Who needs beaches? More boomer retirees are staying put

Forget that knitting needle and rocking chair.

The 76 million baby boomers who have reached, or are nearing, the age of retirement favor a more progressive set of priorities than their parents did before them.

Many are going back to campus, working longer—though often in lower-stress jobs—and leading active lifestyles. They want convenience, affordable housing, access to social and recreational amenities, and top-tier health-care services. And they expect the cities they call home to deliver.

"This generation is very different," said Anusuya Chatterjee, senior economist and associate director of the Milken Institute, a non-profit think tank that recently released its 2014 index of the "Best Cities for Successful Aging."

"Today's older adults want to have amenities, but at the same time they want to live in a safe, affordable and connected community that offers quality health care and an active lifestyle," Chatterjee said. "They want ready access to transportation, education and employment opportunities."

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While warmer weather and tax implications remain a priority for some retirees, the overwhelming majority wish to age in place, close to friends, family and their established community, according to Rodney Harrell, an expert on community livability for AARP.

"Most retirees tend not to move that far from their home," he said. "Typically, they move within their county or they stay where they are, so in terms of livability, weather doesn't necessarily factor in."

In efforts to retain their growing demographic of aging adults, city planners across the country are working to increase senior-friendly housing, health-care and transportation options, while providing opportunities for older adults to work and volunteer locally. Some do better than others.

The following ranking from Milken Institute highlights the metropolitan cities (both large and small) that enable older people to age independently and productively, with security and good health.

1. Madison, Wisconsin. Home to the University of Wisconsin and 11 highly ranked hospitals, Madison rolls out the red carpet for seniors. The city, which is 150 miles from the cultural hub of Chicago, boasts high employment growth and a low crime rate, along with abundant recreational and fitness facilities, YMCAs, libraries, museums and movie theaters.

It also enjoys a healthy lifestyle, with low rates of smoking, falls and diabetes among older people. Madison got lower marks for cost of living, too few grocery stores, and too many fast food outlets.

2. Omaha, Nebraska. Thanks to the five Fortune 500 companies based there (ConAgra Foods, Union Pacific Corp., Mutual of Omaha, Kiewit Corp. and Berkshire Hathaway), the bi-state, Omaha-Council Bluffs, Iowa, metro area offers an enviable mix of high employment among mature adults, low cost of living and relatively short commute times. State-of-the-art medical technologies, easy access to grocery and convenience stores are an added bonus.

Omaha-Council Bluffs does, however, contend with high crime rates, a propensity for binge drinking and statistically higher rates of smoking and sugary beverage consumption, which can lead to chronic disease. Other negatives: the lack of long-term hospitals, dialysis centers and MRI clinics, plus insufficient transportation for special needs.

3. Provo, Utah. Anchored by Brigham Young University, Utah's Provo-Orem region gets high marks for per-capital college enrollment, a safe environment and healthy lifestyles. The metro area—which is among the most religious in the country, according to a recent Gallup poll—enjoys the lowest diabetic rate of all major metros, and low smoking and binge drinking rates.

Its seniors also know how to stock their refrigerator with fruits and vegetables instead of salty snacks. Crime rates are low and volunteerism is among the strongest in the country. It's pricey, though, and the shortage of specialty health-care services and professionals dedicated to aging adults are cause for concern.

4. Boston. The intellectually stimulating Boston metro area—described in the Milken Institute report as including Cambridge, Mass., and Newton, New Hampshire—is home to more than 100 colleges and universities, such as the venerable Massachusetts Institute of Technology and Harvard University. It is teeming with top-notch doctors, physical therapists, nurses, psychologists and orthopedic surgeons.

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The region's percentage of employed adults who are 65 and older is among the highest in the nation, and you'll never want for cultural activities, accessible by its network of public transportation. Just don't expect to get there in a hurry. Commute times in and around Boston are notorious. And, while health-care services are abundant, they are also expensive and ER wait times can test your patience. Another knock against it: The cost of living in Boston metro is well above average.

5. Salt Lake City. With its vibrant economy, affordable health-care support and friendly locals, Salt Lake City is easy living if you're 65 and older. The scenic city, which lies at the base of Great Salt Lake and Wasatch National Forest, encourages an active lifestyle and offers ample employment opportunities for seniors, with many community colleges offering to retrain.

Easy access to banks and grocery stores, plus an abundance of home health-care providers and affordable assisted living and nursing facilities, give the city added cachet. But those with special-needs lack adequate transportation and funding for community programs and services geared to older residence are few. There is also little evidence of housing that meets aging residents' needs, the Milken Institute found.

1. Iowa City, Iowa. The city gets plenty of praise for low unemployment and ready access to health-care professionals, including doctors, orthopedic surgeons, nurses and physical therapists. It also boasts more than its share of specialty-care hospitals, including long-term hospitals, geriatric and hospice services, and Alzheimer's units. Better still, it's affordable with some of the lowest health-care expenses per inpatient day.

Transportation in Iowa City is also a selling point, with one of the highest public transportation riderships in the country. Its intergenerational workforce favors alternative transportation, and many commuters walk to work. Home prices and rents, however, are pricey for a Midwest city, and Milken Institute reports a need for more home health-care service providers for older adults.

It also found a high tax burden, low capital gains receipts and need for more banks and other financial institutions to support the city's population growth.

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2. Sioux Falls, South Dakota. Offering substantial income growth over the last five years, an expanding pool of doctors and nurses, and a commitment from state officials to develop senior-friendly community services, South Dakota's largest city is a retiree haven. Among 252 small metros, the city boasts a higher-than-average number of cultural attractions (museums, movie theaters), high volunteerism and the highest amount of bank deposits per capita.

Its hospitals also provide ample specialty services, such as geriatric, hospice and rehabilitation. And it enjoys low inpatient care costs, and short emergency room waits. Housing prices, however, are above average for small metros, potentially pricing out older residents. The cost for adult day services is also high.

3. Columbia, Missouri. Educational opportunities abound in Columbia, thanks to the University of Missouri in its backyard. The city gets first-place ranking for its number of hospitals with rehabilitation facilities, and many provide geriatric and other specialty services, as well. Its health-care workforce is abundant.

With strong overall employment growth, a large percentage of those 65 and older in Columbia continue to work, primarily in leisure and hospitality services. Yet those seeking arts and recreational outlets may be underwhelmed. There are too few grocers in older adults' neighborhoods, as well. Substantial income inequality exists among its residents, and rates are high for crime and fatal car crashes.

4. Bismarck, North Dakota. The oil boom has fueled economic and employment growth in North Dakota's capital, which benefits seniors seeking an encore career. Opportunities for older adults in the leisure and hospitality industries are prevalent, and Bismarck ranks among the top small cities for income growth over the last five years.

Health-care professionals are prevalent (except in the home health-care services arena) and the quality of care is above reproach, with medical school-affiliated hospitals and highly ranked nursing homes setting the bar higher. Emergency room wait times are also shorter than average.

Few commuters take advantage of public transportation, though, and access to grocery stores and other conveniences are limited for older residents. At the same time, housing prices and the cost of adult day services are relatively high.

5. Rapid City, South Dakota. Rapid City also makes the honor roll with its impressively low unemployment rate for adults 65 and older, flourishing small business climate and abundance of recreational activities. Volunteerism is high among its active community of older adults, and the state continues to invest in community services aimed at engaging older residents.

Unhealthy eating habits (e.g., fast food and sugary drinks), high rates of Alzheimer's disease with no hospitals equipped to treat the illness, and a minuscule pool of home health-care providers, however, are serious drawbacks. Grocery stores and other conveniences are also few and far between.