Could all those retirees in Florida and Arizona have it wrong?

For decades, older Americans have migrated south once they left the workforce, settling in states where they can enjoy year-round sunshine. But according to a report from the Center for the Future of Aging of the Milken Institute, a think tank that focus on economic and public policy issues, putting too much emphasis on the weather and even favorable tax laws doesn't necessarily lead to happier living for seniors.

“These factors are only part of the complex infrastructure and social context that affect health, productivity and purpose as people age,” authors Sindhu Kubendran and Liana Soll write.

The institute created its own ranking of the best cities for successful aging, taking into account a unique set of factors, such as safety, access to healthcare, financial security, and mobility. The team separated the list into two categories: one for large metropolitan areas and one for smaller cities.

Top Five Large Metros

Here are the five cities that ranked highest in the large metropolitan area category. Two of them are in Utah, starting with the number-one choice.

1. Provo-Orem, Utah

Topping the Milken list of best large cities for successful aging: the twin cities of Provo and Orem, Utah. Like Madison and Durham-Chapel Hill (cities 2 and 3), the presence of a major institute of higher education – in this case, Brigham Young University – makes it an ideal spot for lifelong learners. It’s also a place that boasts a higher-than-average rate of volunteerism among older adults, proof that residents are willing to give back to their community.

And because they’re situated near five national parks in a state known for its natural beauty, the two cities also make it easy to lead an active lifestyle. Like Salt Lake City, residents in Provo and Orem have low rates of diabetes, obesity, and Alzheimer’s.

2. Madison, Wis.

The runner-up among larger cities is Madison, the state capital and home of the University of Wisconsin. Despite its chillier winter temperatures, Madison residents do a lot of walking, thanks to its pedestrian-friendly layout and reputation for safety.

The city ranked particularly high in healthcare measures, with access to a large supply of primary care and physical therapy providers. Many of the local hospitals offer geriatric, Alzheimer’s and rehab units, making it easier to get the specialized care that some older individuals need.

3. Durham-Chapel Hill, N.C.

Coming in at the third spot are another pair of college towns, Durham and Chapel Hill, which host Duke University and the University of North Carolina, respectively. Part of the state’s booming Research Triangle, the cities offer low unemployment among older inhabitants and what Kubendran and Soll call a “culture of volunteerism.”

The area ranked highest among bigger metro regions for healthcare, in large part because of its top-tier hospitals and access to geriatric and Alzheimer’s services. It also enjoys a large number of primary care providers, making it simpler for residents to get basic medical services.

4. Salt Lake City, Utah

Surrounded by the majestic Great Salt Lake and the snow-capped Wasatch mountain range, Salt Lake City is the perfect home for seniors who enjoy the outdoors. No wonder, then, that it has one of the healthier adult populations in the country.

But that’s not all the town has to offer. It also has numerous cultural attractions and a high employment rate among those 65 and older. The latter contributes to a low incidence of poverty among older adults and low-income inequality.

5. Des Moines-West Des Moines, Iowa

Even among the “large” metros in Milken’s ranking, cities that ranked highest tend to offer livability and a low cost of living. Those attributes are certainly true of Des Moines and West Des Moines, a pair of unassuming Midwestern cities in central Iowa.

According to the Milken study, the area hosts a strong business community – thanks to multiple insurance companies located there – and a relatively low cost for long-term care. Perhaps more surprising is its flourishing cultural scene, which provides plenty to keep the local retirees engaged.

Top Five Small Metros

Here are the five cities that ranked highest in the small metropolitan area category. Iowa shows up again, with two of the five cities on this list, making it the state with the most good options for retirees in the top 10.

1. Iowa City, Iowa

Despite their chillier winters, Midwestern towns dominate the list of best small metros. At the top of the list is Iowa City, where residents are in close proximity to the University of Iowa. Home to the ground-breaking Writers’ Workshop, the university has long been a hub for artists and storytellers. It’s a distinction that led UNESCO to label the town a “City of Literature.”

A love of reading seems to spill over into the general population; residents are unusually active library users. Also working in the town’s favor is a strong public transportation system and the availability of specialty care providers like orthopedic surgeons and hospices.

2. Manhattan, Kan.

With access to a major Army base, Fort Riley, and a prominent learning center, Kansas State University, residents of this Midwestern town benefit from a stable economic environment and specialized medical care. One stand-out feature is it its abundance of healthcare facilities for older adults, including rehab centers and Alzheimer’s units.

It’s also a pedestrian-friendly city with an ample supply of libraries and civic groups to keep retirees busy. In addition, Manhattan has a high rate of volunteerism, proving that its residents feel connected to their community.

3. Ames, Iowa

One of the keys to staying young is keeping active, physically and cognitively. Ames, Iowa, a town of just over 66,000 residents, excels in both categories.

Despite its rather frigid winter weather, locals can take advantage of the city’s unusually high number of indoor fitness centers. And with its eclectic cultural scene, it offers older adults a pretty good mental workout, too.

4. Columbia, Mo.

Like a number of high-ranking cities, Columbia is an example of how college towns can be great places not just for younger adults, but for those getting up in years. The researchers note that the University of Missouri’s presence helps contribute to a well-educated populace and a solid economic climate.

Other factors working in Columbia’s favor: affordable senior living facilities and a large number of home healthcare providers.

5. Sioux Falls, S.D.

In the fifth spot is Sioux Falls, S.D., even though the average high temperature in January is just 26 F.

What the city has going for it is access to high-quality healthcare services and a robust local economy. It ranks near the top when it comes to income and small business growth. What’s more, Sioux Falls spends generously on its older population, helping residents maintain their independence into advanced age.

The Bottom Line

The Milken Institute study provides a fresh perspective on the qualities adults should seek in the city where they’ll spend their later years. It suggests metro areas don’t have to have great year-round weather to be an attractive destination in retirement. Having a university, on the other hand, definitely helps.