The best places to retire successfully

Retire-abroad-280x165Minnesota just might be the best place to get old in America–if you’re interested mainly in quality health care and don’t mind cold winter weather.

A state-by-state ranking of senior health gives Minnesota top honors for a range of reasons–everything from the rate of annual dental visits to the quality of nursing home beds and low rate of hip fractures.

If a healthy, active lifestyle is your thing, consider Provo, Utah. It edged out other U.S. cities in a study of places for successful aging for its low rates of smoking, binge drinking, and diabetes. More than 5% of Provo residents walk to work, the economy is growing, and crime rates are low.

Rankings of the best places to retire are a dime a dozen. Many are geared to a just a couple of factors, such as sunshine, low tax rates, or the number of golf courses per capita. They don’t tell you much about what would suit you personally.

But I have run across a number of good studies, online tools, and other resources that go deeper. These studies look at quality-of-life issues, such as affordability, health care, public safety, public transportation, culture, and even educational opportunities. They can be useful for older Americans to help evaluate where they live now as well as any relocation decisions. And they can stimulate a more thoughtful approach to the key question: Is the place where I live now–or where I might want to move–a good place to age?

Let’s take a tour.

General Livability

The Milken Institute ranks the Best Cities for Successful Aging. The institute is a nonpartisan think tank focused on public health, medical research, economics, and financial markets. The “best cities” study breaks out results three ways–one for the aging population overall, another for people ages 65-79, and the last for those over 80.

The Milken ranking–which gave the overall nod to Provo–uses six criteria:
Safety, affordability, and comfort. This measure uses statistics on cost of living, employment growth, jobless rates, income distribution, crime rates, alcoholism, and weather.

Health and happiness. Key factors include the number of health professionals, hospital beds, long-term hospitals, geriatric facilities, hospital quality, and affiliation with medical schools.
Financial security. This measure includes tax burden, small-business growth, poverty levels, and employment rates for people over age 65.

Living arrangements. Includes statistics on the cost of homeownership and rental housing, nursing homes, assisted-living facilities, and more.

Mobility and access. Milken studied commute times, fares, public transit, and the number of grocery stores and other key retailers.

Respect and engagement. This included statistics on volunteerism, employment opportunities, and factors relating to encore careers. Milken also reviewed access to fitness and recreational facilities, training and education, senior enrichment programs, museums, cultural and religious institutions, libraries, and YMCAs.

Including job opportunities may seem surprising for a study of retirement locations. It reflects the growing recognition that Americans will be working longer, sometimes because of economic need, but often out of desire to stay engaged. Numerous surveys reflect this changed outlook on retirement, most recently a Merrill Lynch survey that found that 72% of respondents older than 50 say their ideal retirement includes some type of work. Just more than half said they expect to work because they will need the money.

Paul Irving, Milken’s president, says the institute also hopes the ranking will stimulate competition between cities to improve their capacity to accommodate older residents and to offer them opportunities. “When you do that, you actually are improving cities for everyone,” he says. “Cities that enable older people to maximize their potential will have happier, more productive, better-educated, and integrated younger populations, too.
“People have individual views on what’s important to them,” adds Irving. “Everyone needs to create their own priorities.”

The best resource I know for customized information about places is Sperling’s Best Places, which analyzes data on people and places around the U.S. Created by data guru Bert Sperling, it has a nifty interactive find your best place tool that can suggest spots matching your preferences. Or you can compare any two cities of your choice for factors such as cost of living, health, crime, climate, and more.

Health Care

For a deeper dive into health, America’s Health Rankings Senior Report is a good place to start. Produced by the United Health Foundation, it’s a ranking of states using 34 measurements from 12 data sources, including government agencies and research organizations.

Minnesota took top honors for the second year in a row in the latest ranking; Mississippi ranked last. The study breaks out results by “determinants”–factors that affect future health–and outcomes. Minnesota ranked first for its combined determinants and second for outcomes. Mississippi was dead last for senior poverty, how people rank their own health, and premature deaths.

What’s so great about Minnesota? The state ranked high for everything from the rate of annual dental visits (dental care is important for senior health), volunteerism (keeps people active and mentally alert), a high percentage of quality nursing home beds, and a low percentage of food insecurity. Prescription drug coverage also is high, and the state ranked in the top five for a low rate of hospitalizations for hip fractures and a high percentage of able-bodied seniors.

On the other hand, this ranking doesn’t include climate. Before you head north, consider that Minneapolis-St. Paul has 45 days per year below 5 degrees Fahrenheit; Jackson, Mississippi, has one. Just saying.

Long-Term Care Cost

The cost of long-term care continues to rise much faster than overall inflation. The median cost of a private nursing home room rose at a 4.19% compound annual rate during the past five years, and assisted-living facility prices increased at a 4.29% pace (to $42,000), according to an annual survey of private-payor long-term care providers by Genworth Financial (GNW) and its Carescout subsidiary.

But the cost of care varies dramatically by location. For example, the national median cost of a private nursing home this year is $87,600–but it’s $134,320 in Massachusetts, $91,980 in Colorado, and $58,765 in Louisiana. The differences are driven mainly by demand and supply of labor, the cost of living and level of affluence in a particular region, and therefore the ability to pay for services.

Retiring Abroad

Increasing numbers of Americans are retiring abroad; the number of retirees, spouses and widows receiving Social Security benefit payments outside the U.S. rose 26% to 542,451 between 2006 and 2012, according to the Social Security Administration. And that figure paints only a partial picture because many retirees abroad simply withdraw their benefits from U.S. bank accounts.

Adventure and cultural stimulation aside, living abroad can save money; retirees can live comfortably on just $25,000 a year, according to Suzan Haskins and Dan Prescher, authors of The International Living Guide to Retiring Overseas on a Budget (Wiley, March 2014). Haskins and Prescher are editors of International Living, a website and magazine offering detailed information on top international retirement destinations. You’ll find country profiles with details on everything from the cost of real estate and food, the economy and lifestyle, to even the cost of garbage removal.

Health care is an important consideration when retiring abroad, and Patients Beyond Borders publishes a guide to health-care facilities around the world.

Special Concerns

Sperling has done some interesting special data runs dealing with specialized interests, concerns, and obsessions.

Disasters. Worried about the risk of hurricanes, floods, droughts, or earthquakes? Here’s a map analyzing 379 metro areas for the best places to live to avoid a natural disaster.

Congestion. Not traffic–we’re talking nasal congestion here. This study looked at the best and worst cities for breathing easy, using factors such as tree, grass, and weed pollens; molds and spores; air pollution; climate; and smoking. Allergies actually can wreck a retirement-location plan, as Kerry Hannon notes in this feature for The New York Times.

Stress. You may want to avoid the most stressed-out towns, calculated using data points such as suicide, divorce, crime, joblessness, and length of commute. (Tampa-St. Petersburg-Clearwater, it seems you need to chill out).

Photo: Arturo Sotillo via Flickr.