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20 Best Big Cities for Successful Aging

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As boomers age, their retirement ambitions are likely to include more than just trading in their winter snow shovels for a fair-weathered community in a low-tax state. That is why the Milken Institute has created its new Best Cities for Successful Aging Index, which they compile every other.

Far from a list of Florida cities with cheap, and early, eats, the Milken Institute rankings (which are actually dominated by cold-weather places) take into account a wide number of variables—78 in fact—that point to a community’s health care resources, safety, affordability, comfort, ease of transportation, second-career opportunities, cultural offerings and community connectedness.

The study’s authors—Anusuya Chatterjee, Ross DeVol and Paul Irving—drilled deeply. In the area of heath care, for example, they looked at the number of doctors, hospital beds, dialysis centers and more; the number of hospitals with Alzheimer’s units and hospice centers; hospital expenses per inpatient day; the percentage of hospitals with medical school affiliations; and more than a dozen other factors.

They did the same for wellness indicators; financial indicators; employment and education indicators as well; they did all this for large metro areas and small metro areas; and they did this for two age cohorts—65 to 79 and 80 and older. The result is a multivariate ranking on steroids.

“This index is a first research of its kind in the United States using public-use data that determine the overall quality of life for seniors,” Milken Institute scholar Anusuya Chatterjee said, commenting on the study for ThinkAdvisor. “Ninety percent of seniors want to age in [the same] place, and this index looks directly at how cities are meeting these needs.”

Chatterjee said the Milken Institute’s Successful Aging data site can be used as a tool for Americans to assess where each metro area stands. “Personal preference is of course the ultimate deciding guide,” she adds.

The big study examined two cohorts: one that included the 100 largest cities and regions and the other 259 smaller metropolitan areas. First up from ThinkAdvisor is the 20 Best Large Cities for Successful Aging, next will be the 15 Best Small Cities for Successful Aging.

Hula dancer in Hawaii

20.  Honolulu, Hawaii

Overall Score: 93.53

Age 65-79 Rank and Score: 11; 93.70

Age 80+ Rank and Score: 37; 92.87

TAKEAWAY: This prime tourist spot is an expensive place to live. But it offers an excellent quality of life, good health care and many employment opportunities for seniors. The metro needs a more efficient transport system. Although ridership is high, fares are expensive. A long commute time adds to residents’ transportation woes.

Skyline of Scranton, Pa.

19.  Scranton—Wilkes-Barre, Pa.

Overall Score: 93.54

Age 65-79 Rank and Score: 24; 90.55

Age 80+ Rank and Score: 23; 94.13

TAKEAWAY: Scranton offers a low cost of living, a large senior population and a low crime rate. It benefits from its proximity to the services, cultural events and markets of Philadelphia. Owing to educational and retraining opportunities, the metro ranks high in the employment category. However, its economy is struggling.

Fountains in downtown Syracuse, N.Y.

17. (tie) Syracuse, N.Y.

Overall Score: 93.56

Age 65-79 Rank and Score: 18; 91.96

Age 80+ Rank and Score: 27; 93.40

TAKEAWAY: A university town with quality health care, Syracuse enjoys the slower pace of a midsize burg but with access to larger metros like Rochester, Albany and New York. The metro’s weaknesses include living arrangements, a high tax burden and, of course, the weather.

17. (tie)  Bridgeport-Stamford-Norwalk, Conn.

Overall Score: 93.56

Age 65-79 Rank and Score: 22; 91.29

Age 80+ Rank and Score: 29; 93.31

TAKEAWAY: The metro is highly connected to New York City and is a global financial center. One of the safest places to live, the metro has educated residents who support all kinds of arts and culture. While residents are engaged and healthy, the metro ranks 99th in living arrangements due largely to cost and housing needs.

Liberty Bell in Philadelphia

16.  Philadelphia-Camden-Wilmington, Penn.-N.J.-Del.-Md.

Overall Score: 94.07

Age 65-79 Rank and Score: 15; 92.21

Age 80+ Rank and Score: 17; 95.52

TAKEAWAY: Greater Philadelphia, a hotbed for pharma, has a large share of medical services and research facilities. It is well connected, with many educational facilities, historic landmarks and cultural venues, not to mention its proximity to other major cities in the Northeast. But all those amenities don’t come cheap.

Skyline of Little Rock. (Photo: AP)

15.  Little Rock-North Little Rock-Conway, Ark.

Overall Score: 94.19

Age 65-79 Rank and Score: 17; 91.97

Age 80+ Rank and Score: 17; 95.52

TAKEAWAY: This capital city, home of the University of Arkansas and its medical school, has great health care, a low cost of living and a learning environment. But a less active population and unhealthy eating habits breed chronic disease in the metro. High rates of crime and fatal car crashes add to these woes.

Old Capitol building of Baton Rouge

14.  Baton Rouge, La.

Overall Score: 94.73

Age 65-79 Rank and Score: 9; 94.62

Age 80+ Rank and Score: 16; 95.83

TAKEAWAY: Baton Rouge enjoys a thriving economy, a great medical school, and its status as the state capital. However, job opportunities for those 65 and older are limited, and community engagement is on the low side, with few volunteer opportunities and a smaller population of seniors with whom to socialize.

Baltimore's port, with inner harbor in background. (Photo: AP)

13.  Baltimore-Towson, Md.

Overall Score: 94.81

Age 65-79 Rank and Score: 14; 92.29

Age 80+ Rank and Score: 19; 95.32

TAKEAWAY: Greater Baltimore enjoys the benefits of Johns Hopkins University and its proximity to Washington, offering residents opportunities in education, retraining, and cultural fulfillment. However, living arrangements are expensive, and small-business growth is sluggish.

City Hall of Jackson, Miss. (Photo: AP)

12.  Jackson, Miss.

Overall Score: 95.09

Age 65-79 Rank and Score: 16; 92.12

Age 80+ Rank and Score: 9; 97.21

TAKEAWAY: This city has a strong pool of health care providers and colleges, including the University of Mississippi. However, unhealthy lifestyles suggest residents will need more quality health care in the future. A dearth of cultural enrichment opportunities hurts its ranking in this regard.

Aerial view of San Francisco

11.  San Francisco-Oakland-Fremont, Calif.

Overall Score: 95.11

Age 65-79 Rank and Score: 13; 93.28

Age 80+ Rank and Score: 5; 98.17

TAKEAWAY: Beautiful weather, picturesque landscapes and a lively atmosphere make the metro by the Bay a desirable place to live. Top-notch health care, an innovative business atmosphere, public transit and active lifestyles only add to its appeal. But the metro area has its flaws: It’s extremely pricy to live in paradise.

Pittsburgh skyline

10.  Pittsburgh, Pa.

Overall Score: 95.99

Age 65-79 Rank and Score: 10; 93.88

Age 80+ Rank and Score: 13; 96.43

TAKEAWAY: Top-tier education and research centers, museums and libraries, safe and affordable neighborhoods and significant community engagement make Pittsburgh a suitable place for seniors. Although opportunities for education and retraining are available, this metro lacks mom-and-pop entrepreneurial activities.

Capitol at night

9.  Washington-Arlington-Alexandria, D.C.-Va.-Md.-WVa.

Overall Score: 96.80

Age 65-79 Rank and Score: 4; 97.11

Age 80+ Rank and Score: 12; 96.49

TAKEAWAY: The Washington, metro area is a prime spot for seniors who want to work, further their education or find satisfying volunteer work. But the area is pricy and ranks below the median in community engagement in part because its population skews younger, so seniors have fewer contemporaries.

Toledo skyline

8.  Toledo, Ohio

Overall Score: 96.86

Age 65-79 Rank and Score: 12; 93.37

Age 80+ Rank and Score: 8; 97.62

TAKEAWAY: Toledo is a safe, affordable city with excellent health care and recreational facilities. But the economic environment makes it more difficult to find employment or start a new business. And although the metro is proud of its quality hospitals, it lacks specialized medical facilities.

Mormon Tabernacle in Salt Lake City (Photo: AP)

7.  Salt Lake City, Utah

Overall Score: 98.36

Age 65-79 Rank and Score: 2; 98.27

Age 80+ Rank and Score: 14; 96.05

TAKEAWAY: Salt Lake City has a strong economy with solid financial infrastructure and a well-educated population. It’s a perfect place for someone looking to engage in a second career or start a business, given the atmosphere and ready access to education and retraining. However, safety is a big concern.

Bikers in Des Moines. (Photo: AP)

6.  Des Moines-West Des Moines, Iowa

Overall Score: 98.36

Age 65-79 Rank and Score: 8; 95.71

Age 80+ Rank and Score: 6; 98.01

TAKEAWAY: Des Moines has dynamic financial services and insurance industries, and its economic outlook is bright. However, the car is still king in this midsize Midwestern city, making it difficult for seniors who no longer drive. Des Moines ranks 45th out of 100 in the transportation/convenience indicator.

Jets flying in formation past Lower Manhattan. (Photo: AP)

5.  New York-Northern New Jersey-Long Island, N.Y.-N.J.-Penn.

Overall Score: 98.49

Age 65-79 Rank and Score: 3; 97.19

Age 80+ Rank and Score: 2; 99.96

TAKEAWAY: Greater New York hosts two of the top 20 hospitals in the U.S. 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 all the negatives, too.

Boston park. (Photo: AP)

4.  Boston-Cambridge-Quincy, Mass.-N.H.

Overall Score: 98.93

Age 65-79 Rank and Score: 6; 96.70

Age 80+ Rank and Score: 1; 100.00

TAKEAWAY: 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.

Fountains in Omaha.

3.  Omaha-Council Bluffs, Neb-Iowa

Overall Score: 99.46

Age 65-79 Rank and Score: 7; 96.22

Age 80+ Rank and Score: 3; 99.53

TAKEAWAY: The greater Omaha area hosts the headquarters of five Fortune 500 companies, which contribute significantly to the area’s financial well-being and are a testament to its low-cost environment. The metro is becoming a health care hub for the surrounding area and a popular place for holding conferences.

Aerial view of Madison

2.  Madison, Wis.

Overall Score: 99.95

Age 65-79 Rank and Score: 5; 96.84

Age 80+ Rank and Score: 4; 98.67

TAKEAWAY: 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’s amenities, services and consumer markets.

Provo from above

1.  Provo-Orem, Utah

Overall Score: 100.00

Age 65-79 Rank and Score: 1; 100.00

Age 80+ Rank and Score: 7; 97.93

TAKEAWAY: Provo has a relatively young population, but more older Americans have been moving to the metro over the past decade. A learning environment and vibrant economy provide opportunities for a second career and retraining. The presence of Brigham Young University, one of the largest private universities in the U.S., 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 entrepreneurship.


Check out the full Milken Institute report on Best Cities for Successful Aging.

More Top 10 lists from ThinkAdvisor:


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