America’s 10 Healthiest Cities

Santa Fe, New Mexico makes it into the top 10

AARP The Magazine’s Healthiest Hometowns
By Sarah Mahoney and Brad Edmondson, September & October 2008

These cities have made robust living—and active retirement—a priority. After reading why, you might want to move there too.

We all want to live long and be healthy. As it turns out, where you choose to live in the second half of your life can make all the difference. So, exactly what makes a city healthy? In doing our research, combing through the government records of hundreds of cities for more than 20 measures of vitality, we looked not only at the physical aspects of a community (clean air and water, for instance) but also at the health and habits of the people who live there. The two are closely linked: if you live near a hiking-and-biking trail and all your neighbors use it, you’ll probably use it, too. If a farmers’ market is just down the street, you’re likely to eat more fruits and vegetables. If your city has multiple hospitals, there’s a good chance you’ll get superior medical care.

The winners? It’s not surprising that our list includes several college towns. Large universities often have teaching hospitals, which employ top doctors using the latest technology. In addition, college towns are full of young people, and younger residents often create a demand for lifestyle perks such as bike paths and accessible fitness programs, which benefit all members of a community.

Few southern towns made our list, despite the warm weather and the relaxed pace of life that have long attracted retirees. Research has consistently shown that cities in the South tend to have some of the highest rates of obesity and chronic disease in the nation. Of course, there are always anomalies—and thank goodness for that, since the thought of retiring to a colder climate may have little appeal for some. Balmy Naples, Florida, came out high on our list, as did Santa Fe, New Mexico, and Honolulu, Hawaii.

1. ANN ARBOR, MICHIGAN

Carol and Bob Mull moved to Ann Arbor in 1977—when Bob went to work as an engineer for Ford Motor Company—and they came to love it as they raised their family here. So when Bob retired nearly two years ago, they had no doubt that they’d stay put. “I always knew this was a special town,” says Bob. “But it wasn’t until I retired that I realized how truly great this place is.”

He’s enjoying having time to play as hard as he wants—both he and Carol play golf often and are big fans of the area’s YMCA. Carol, 55, is especially partial to swimming and yoga; Bob, 59, likes lifting weights, biking in some of the city’s 150 parks, and walking through the spectacular, 123-acre Nichols Arboretum, which boasts a mile of frontage along the rolling Huron River. The couple are also fully engaged in the community: Bob is an active member of the Rotary and spends Friday mornings tutoring fifth graders. Carol, a part-time curator, is writing a book about the region’s Underground Railroad.

What’s more, Ann Arbor is a hotbed of medical innovation. The University of Michigan Health Center is one of the largest university medical centers in the world, and it created the first human genetics program in the United States, in 1940.

That spirit of innovation spills over into the city’s economy—it’s no accident, for example, that Google recently opened a satellite office in Ann Arbor. The company says it chose Ann Arbor partly because of the talent pool the university provides but also because Ann Arbor is such a great community to live in, and that’s very attractive to people who might consider relocating.

Carol agrees that Ann Arbor’s varied populations—young and old—help shape the city. “Sometimes I love to just wander through the neighborhoods or sit in coffee shops and watch all these people. I love the way it all comes together.”

Population: 113,206
Median housing price: $312,200
Average number of sunny days: 178 per year
Healthy bragging rights: 86 percent of residents get regular exercise; 580 physicians per 100,000 people, compared with U.S. average of 223
Where the action is: Kerrytown, a downtown neighborhood with shops, coffeehouses, and galleries
Favorite workouts: At the YMCA, which offers fencing and nine kinds of Pilates classes
Totally unexpected: An efficient and affordable bus system for a town of this size

2. HONOLULU, HAWAII

Hawaiians sum up Honolulu’s high marks for health in a single word: paradise. With Honolulu’s warm weather and postcard-ready scenery, residents spend more time exercising than do people in almost any other city we surveyed—and have one of the highest life expectancy rates.

Bill Goding, 55, who after retiring from the U.S. Air Force signed on as a full-time lifeguard for the City and County of Honolulu, surfs now and then, lifts weights, and jogs. But that’s just for fun. For exercise, he and his wife, Pat, 51, a registered nurse, train with a group that does grueling island-to-island swims.

“I’m lucky,” Bill says. “I work at Ala Moana Beach Park, which has a half-mile-long swimming area protected by a reef, so I can train on my breaks.” And he loves the atmosphere. “Just about every triathlete comes down here to train at some point. It’s just a very active, happy place—people are always walking or jogging. The weather is great all year long, so there’s no reason to be indoors.”

The city isn’t perfect, he concedes. For one thing, the traffic is awful. “And when it’s time to travel off the island, nothing is nearby.” Even more daunting: the über-expensive housing. The Godings, for example, live just outside the city, in Waikele. But experts say other economic strengths—a very low unemployment rate, for instance—can offset that weakness. Plus, residents stand to gain from Honolulu’s commitment to preserving the island, with strict growth limits, sustainable-tourism efforts, and programs to protect views and the shoreline.

Sarah Yuan, an expert on aging at the University of Hawaii, says it also helps that Hawaiians embrace growing older. “In island culture, people feel more natural about aging, in general. They have a lot of respect for their elders, and older people have a higher status,” she says. “They don’t see growing older as a negative.”

Population: 377,357
Median housing price: $926,300 (less outside the city)
Average number of sunny days: 276 per year
Healthy bragging rights: 95 percent of residents are covered by health insurance
Where the action is: Kapi‘olani Park, with its jogging course and free concerts
Favorite workouts: At Hanauma Bay Nature Preserve, residents swim and snorkel in the calm water formed by a collapsed volcano crater
Totally unexpected: The Spam Jam, a spring festival celebrating the fact that Hawaiians consume 7 million cans of the stuff per year

3. MADISON, WISCONSIN

As far as Charles McDowell, 58, is concerned, there aren’t many places where a person can get the best of a big city—like world-class concerts and top-notch health care—and still be in a very small town: “When we go shopping at the Farmers’ Market, it’s not just a great place to get food, it’s a big social outlet—I can see 30 or 40 people I know in a few hours.”

So when he and his wife, Candace, 57, director of the University of Wisconsin’s Multicultural Student Center, started planning for retirement, the decision to stay in town was an easy one. Charles loves that it’s an easy walk to shopping and health clubs, and that there are four golf courses within ten minutes of his house. And between the university and civic groups, meaningful volunteer opportunities are everywhere.

Madison has worked hard to earn its reputation as a green—and healthy—city. An extensive bus system cuts down on congestion and air pollution, and the bike trails are numerous and well maintained (when it snows, bike paths are plowed at 4:00 a.m.). In warmer weather, kayaks, canoes, and sailboats dot the local lakes; in winter, snowmobiling, cross-country skiing, and ice-boating are popular.

Nor is it surprising that Madison—known for its cutting-edge environmental and urban-planning policies (it had the nation’s first curbside newspaper-recycling program, back in 1968)—is embracing retirement issues with the same enthusiasm. For example, the Madison Senior Center recently received a prestigious research grant to study ways in which boomer volunteers can best work with older adults, says Margie Groom, program coordinator.

Certainly some of the credit for that goes to the University of Wisconsin, whose presence is a primary reason people choose to retire here: those 60 and older can audit many of the courses on campus for free. But one of Madison’s key strengths is that it’s more than just a college town. It was named Wisconsin’s capital long before the university was born, and the handsome granite capitol building continues to be the city’s centerpiece.

Population: 223,389
Median housing price: $257,400
Average number of sunny days: 187 per year
Healthy bragging rights: Residents have low rates of diabetes, of high blood pressure, and of high cholesterol
Where the action is: At the Memorial Union Terrace, students and other residents relax and watch the sailboats
Favorite workouts: Bikes rule here, even by college-town standards; when there’s snow, the city begins plowing bike paths at 4:00 a.m.
Totally unexpected: One of the highest per-capita rates of registered moped users

4. SANTA FE, NEW MEXICO

When Susan McDuffie, 56, retired last year as an occupational therapist for the Santa Fe public schools, she didn’t lack for things to do. In fact, she’s not sure how she ever found time for a job in the first place. She works a few days a week at a gallery that sells work from more than 400 Native American artists. Her own pottery is shown at another gallery where she works one day a week. She’s a regular at a flamenco dancing class, and she’s writing a sequel to A Mass for the Dead, a mystery set in 14th-century Scotland that she published two years ago.

Susan is a good match for the place that calls itself “the city different.” Santa Fe has been blending Spanish and Native American cultures since it was founded as a Spanish trading post 400 years ago. The result is an unparalleled range of artistic and cultural influences—it is “the artiest, sculpturest, weaviest, and potteryest town on earth,” according to travel writer Jan Morris. Artists flock to Santa Fe for the kind of light you get by combining low humidity, clean air, and an elevation of 7,000 feet.

Of course, those are some of the same qualities that make Santa Fe a healthy place in which to live and retire, too. Its rates of diabetes, hypertension, and high cholesterol are among the lowest in the country, in part because of a city-funded health campaign aimed at older residents. In addition to offering a 268-bed hospital and easy access to specialists in nearby Albuquerque, Santa Fe is teeming with alternative medicine specialists who graduated from the local University of Natural Medicine or the New Mexico Academy of Healing Arts.

Known for its outdoor lifestyle and emphasis on healthy eating, Santa Fe boasts a network of trails that leads into the foothills of the Sangre de Cristo Mountains. And Deborah Madison, author of several bestselling cookbooks, is a regular at the local farmers’ market, which recently celebrated its 40th anniversary and has a new building in the city’s rail yard.

Despite its relatively small size, the city has its own symphony and community orchestra, plus an opera with an international reputation and the annual High Mayhem Emerging Music and Arts Festival. “I love the mix of cultures and influences here,” says Susan. “You can’t get it anywhere else.”

Population: 72,056
Median housing price: $499,900
Average number of sunny days: 283 per year
Healthy bragging rights: American Lung Association ranks it #2 in the United States in air quality
Where the action is: The Plaza is the heart of downtown
Favorite workouts: Hiking in the 1.6 million-acre Santa Fe National Forest
Totally unexpected: Has the highest U.S. art-per-capita rate—even greater than New York City’s

5. FARGO, NORTH DAKOTA

People don’t move to North Dakota for the weather. But for the hardy residents of Fargo, the area’s four seasons—each with its own activities, from hockey and ice fishing to softball and vegetable gardening—are a prime attraction.

“In the summer the weather here is beautiful,” says Greg Sanders, Ph.D., a professor of child development and family science at Fargo’s North Dakota State University. “There’s low heat and humidity, and people really get out and enjoy it. And in the winter—keeping in mind that many of the natives are from pretty healthy stock—it’s the same thing, especially cross-country skiing. That’s the spirit of this place—people tend to get out and make the most of whatever weather they get.” The city’s 18 outdoor ice-skating rinks all have heated warming houses. And the rolling prairies outside of town provide plenty of outdoor escapes.

But Fargo has urban pleasures, too. The renovation of its downtown district has made the area hip, with newer French cafés and ethnic restaurants mingling with the German, Russian, and Scandinavian diners the region has long been known for.

And surrounded by three major universities, the area is rich in medical facilities, entertainment—in particular, a wide range of performing arts—and college sporting events.

John Mark, 65, grew up here, and when he retires this year, the only big change he plans to make is to look for a little part-time work on a golf course. He’ll also step up his volunteer work, organizing charity tournaments. Although he has plenty of friends who have moved to Florida or Arizona, the prospect of being a snowbird leaves him cold. “The idea of packing up and going away for four months? I don’t need to do that—Fargo is just a good place to be.”

Plus, Fargo’s fresh air—and commitment to preserving it—makes this one of the cleanest, greenest cities on our list, with one of the best air-quality–index scores. It uses biodiesel fuel to power its transit buses, and it has made a serious commitment to incorporate methane-powered generators, solar panels, and wind generators into the city’s infrastructure. The city has even handed out cloth shopping bags to residents.

Population: 90,056
Median housing price: $156,200
Average number of sunny days: 200 per year
Healthy bragging rights: Ranks ninth in the nation for regular flossing and brushing
Where the action is: The Hjemkomst Center in Moorhead, a multiuse facility built around a replica of a Viking ship
Favorite workouts: Walking and biking in city parks; fishing and canoeing in the Red River in summer
Totally unexpected: “Wood-Chip Marge,” an 8-foot, 500-pound statue commemorating the main character in the 1996 dark-comedy film Fargo

6. BOULDER, COLORADO

Forty-one years ago the residents of Boulder undertook a bold experiment: they approved a referendum that raised the sales tax, to buy and manage parkland in and around the city. Since then, they have voted three more times to tax themselves for open-space protection. The result: 130 miles and 45,000 acres of open space and pristine wilderness at the foothills of the Rocky Mountains—boosting tourism and attracting an influx of environment- and health-conscious residents.

It has also helped transform this city of 91,481 into one of the nation’s healthiest, with extremely low rates of smoking and obesity—it is the skinniest city we surveyed, with a BMI of 24.94—and high rates of healthy eating and regular exercise. In fact, the city has been called the Gore-Tex vortex because it has seen so many affluent transplants who are relentlessly dedicated to self-improvement.

Population: 91,481
Median housing price: $660,600
Average number of sunny days: 245 per year
Healthy bragging rights: This city is so fit, one of its main problems is managing biker-and-runner sprawl. The most recent BolderBoulder race had more than 54,000 participants, prompting a discussion of a possible cap on the number allowed to run.

7. CHARLOTTESVILLE, VIRGINIA

Charlottesville regularly makes it onto best-places lists for its scenery, culture, and history. Thomas Jefferson’s father was one of its founders; James Madison and James Monroe lived here, too. But what really sets the place apart is its strong focus on medicine. It ranks fourth among U.S. metropolitan areas in the number of physicians per capita, and it also makes the top ten for family-practice doctors, oncologists, and cardiologists. The most obvious reason is the University of Virginia’s medical school and 572-bed teaching hospital.

Of course, good medicine is critical when you’re sick. But Charlottesville also has a strong tradition of helping its residents stay healthy. When Susan Seidler, now 59, learned that her bones were losing density, she went to a midlife counselor, two nutritionists, and an exercise physiologist who helped her design a diet and exercise program to ward off osteoporosis.

Luckily for Seidler, it’s easy to get lots of exercise in Charlottesville. The city is in a natural bowl between the Blue Ridge and Southwest mountains. The Rivanna River runs around the city, and a network of trails parallels the river and climbs the hills.

Population: 40,315
Median housing price: $382,800
Average number of sunny days: 219 per year
Healthy bragging rights: Residents are not just the healthiest eaters on our list, they are also among the happiest, and most likely to say they are satisfied with their lives.

8. MINNEAPOLIS-ST. PAUL-BLOOMINGTON, MINNESOTA

Last year the Agency for Healthcare Research and Quality ranked Minnesota first in the nation for the overall quality of its health care. Minnesota is also the top-ranked state for residents covered by health insurance, at 91.5 percent. And despite its frequently inclement weather, the Minneapolis metro area ranks among the top ten in the country for share of residents who exercise regularly.

But those are just the numbers. Ask any Minnesotan why the Twin Cities area is a great place to live and you’ll get a litany of reasons, from its forward-thinking policies (the state was the first to designate smoke-free areas in restaurants, in 1975) to its many cultural offerings (which include the new Guthrie Theater on the Minneapolis waterfront) to its sense of community (four in ten residents do some kind of volunteer work, the highest rate in the nation).

“There is a can-do spirit here,” says Charlie Boone, 80, who has a weekly radio show at WCCO-Minneapolis. “It’s easy to stay healthy because it’s easy to stay connected.”

Population: 3,175,041
Median housing price: $308,000
Average number of sunny days: 200 per year
Healthy bragging rights: With 90 percent of households recycling, more than 80 green rooftops, and a nearly complete wireless network that extends city services everywhere, Minneapolis is redefining healthy livability.

9. SAN FRANCISCO BAY AREA, CALIFORNIA

Spanning more than 100 miles, from the vineyards of Napa Valley to the Silicon Valley, the San Francisco Bay Area is famous for its natural beauty and free spirits. But it’s also a great place to be healthy after 50. Its residents are among the least likely in the country to be overweight. Plus, they are among the least likely to smoke.

One visit to the Bay Area and you can quickly see why the region fosters health and vitality. Densely populated, with lots of neighborhoods where residents can easily get around via foot, bicycle, or public transportation, the region also has a long history of people banding together to improve services. Then there are the region’s world-famous medical centers, including those of Stanford and the University of California, San Francisco. And last year the city of San Francisco launched Healthy San Francisco, an initiative that offers free or subsidized health care to uninsured residents.

Population: 4,180,027
Median housing price: $825,500
Average number of sunny days: 263 per year
Healthy bragging rights: San Francisco’s pedestrians are treated to urban forestry, greenways, and plenty of public toilets, and the city is fierce in its environmental commitment. It was first to ban plastic bags, and it is now restricting plastic water bottles.

10. NAPLES-MARCO ISLAND, FLORIDA

Despite the area’s long building boom, Naples still deserves its real-estate nickname: Florida’s last paradise. At least 80 percent of Collier County’s land has been set aside as open space, protecting places such as Big Cypress National Preserve and Everglades National Park; biologists believe the Everglades is the only place in the world where crocodiles and alligators cohabitate.

The area has hung on to its small-town feel: its beaches and art scene (more than 134 galleries in the vicinity) are often voted tops in the nation. And for links lovers, it’s heaven: Naples–Marco Island has the second most golf holes per capita in the country. In our survey, residents got high scores for regular exercise, healthy eating, and not smoking, so it’s no surprise that the area also has one of the lowest cancer mortality rates going.

The downside is high housing prices and a high cost of living. Naples has been hit hard by the foreclosure crisis—but that means you might be able to find some bargains here.

Population: 314,649
Median housing price: $637,100
Average number of sunny days: 264 per year
Healthy bragging rights: Long walks on the beach pay off, as residents of this sunny spot score second highest on our longevity scale.

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