The Milken Institute, founded by financier Michael Milken, has analyzed 252 small cities and rated them on their ability to provide healthy, productive and purposeful lives for their aging residents.

The rankings are based a wide range of factors that promote age-friendly communities such as health care, wellness, living arrangements, transportation/convenience, financial well being, employment/educational opportunities, community engagement, and overall livability.

The following 15 cities offer aging residents the ability to lead fulfilling lives with No. 1 receiving the highest score. Part 1 of this report ranked the top large metro areas for aging well.

No. 15
Morgantown, W.V.

This college town is home to West Virginia University, which helps propel economic growth and provides employment opportunities for mature residents as well as educational options. The city rates high for its large selection of doctors, orthopedic surgeons and nurses, and health care is affordable. Crime rates are low, but housing is expensive and there are elevated levels of obesity and diabetes.

 

No. 14
Lubbock, Texas

The West Texas oil industry is fueling economic expansion and employment. A high percentage of older adults are employed and the cost of living is low. There are affordable nursing homes and adult day services. The drawbacks include a lack of libraries, recreational and fitness centers as well as low rates of volunteering and active community engagement from senior residents.

 

No. 13
Lincoln, Neb.

The capital of Nebraska, Lincoln has an economy that is steadily expanding. The city  has surpassed many others in recovering from the recession. It boasts stable growth for small businesses, low unemployment for mature adults and a low level of reverse mortgage debt. But a high crime rate is problematic, and more specialty-care facilities, such as hospitals with rehabilitation services, are needed.

 

No. 12
Gainesville, Fla.

This area ranked high for its quality health care and abundance of doctors, nurses, physical therapists and orthopedic surgeons. The University of Florida provides a large service-sector job market for older adults, as well as learning opportunities. But recreational activities, entertainment venues and funding for senior programs are low, as are volunteer rates. In addition, the large quantity of fast food outlets leads to unhealthy diets among residents.

 

No. 11
Midland, Texas

This city’s booming energy industry makes for an expanding economy and the highest employment growth among all 252 small metro areas analyzed. In addition, the cost of living is among the lowest for areas of this size, and adult day services and nursing homes are reasonably priced. However, the city lacks in transportation options and specialty-care hospitals.


 

No. 10
Fargo, N.D.-Moorhead, Minn.

Many older residents are employed as a result of a fast-growing job market and small business growth, which is among the highest for small metro areas. The area offers lots of cultural and recreational activities, such as museums, theaters and YMCAs, and strong funding from the state aimed at services for the aging population. Volunteerism rates are also high. But living options for mature adults are lacking, a low number of home-health care providers, and specialty care is limited.

 

No. 9
Cheyenne, Wyo.

This city has a firm financial base and the economy is strengthening. It boasts many job opportunities for mature residents, good income growth and has the highest capital gains of small metro cities. The drawbacks include too few fitness centers, a shortage of home health service providers, and few continuing care facilities to meet the needs of an aging population.

 

No. 8
Ann Arbor, Mich.

Home to the University of Michigan, this city provides ample opportunities for intellectual pursuits, boasts quality health-care services with a large pool of doctors, nurses and surgeons as well as hospitals with specialty-care units. It rates high for public transportation. However, house prices and rents are high, as well as assisted living and adult day services. Income growth is sluggish and income inequality is worsening.

 

No. 7
Rochester, Minn.

The Mayo Clinic provides this area with an abundance of health-care providers and specialty services. Residents are health conscious, with lower-than-average obesity rates. The area has low rates of income disparity, unemployment and crime. The downside includes stagnant job opportunities for mature adults and a high cost of living.

 

No. 6
Ames, Iowa

This city has one of the lowest overall unemployment rates and little poverty among mature adults. Workers have short commute times and annual ridership on public transportation is the highest for small metro areas. But there are few top-rated nursing homes and specialty-care hospitals to meet older patients needs.

 

No. 5
Rapid City, S.D.

Low unemployment rate for older adults, flourishing small businesses and steady income growth provide a strong, stable economy for this city. There are plenty of recreational activities and state investment in community services aimed at engaging older residents. However, too many fast food outlets and inadequate access to grocery stores contribute to unhealthy eating habits among residents. The area needs more health care providers.

 

No. 4
Bismarck, N.D.

The oil boom in this state provides a strong economy and employment opportunities for older adults. There is a high growth rate in the leisure and hospitality industries and the state has made investments in public transportation. Drawbacks include few grocery stores, pricey housing and a shortage of home health-care services and caregivers.

 

No. 3
Columbia, Mo.

Home to the University of Missouri, this city’s economy is expanding and has seen stable small business growth for the past five years. Many mature adults are employed. The city ranks first for hospitals with rehab facilities and good availability of hospitals with specialty services. But few arts and recreational services are available, there is substantial income inequality, and the cost of living is high.

 

No.  2
Sioux Falls, S.D.

This city has the highest amount of bank deposits per capita among areas analyzed, making for a strong financial base. There are many hospitals, large pools of doctors and nurses, and low inpatient costs. Numerous museums, movie theaters, community services and high volunteerism rates keep older adults engaged. However, high housing costs and a shortage of convenience stores can pose a problem for aging residents.

 

No. 1
Iowa City, Iowa

The highly rated health care system, strong economy and low unemployment in this city may be an attractive option for seniors. Home to the University of Iowa, there are multiple learning opportunities and entertainment venues for older adults. Residents are health conscious and have low diabetes and obesity rates. There is a need for more health-care service providers, affordable housing and financial institutions.

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