COLUMBIA — A new study ranked Columbia the fourth best place for successful aging out of 259 small metropolitan areas studied in the United States.
The Milken Institute published the comprehensive research on the best cities to age in within the United States. The study distinguished large metropolitan areas from small metropolitan areas — Columbia fitting into the latter category.
Cities that beat Columbia were Sioux Falls, S.D., Iowa City, Iowa, and Bismarck, N.D. Falling into the top 10 behind Columbia were Rochester, Minn., Gainesville, Fla., Ann Arbor, Mich., Missoula, Mont., Durham, N.C., and Rapid City, S.D.
Top large metropolitan areas include Provo, Utah; Madison, Wis.; and Omaha, Neb. A full list of the rankings can be found on Milkin's Best Cities For Successful Aging interactive website.
The study was funded by AARP and Humana, two companies with significant financial interests in the elderly demographic. The goal of the study was to "shape the future and spread successful aging across America" by publishing rankings to stimulate competition among cities, eventually leading to the implementation of life-enhancing programs for aging Americans.
How the rankings were made
The study was a comprehensive literature review, meaning no new research findings were presented. Instead, researchers preformed in-depth analyses on publicly available empirical data for 359 cities. To account for the potential disparity of resources between large cities and smaller metropolitan areas, cities were split into two groups.
The 100 largest cities examined were ranked separately from the remaining 259 smaller metropolitan areas. Rankings were determined based on eight subcomponents — health care, wellness, living arrangements, transportation convenience, financial well-being, employment and education, community involvement and general indicators. Seventy-eight empirical factors were used within these eight sub-categories.
In an effort to acknowledge the differences in needs and desires between new retirees and older seniors, the "aging" population was split into two categories. Data were weighted differently for 65- to 79-year-olds and those older than 80.
Jessica Macy, executive director of the Boone County Council on Aging, explained why distinguishing between these two groups is highly relevant.
"Everyone's health tends to go downhill as they age," she said. With the onset of health issues and increasing barriers to independence, chances are an 80-year-old is going to need a lot more care than a 60-year-old, Macy said.
Aside from this difference, Macy also pointed to differences in generational ideologies.
"It's just a very different mindset," she said, referring to World War II-era elderly, who are now in their 80's, and baby boomers, who are just coming into retirement. "As they age, it is going to cause senior services to look very different in the future," she said.
Three sets of rankings came from the eight factors analyzed – one for the 65 to 79 age range, one for the over 80 age range and one overall ranking.
Each city ranked has its own comprehensive page on the successful aging website. Columbia was ranked number four overall, number four for ages 65 to 79 and number five for ages 80 and up.
Columbia's highest-scored asset was healthcare – it was ranked third out of 259 cities. According to the study, "abundant doctors, nurses, orthopedic surgeons and hospital beds," contributed to the high ranking, as well as many hospitals being affiliated with medical schools. Among the small metropolitan areas, Columbia ranked first in geriatric services and continuing-care facilities.
Macy warns not to be fooled by these bright statistics, though.
"We still have seniors in need in our community," she said. The Boone County Council on Aging works specifically with low-income seniors; Macy said the most recent data places 10 percent of all Columbia seniors below the poverty line. The average income of their clients is below $16,000 a year.
Although it is true that there are two great teaching hospitals in Columbia, Macy said that healthcare is still a major problem for seniors — even on Medicare or Medicaid.
"When you have to decide between copays to see a doctor and fairly high prescription expenses or paying rent and buying food, it becomes very hard to make everything come together and keep all the bills paid," she said.
That being said, Columbia's second-highest ranking area, just under healthcare, was finance. A large working-age population and a relatively low poverty rate among seniors contributed to the city's eighth place ranking in the category.
Alzheimer's Disease care lacking in Columbia
Although Columbia was highly praised for geriatric services, rehabilitation and continuing-care facilities, the study specifically addressed a need for more specialized care. Long-term hospitals and Alzheimer's-specific care facilities were lacking.
According to Mid-Missouri Alzheimer's Association Executive Director Linda Newkirk, the need for more specific care is evident.
"Facilities that are available are full," she said. "There is a great need in Columbia for good choices for families when they reach the decision that they can no longer care for their loved one at home."
Newkirk said these facilities should have an Alzheimer's-specific wing or unit for Alzheimer's and dementia patients, with fewer residents per staff member and staff specifically trained to help Alzheimer's and dementia patients. Insurance does not cover these specific-care facilities.
"The reason we don't have more of those is because the cost of placing someone in one of those is personal expense," Newkirk said. She said building Alzheimer's-specific facilities is very costly, and because of the expense, filling them is always a concern.
Newkirk said there usually comes a time when families cannot care for elderly family members alone anymore. "Families that don't have the level of resources to place someone in a really good care facility don't have that as an option available to them," she said.
Where do we fall short?
The areas Columbia needs improvement in are wellness and community engagement, according to the study. Of the eight attributes examined, Columbia's lowest score was in wellness — by far.
Columbia ranked number 209 out of 259 on the wellness scale. This was determined by a 13-point analysis of statistics on things like Medicare enrollment, the smoking rate, diabetes cases and Medicaid eligibility. Columbia received a low ranking in wellness due to a high obesity rate, high levels of soda consumption and a high ratio of fast food restaurants to people.
The study also determined that Columbia falls short compared to other cities in terms of museums, recreational facilities, parks and golf courses.
Supervising editor is Celia Darrough.