Biannually, the Milken Institute puts out a list of the Best Cities for Aging in Place. They look at 84 data indicators in 8 different categories and prioritize them by what factors matter most to Americans over 65. Specific data indicators include things like availability of special needs transportation, average wait time in hospitals, and number of movie theaters.

The most recent list had some surprising results. There were no cities from Florida or Arizona in the top ten, even though these states are known for being retirement hotspots. There were however an abundance of cities in the Midwest. Why? As the president of the Milken Institute Paul Irving puts it, “They [Midwestern cities] have very strong economies, high rates of employment and are relatively low cost. In some circumstances, they have very strong health systems.”

Madison, WI got the number one spot for big cities because of its high employment rate and low poverty rate amongst older adults, quality health care,, access to recreational and intellectual activities, low crime rate, and low rate of falls and diabetes amongst seniors. However, the report also said the city had a higher cost of living and fewer convenient grocery stores than many other cities.

Iowa City, IA got the number one spot for smaller cities because of its high job growth and employment rate amongst older adults, good public transportation system, great health care system, and low obesity rate.

The top ten big cities are:

  1. Madison, WI

  2. Omaha, NE

  3. Provo, UT

  4. Boston, MA

  5. Salt Lake City, UT

  6. Jackson, MS

  7. Des Moines, IA

  8. Toledo, OH

  9. Austin, TX

  10. Bridgeport, CT

The top ten small cities are:

  1. Iowa City, IA

  2. Sioux Falls, SD

  3. Columbia, MO

  4. Bismarck, ND

  5. Rapid City, SD

  6. Ames, IA

  7. Rochester, MN

  8. Ann Arbor, MI

  9. Cheyenne, WY

  10. Fargo, ND