7. Pearl City, Hawaii

Home to Hawaii’s most popular tourist attraction, Pearl City ranks 174th with Honolulu, New York City, Washington, D.C., San Francisco and Fremont, Calif., for highest adjusted cost of living. While the city also has the second-highest percentage of seniors living there, it ranks 44th in quality of life; 145th in healthcare; 173rd in affordability; and 178th in activities. Total Score: 39.50.

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