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Best Cities for Successful Aging: Why the Midwest Trumps the Sunbelt

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Of the few things that are certain in this life, getting older is one of them.

And as Americans grow older and reach retirement-age, a major question for baby boomers is where to spend those so-called golden years.

To help answer that question the Milken Institute, a nonpartisan economic think tank, has released its first-ever "Best Cities for Successful Aging" Index, which ranks the top 100 large metros and top 259 small cities in America based on 78 various criteria. The factors used in the index include everything from access to health care, low crime rates, satisfactory infrastructure and good weather in addition to important economic aspects like affordable housing and employment.

This index rates the best cities for successful aging, not to be confused with retirement, as more and more people continue to work out of necessity and by choice into their senior years.

The results may surprise you.

Sunbelt metros, most often considered retirement havens due to favorable weather conditions, did not top either list while many Midwest cities ranked very high. For example, no cities from Arizona nor Florida made Milken's top 20 list of large metros. At the same time, Iowa saw four of its metros rank in the top 20.

Provo, Utah is the number one large metro to live in as an older American and Sioux Falls, South Dakota came in first ahead of all other small metros, according to the Milken index.

"While weather is certainly important, there are other factors that are increasingly important and one of them is the opportunity for jobs among those 65 and older," says Ross DeVol, chief research officer at The Milken Institute, in the accompanying video. "Best cities for successful aging are cities that provide access to quality healthcare, safety but also increasingly encore career opportunities."

In determining the weight of each category, Milken looked to two recent surveys; one conducted by the AARP and the other by Sunlife Financial. According to the AARP findings, 41 percent of Americans over 50 are most concerned about health care and 35 percent said economic struggles were their top challenge. The Sunlife Financial poll found similar results.

"Based on these two surveys, our literature review, and recommendations from our advisors, we are comfortable concluding that health care and wellness top the priority list, followed by financial security, safety, and security," says the Milken report.

Top Large Cities for Successful Aging

Provo received its high marks for a number of reasons, including a healthy lifestyle and its position as the number one place for small business growth. The metro is home to seven medical centers, the fewest fast-food restaurants per capita and five percent of the city's workforce walks to work. It also has the lowest poverty rate among seniors.

But Provo does have its faults, according to Milken, including the highest unemployment rate for those 65 and over. It is also expensive to live there.

Milken's top 10 large metros for successful aging:

  1. Provo, Utah
  2. Madison, Wis.
  3. Omaha, Neb.
  4. Boston, Mass.
  5. New York, N.Y.
  6. Des Moines, Iowa (tied with Salt Lake City)
  7. Salt Lake City, Utah (tied with Des Moines)
  8. Toledo, Ohio
  9. Washington, D.C.
  10. Pittsburgh, Pa.

Top Small Cities for Successful Aging

Sioux Falls is considered Milken's number one place to age among small cities due to its level of specialized geriatric services and its booming economy. The city has a large number of healthcare workers and the lowest inpatient expenses compared to the other small metros on the list.

Employment for those 65 and older is also the highest in Sioux Falls due in part to the city's large private service sector.

Milken's top 10 small metros for successful aging:

  1. Sioux Falls, S.D.
  2. Iowa City, Iowa,
  3. Bismarck, N.D.
  4. Columbia, Mo.
  5. Rochester, Minn.
  6. Gainesville, Fla.
  7. Ann Arbor, Mich.
  8. Missoula, Mont.
  9. Durham, N.C.
  10. Rapid City, S.D.

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