philanthropy engagement, and many libraries and cultural opportunities.

What needs work? Affordability, employment opportunities, and aging in place supports. Madison has high taxes, substantial unemployment among older adults, very little home health care providers, and pricey long-term care services.

Number 3: Durham-Chapel Hill, NC

Durham-Chapel Hill thrives in health care, culture, and employment. It has some of the nation’s best hospitals; top-notch access to geriatric, Alzheimer’s, hospice, and physical therapy services; many religious and civic organizations; a high rate of volunteerism; and low unemployment among older adults.

What needs work? Safety, economic resources, and health habits. It has a high rate of crime and traffic accidents, high income inequality, poor walkability, too many fast food restaurants and too few grocery stores, and high chronic disease rates.

Number 4: Salt Lake City, UT

Salt Lake City flourishes in economic opportunity, engagement, and health consciousness. It has low Alzheimer’s, diabetes, and obesity rates; easy access to primary care; a high level of volunteerism among older adults; many community colleges for learning new skills; and low older adult poverty rates.

What needs work? High housing costs, low funding for older adult programs, lack of fitness facilities, and a high crime rate.

Number 5: Des Moines-West Des Moines, IA

The Des Moines area offers great health services, low cost of living, and community engagement options. There are many older workers, moderately priced medical and long-term care services, several well-recognized rehab and Alzheimer’s facilities, and adequate funding for older adult programs.

What needs work? Health and lifestyle. There are few 5-star government-rated nursing homes, high obesity and Alzheimer’s rates, limited public transportation options, too few grocery stores, and high rates of binge drinking.

Top 5 small metro areas

Number 1: Iowa City, IA

Iowa City ranks high for employment, quality health care, and convenience. It has one of the highest employment rates for older adults; high-quality nursing homes and geriatric facilities, hospices, and Alzheimer’s units; lots of pedestrian commuters; and ample funding to help older adults live independently.

What needs work? Expensive housing, few aging in place opportunities and diagnostic centers, and limited public transit funding.

Number 2: Manhattan, KS

Manhattan flourishes in health care, economy, and convenience. Very few older adults live in poverty and many are employed; there are many rehab centers, Alzheimer’s units, and geriatric facilities; it has very high Medicare enrollment; and it boasts many nearby amenities and high levels of volunteerism.

What needs work? Air quality is poor; not many older adults age in place; and there are high rates of Alzheimer’s disease, depression, and binge drinking.

Number 3: Ames, IA

Ames has a lot going for it on the livability, medical care, and healthy lifestyle scales. It boasts the lowest poverty rates for older adults among small cities, Internet-savvy seniors, few car crashes, lots of affordable rehab centers and hospice care options, very low smoking and diabetes rates, and many walkers and transit users.

What needs work? Lack of employment opportunities for older adults, poor air quality, high cost of living, lack of 5-star nursing homes and home health care providers, and an abundance of fast food restaurants.

Number 4: Columbia, MO

Columbia ranks high for medical care and healthy living. There are many fitness centers and high exercise rates; affordable assisted living options; ample home health care providers, caregivers, and physical therapists; and many medical school affiliated hospitals.

What needs work? Too many fast food restaurants; high rates of Alzheimer’s disease, depression, crime, and car crashes; limited Medicare outreach and enrollment; and high income inequality and cost of living.

Number 5: Sioux Falls, SD

Sioux Falls excels in cost-effective care and community engagement. It’s tied for lowest hospital costs among small cities; there are ample nurses, hospices, physical therapists, and geriatric services; strong funding to help older adults age independently; easy access to libraries and cultural recreation; and there is a high rate of volunteerism.

What needs work? Housing is pricey, many older adults are living in poverty, there is insufficient funding for public transit and walkability, and there is small growth in health and leisure employment options.

Read the full report

To see the rankings for all 381 metro areas or learn more about programs that can help you make successful aging a priority, download the full Best Cities for Successful Aging™ 2017 report.

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About Healthy Aging Team

NCOA's Center for Healthy Aging gives older adults the knowledge and resources to prevent falls, manage chronic diseases, and lead healthier lives.

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