Think the best cities for aging in place are in Arizona and Florida? Think again. Those two states didn’t even make it onto a list ranking the top cities best prepared for the 65-and-over crowd to age well, compiled in July by nonprofit, nonpartisan think tank Milken Institute.

Instead, cities like Boston, Mass., New York, N.Y., and Des Moines, Iowa feature on the list, with Provo, Utah winning top billing.

“America is growing older. The implications and costs of this extraordinary demographic shift are now upon us,” says Milken Institute. “Despite the strain on health-care and social-safety nets, many communities are well-positioned to help mature Americans age in place.”

Roughly 90% of Americans want to age in place, according to an AARP study. Milken’s data-driven index measures and ranks the performance of 359 U.S. metropolitan areas based on how well-prepared they are to serve their aging populations.

The report analyzed 78 different factors deemed to most affect seniors’ quality of life, including housing costs, the job market, weather, and opportunities for social engagement. Affordability, well-being and healthcare, financial security, suitable living arrangements, convenient transportation systems, and community involvement were all included in Milken Institute’s definition of what successful aging in America should look like.

“I think it will surprise people that the best places for aging are not just Florida and Arizona,” said Nancy LeaMond, executive vice president of AARP, which advised Milken on the study and provided financial support. “There’s this ­notion that you reach a certain age and there is this immutable force that moves you to the South.”

10 Best Cities for Successful Aging

1. Provo-Orem, Utah
2. Madison, Wisc.
3. Omaha, Neb.
4. Boston, Mass.
5. New York, N.Y.
6. Des Moines, Iowa
7. Salt Lake City, Utah
8. Toledo, Ohio
9. Washington, D.C.
10. Pittsburgh, Pa.

“With 80 million boomers on their way to senior status, entrepreneurs and business leaders are seeking to capitalize on the emerging opportunities presented by the massive longevity economy. Innovation abounds—from new approaches to wellness and health-care delivery, to senior-friendly housing and transportation systems, to encore education, career, and engagement opportunities, to aging-centered technologies and social networks, to travel, entertainment, and leisure,” says Milken.

*Editor’s note: the study cited the number of reverse mortgages as an indicator of financial distress in some areas. 

View the report.

Written by Alyssa Gerace