Click on an icon to learn more about each indicator
Cost of living
% binge drinkers
Fatal car crashes
Number of doctors
Number of hospital beds
Number of long-term hospitals
Number of hospitals with geriatric services
Number of hospitals with rehabilitation services
Number of hospitals with Alzheimer's units
Number of hospitals with hospice services
Number of orthopedic surgeons
Number of psychologists
Number of dialysis centers
Number of medical and diagnostic centers (including X-ray, MRI, and ultrasound imaging)
Number of nurses
Number of physical therapists
Cost of care
Expenses per inpatient day
Quality of care
% of hospitals with JCAHO accreditation
% of hospitals with medical school affiliation
% of Magnet hospitals
Number of caregivers
Life expectancy at 65
% of seniors living in family households
% of seniors with frequent mental distress
% of seniors with no physical activity
% of commuters who walk to work
Number of fitness and recreational sports centers
Number of fast-food outlets
Number of golf courses, skiing resorts, marinas, bowling alleys, etc.
Living Arrangements Indicators
Median house price
Median rental price
% of households with 65+ residents
Number of nursing beds
Cost of semi-private nursing room
Home health-care service providers
Cost of assisted living
Average commute time to work
Number of passenger trips
Mean fare in public transport
Investment in public/senior transportation
Number of grocery, convenience stores, etc.
% of households near grocery
Number of banks, financial institutions, etc.
Total bank deposits
Indexed growth of small businesses
% of 65+ population below poverty line
Capital gains as % of adjusted gross income
Amount of reverse mortgages
Percent of 65+ employed
65+ unemployment rate
Employment growth (health,education,leisure, and hospitality)
Output of service sector/ manufacturing
Number of community colleges
Number of universities
Community Engagement Indicators
% of population 65+
Number of arts, entertainment, and recreation facilities
Senior volunteer rates
Number of public libraries
Number of YMCAs
Funding for seniors
Best Cities for Successful Aging is a comprehensive index that generates a composite ranking for each metro area.The composite ranking is based on eight subcomponents (general indicators, health care, wellness, living arrangements, transportation/convenience, financial well-being, employment/education, and community engagement). Each of the eight subcomponents is composed of multiple individual indicators—78 individual indicators in all.
Note that our methodology is based on publicly available data, not surveys of households or consumers. (However, we have included a list of relevant indexes on topics related to aging, most of which use survey data.) In our index, each metro is benchmarked against the top-performing location for every indicator in each subcomponent. This creates a normalized scoring system that could be consistently compared across each measure. (Please click on the icons above to learn more about the indicators included in the subcomponents and how they were weighted.)
At the same time, we recognize that a 65-year-old’s needs likely differ from an 80-year-old’s. By using the same data but weighting the indicators differently, we created two subindexes, one for ages 65 through 79 and another for age 80 and up.
Determining Weights for the Overall Composite Index
How did we determine the weighting? In a recent AARP survey , 41 percent of Americans 50 and older identified health care as their top problem or challenge. Thirty-five percent cited economic issues such as unemployment and financial stability as their top concern. And 20 percent put issues such as transportation, how to spend their time, family values, politics, and government at the top of their priority list.
Another survey by Sunlife Financial revealed that 43 percent of Americans are “not at all confident” about meeting retirement health-care costs. Approximately 53 percent had made healthy changes in lifestyle out of concern for future health-care costs. Nine percent had already tapped retirement savings, sold assets, or borrowed to pay for an illness or medical procedure; more than half believed they would never replace what they spent.
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 (included in the general indicators), and the rest. We assigned the weights below to arrive at the composite index score and ranking and to arrive at the subindexes for the two age ranges:
Data Creation and Resolving Data Issues
The index uses publicly available data at the metropolitan statistical area (MSA) level. (Population statistics are used to normalize measures on a per-capita or per-population 65+ basis where appropriate.) The methodology faces some challenges that we addressed this way:
- Missing/inadequate data: For many indicators, data are not available for all metros. But in a number of cases, data were available at the state or even national level. The first step was to come up with proxy measures for the indicators. Example: Life expectancy at age 65 is available at the state level. But we estimated the measure at the metro level using shift shares. Even at the MSA level, many small cities do not have public-use data. To utilize as much data as possible, we divided the sample into the 100 large metros and 259 small metros, with the latter category including fewer indicators.
- Using state-level data: In many cases we could not find a proxy measure to break down to the metro level. However, state-level indicators were assigned a lower weight. Certainly, there are thousands of innovative programs that operate locally or regionally. The index cannot take these initiatives into account because no standardized data exist by which to measure them, but a section in the main report highlights a few examples that could be replicated on a wider scale.
We considered two sets of indicators:
- General indicators influence decisions about where to live regardless of age. Examples include the cost of living, crime and safety, overall economic prosperity, and weather.
- Specific indicators focus explicitly on the needs of older Americans although they might affect the general population as well. These include access to high-quality health-care and wellness programs, the availability of specialized housing and living arrangements, financial factors, transportation and convenience, continuing education and job training programs; and community engagement.
Click on the icons at the top of the page to learn the rationale for the indicators we selected.