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Frequently Asked Questions


How is this study different from all those "best places to retire" lists?

"Best Cities for Successful Aging" is the first research of its kind in the United States. It is based on public data, as opposed to a survey of households, and utilizes 83 indicators that determine the overall quality of life for older adults. Ninety percent of them want to age in place, and this index looks directly at how cities are meeting these needs

What do you mean by a "best city for successful aging"?

We define a best city for successful aging as a safe, affordable, engaging and connected community that offers quality health care and an active lifestyle together with ready access to transportation, education, employment and recreation.

Why focus on aging and cities?

This focus is timely given the twin trends of urban living and shifting demography:
  • The US population is aging at an unprecedented pace: By 2030, one in five Americans is projected to be 65 and over (Source: US Census)
  • Older adults predominantly live in metropolitan areas: In the US, 80% of those 65+ lived in metropolitan areas in 2014. (Source: DHHS, "A Profile of Older Americans: 2015")
  • Older adults want to age in place: 87% of adults age 65+ and 71% of adults age 50 to 64 want to stay in their current home and community as they age. (Source: AARP)
  • Longevity is linked to location: A widening longevity gap is tied to factors including education, income, access to health care, food choices, smoking rates, exercise, housing safety and pollution. (See Virginia Commonwealth University's Mapping Life Expectancy Project and California Endowment's longevity by zip code calculator)

What was the most surprising result from this study?

Many of the top cities in our index are places that aren't often thought of as retirement havens. Even accounting for weather, we saw in the results that other factors were significantly more important for an aging population. Weather was just a small piece of a larger set of factors. The common themes that emerged from our data are economic strength, an abundance of health services, an active lifestyle, opportunity for intellectual stimulation and easy access to amenities.

Why do metro areas with universities score so well?

Several of the factors examined in this study are directly linked to universities, such as the percent of hospitals with a medical school affiliation used in the health-care indicator and the number of universities used in the education indicator. Other factors are often associated with universities, such as the number of arts, entertainment and recreation facilities used for the community engagement indicator, or transit programs that may have been developed for students and faculty to access the greater community in the transportation/convenience indicator. Conversely, binge drinking is also a factor that could be viewed as weighted against a university, as a higher rate would reduce the score.

"Sunbelt" cities did not generally score high in the rankings. Why is weather such an insignificant factor in the index?

Weather is one of many factors that contribute to successful aging. This study looked at weather, but also at access to health-care facilities, the number and specialty of doctors, and over 80 other factors. Taken in totality, weather, while important, was not seen as an overriding factor.

When will this study be updated?

We expect to update our index every two years.

I'm a municipal leader in my town. How can I improve my city's score?

This index looks at many complex issues surrounding successful aging. With 83 indicators, there is no set way to "improve a city's score" other than to continually improve the areas addressed in the study. Health care, financial security and general livability indicators are heavily weighted in the study, but improvements in these areas are only part of the larger equation.

I'm an active citizen in my community. How can I improve the community for older adults?

This index looks at macro issues within a community. We also included sections on Programs With Purpose and Initiatives for Innovation to acknowledge some of the great work being done that wasn't quantifiable within the study. These programs provide a good starting point for greater community engagement. In addition, this study is meant to help civic leaders understand the concept of successful aging and help cities figure out how best to support it. Sharing this information with friends, neighbors and civic leaders can help create a greater understanding of these issues.

How is the overall score for a metro calculated? What are the differences between the overall score and the sub-scores for ages 65-79 and 80+?

The overall score for a metro is the combined scores of the nine categories: 1) general livability, 2) health care, 3) wellness, 4) financial security, 5) living arrangements, 6) employment, 7) education, 8) transportation and convenience and 9) community engagement, with the proper weighting for each age sub-group applied to each category.

Why is the data broken down for two age sub-groups?

The needs of the oldest Americans differ somewhat from their younger counterparts, particularly in terms of health care and employment. A 65-year-old may be seeking an encore career, while an 80-year-old may be looking instead at living in a safer city with better access to health care. Factors such as binge drinking, crime and employment opportunities may differ as well in different metropolitan areas. The overall index score uses a different weighting from the two sub-indexes, not an average of the weights between the two groups. This accounts for the overall needs of those over the age of 65.

How can a city have an overall rank that is lower or higher than its rank for the two age-specific sub-scores?

The overall score is generated independently of the two age-range sub-scores (65-79 and 80+). The score uses a slightly different weighting of the nine indicator categories to better reflect the overall needs of older adults. A chart of the weights can be found in the methodology section.
See Methodology

How current is the data you used?

To ensure the validity of this study, we used pre-existing data sets with sound methodological practices. In every case, the data we used was the most up-to-date available at the time of compilation.

What is the size difference between a small city and a large city in this study? How did you determine this criterion?

Cities (these are actually metro areas defined by the federal Office of Management and Budget, which derives its population estimates using Census Bureau data) were ranked by population. The 100 largest cities were broken into one subgroup and the remaining 281 into another. This allowed for appropriate data comparisons among cities with smaller populations, using a slightly different data set. Not all the data available for New York City was available for Fargo, as an example

Can we compare these rankings with the 2012 and 2014 publications?

We do not advise a comparison of this year's rankings with the 2012 or 2014 publications. First, the metro area definitions have changed since the earlier publications. This year, we analyzed employment and education separately (they were combined in 2014); we have new indicators to measure technology use (Internet access among older adults), walkability and neighborhood convenience (WalkScore®) and health-care delivery (nurse practitioner and physicians' assistant numbers). Above all, we adjusted weights for the indicators to be more reflective of this year's data.

Our research team found the Programs With Purpose and Initiatives for Innovation while producing the index. The lists are by no means exhaustive but rather demonstrate some of the qualitative attributes we found but could not compare across cities. We hope these programs, along with the study, will spark a larger discussion and new ideas.