Best Cities for Successful Aging | Press FAQs
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Frequently Asked Questions

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

A: "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. It is an index that utilizes 78 indicators that determine the overall quality of life for seniors. Ninety percent of seniors want to age in place, and this index looks directly at how cities are meeting these needs.


Q: What do you mean by "successful aging?"

A: We define successful aging as living in 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.


Q: What was the most surprising result from this study?

A: 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. Health care, employment, living arrangements and financial factors are even more important in creating communities that enable successful aging.


Q: Why do metro areas with universities score so well in your index?

A: 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 employment/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 greater binge drinking rate would result in a decreased score in the index.


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

A: 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 70 other factors. Taken in totality, weather, while important, was not seen as an overriding factor to these other issues.


Q: How soon will this study be updated?

A: We expect to update our index every two years.


Q: I'm a municipal leader in my town. How can I improve my city's score on this index?

A: This index looks at many complex issues surrounding Successful Aging. With 78 indicators, there is no set way to "improve a city's score" on the index other than to continually improve the areas addressed in the study. Health-care, financial and general indicators are all areas heavily weighted in the study, but improvements in these areas are only part of the larger equation. We have created a calculator tool to help cities understand how improvements in particular areas can impact their overall ranking. This is available at http://successfulaging.milkeninstitute.org/bcsa.taf?page=calculator


Q: I'm an active citizen in my community. How can I improve the community for seniors?

A: This index looks at a macro issues within a community. We also included a section of Programs with Purpose to acknowledge some of the great work we saw being done that wasn't as 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 as you see fit with friends, neighbors and civic leaders can help create greater a greater understanding of these issues.


Q: How can a city score well on 65-79 but poorly for 80+, or vice versa?

A: The data for each subcategory is the same, but the weighting is different to reflect the different needs of the two subpopulations. A 65-year-old may be looking at another career in retirement, while an 80-year-old may be looking instead at living somewhere safe with better access to health care. Factors such as binge drinking, crime and employment opportunities may differ significantly for 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.


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

A: The overall score for a city is the combined scores of the eight subcategories - general indicators, health care, wellness, financial, living arrangements, education/employment, transportation/convenience and community engagement - with the proper weighting applied to each category.


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

A: We created two sub-indexes that measure each metro area's capacity in the age groups 65-79 and 80-plus. This is because the needs of the oldest Americans differ somewhat from their younger counterparts, particularly in terms of health care and employment. 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.


Q: How can a city have an overall rank that is lower or higher than its rank for the two age-specific sub-scores? Example: I see that Madison has an overall rank of #2 for large metros but has two sub-ranks of #5 and #4. How is that possible?

A: 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 eight indicator categories to better reflect the overall needs of seniors. A chart of the weights can be found in the methodology section. http://successfulaging.milkeninstitute.org/bcsa.taf?page=methodology


Q: How current are the data you used?

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


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

A: Cities were ranked by population. The top 100 largest cities were broken into one subgroup and the remaining 259 into another. This allowed for appropriate data comparisons between cities with a smaller population, using a slightly different data set. Not all the data available for New York City were available for Fargo, as an example.


Q: How were the programs with purpose selected?

A: The programs with purpose were programs our research team found while producing the index. The list is by no means exhaustive but rather demonstrates some of the qualitative attributes we found but could not compare across multiple cities. We hope these programs, along with the study, will spark a greater discussion and new ideas.