20+ Worst Towns for Retirees in Iowa

Welcome to our exclusive tour of Iowa’s not-so-golden retirement spots.

Iowa’s economy shrank by 0.5% in 2024, reflecting a decline in economic performance.

They say “Home is where the heart is,” but sometimes it’s also where the hassle is.

From healthcare deserts to crime havens, we’ve got all the info you need to know where not to slow down.

Updated after talking to locals: removed a few towns and added Clinton, Des Moines, Waverly. Updated the pictures.

1. Denison, Iowa

Denison, Iowa, is a small yet vibrant city located in the western part of the state. Known for its deep roots in American history and a strong sense of community, Denison serves as the county seat of Crawford County.

The city is recognized for its picturesque landscapes and predominantly agricultural economy, contributing significantly to its local charm and appeal. However, the city faces demographic challenges with a declining population rate of approximately -0.8% annually.

According to Census Bureau data, Denison has a poverty rate of 19.1%, which is significantly higher than the national average.

2. Fort Madison, Iowa

Fort Madison offers scenic river views but falls short in catering to the needs of its senior population. The infrastructure in this historic town is undergoing improvements, with ongoing road maintenance and new government office construction, though some mobility considerations remain for retirees.

Additionally, Fort Madison experiences high property taxes, which have been rising steadily, creating a financial burden for retirees living on fixed incomes.

Fort Madison’s median effective property tax rate is 1.66%, higher than the national median of 1.02% and above Iowa’s state median of 1.54%.

While Fort Madison Community Hospital provides some healthcare services, including oncology care through Quincy Medical Group, residents often need to travel to nearby cities for more comprehensive medical care, adding inconvenience to their daily lives.

3. Burlington, Iowa

Burlington appears frequently in discussions about challenging Iowa communities. This Mississippi River town has struggled to maintain economic vitality as manufacturing has declined over decades.

The population continues to shrink, declining at a rate of -0.52% annually, with the 2025 population estimated at 23,320, down from 23,932 in 2020.

For retirees, a community’s economic health directly impacts available services, property values, and overall quality of life.

Burlington’s challenges in these areas create concerns for those considering it as a retirement destination. The unemployment rate has historically been higher than the state average, and recent news indicates further economic challenges with CNH considering closing its Burlington plant, which could eliminate 350 jobs.

Want me to explain why this matters? When local tax bases shrink, everything from road maintenance to emergency services can suffer – all critical considerations for retirees.

With an aging population (median age of 42.8 years) and a poverty rate of 15.91%, the city faces significant challenges in maintaining services.

4. Mason City, Iowa

Mason City, Iowa, is a culturally rich and historically significant town located in the north central part of the state.

It is known for its Prairie School architecture, including works by Frank Lloyd Wright, and its musical heritage.

Mason City serves as a retail and economic hub for the region, offering a blend of cultural attractions, historic sites, and community events. However, despite recent improvements in crime rates, safety remains a concern for potential retirees.

5. Keokuk, Iowa

Keokuk, while picturesque along the Mississippi River, has its drawbacks, particularly for retirees. The town has adequate grocery options including a large grocery store, Hy-Vee and Walmart Supercenter, though other amenities and services for seniors remain limited.

The town’s healthcare situation is in transition, with the local hospital set to reopen after being closed by its previous owner. Until then, retirees must travel to neighboring communities for emergency and specialized care.

Internet connectivity in Keokuk has improved with multiple providers offering service, but the quality and reliability can vary throughout the town, potentially limiting retirees’ ability to use telehealth services or stay connected with family.

6. Ottumwa, Iowa

Ottumwa may charm visitors with its picturesque settings and historic sites, but it faces its share of challenges that may deter retirees. The town has a relatively high unemployment rate, impacting the vibrancy of the community and availability of local services.

While public transportation exists, it is somewhat limited, which may inconvenience those retirees who depend on transit options to reach healthcare services or social activities in and around the area.

Additionally, while there are educational opportunities, Ottumwa lacks specific programs tailored for the lifelong learning needs of retirees, which could enhance their engagement and personal development.

7. Clinton, Iowa

Clinton, Iowa, faces significant challenges concerning crime rates, which may be concerning for retirees seeking a safe and secure environment. The crime statistics place Clinton among the cities with the highest crime rates in Iowa, raising concerns about personal safety and the security of personal property.

8. Waverly, Iowa

Waverly, Iowa, offers a small-town atmosphere with a close-knit community.

Despite this, the town’s limited public transportation options can pose challenges for retirees who prefer not to drive, making it difficult to access healthcare facilities, shopping centers, and social events independently.

While services like OnBoard Public Transit are available, they may not operate with the frequency or coverage that seniors require for daily activities.

This reliance on personal vehicles or infrequent transit services can lead to decreased independence for those unable to drive.

9. Waterloo, Iowa

Waterloo, Iowa, is recognized for its cultural attractions and industrial background. Nevertheless, the city’s harsh winter climate, characterized by heavy snowfall and icy conditions, may not be suitable for retirees seeking milder weather conditions.

The cold season lasts for over three months, with average daily high temperatures below 39°F, which can limit outdoor activities and social interactions. Additionally, the frequent overcast skies during winter months may contribute to seasonal mood disorders among seniors.

10. Sioux City, Iowa

Sioux City, Iowa, sits at the confluence of the Missouri and Big Sioux Rivers, offering scenic landscapes.

With a population of 85,797 as of 2020, it has a rich history dating back to when it was inhabited by Yankton Sioux before European settlement.

While Sioux City offers some cultural attractions like the Sioux City Public Museum, Sioux City Art Center, and the Sergeant Floyd Monument (a National Historic Landmark), it presents several significant challenges for retirees.

11. Knoxville, Iowa

Knoxville, Iowa, is famed for its annual sprint car races, attracting motorsport enthusiasts. The town offers various recreational opportunities including parks, trails, and Lake Red Rock just five minutes away.

While the Knoxville Recreation Center offers comprehensive fitness facilities including a gymnasium, racquetball court, strength training room, indoor pool, and more, retirees seeking certain specialized activities might find options more limited than in larger cities.

The town has cultural venues including the Grand Theater, Knoxville Performing Arts Center, and multiple museums, but the scale and variety may not compare to metropolitan areas.

12. Centerville, Iowa

Centerville, Iowa, boasts a historic town square and a strong sense of community. The town offers several senior living options, including Centerville Senior Lofts for those 55+ and Centerville Specialty Care which can accommodate up to 67 residents.

While there are approximately 44 assisted living facilities in the area with an average monthly cost of $4,818, the town’s healthcare situation is in transition with the local hospital set to reopen by the end of 2025.

This healthcare gap could present challenges for seniors requiring immediate medical attention or specialized care.

13. Oelwein, Iowa

Oelwein, Iowa, is a small city with a rich railroad history and a population of 5,878 as of 2023, showing a slight decline of -0.944% from the previous year.

While the median household income grew by 19.7% between 2022 and 2023 (reaching $49,821), the median property value remains relatively low at $96,800, potentially indicating underlying economic challenges.

The town does offer senior living options like Arlington Place, which provides Independent Living, Assisted Living, Memory Care, and Respite Care with amenities including exercise facilities, spa services, and 24-hour support.

14. Algona, Iowa

Algona, Iowa, offers a peaceful rural setting with a close-knit community. The town does have some senior living options, including Good Samaritan Society – Algona which offers assisted living and independent living services, as well as rehabilitation therapy.

Homestead of Algona also provides assisted living and memory care in a warm, home-like setting, offering support with activities of daily living, home-cooked meals, laundry services, and spiritual and social activities.

While these facilities provide quality care for seniors who need some support, specialized medical services may still require travel to larger cities.

15. Marshalltown, Iowa

Marshalltown, Iowa, is known for its diverse population and manufacturing base.

Contrary to the claim of limited recreational facilities for seniors, Marshalltown actually offers several assisted living options including Bickford of Marshalltown, Glenwood Place, and The Willows of Marshalltown which spans 24 acres near the town center.

The Willows particularly stands out for its eco-friendly approach to land management and offers numerous amenities including educational, creative and recreational events, regular exercise classes, a spa room with walk-in whirlpool, a bar and games room, a private dining room, and a 7,000-square-foot courtyard with walking paths.

16. Hiawatha, Iowa

Hiawatha, Iowa, is a small suburban community near Cedar Rapids.

Hiawatha does have food delivery options through services like Uber Eats, with approximately 80 restaurants and shops offering delivery. However, many of these establishments appear to be located in nearby Cedar Rapids rather than in Hiawatha itself.

There are some dining options available, though perhaps not as diverse as in larger cities.

17. Iowa Falls, Iowa

Iowa Falls, Iowa, is known for its picturesque landscapes along the Iowa River, offering a serene environment that appeals to many.

Nonetheless, the town’s limited public transportation can be a drawback for retirees, making it challenging to access essential services and maintain social connections without personal transportation.

While transportation assistance programs exist in Iowa Falls, as indicated by findhelp.org which lists services specifically for seniors 55 years and older, these options may not provide the flexibility and convenience that many retirees need for daily activities.

This limitation can lead to increased reliance on family members or neighbors for transportation, potentially affecting retirees’ independence.

18. Sheldon, Iowa

Sheldon, Iowa, offers small-town charm with a friendly community, making it an inviting place for many.

While the town provides some recreational opportunities like the Sheldon Recreational Trail, Hills Park Disc Golf Course, and the Sheldon Golf and Country Club, it lacks diverse cultural and entertainment venues that many retirees seek.

Downtown Sheldon offers shopping options including Ben Franklin (the last one left in Iowa), Uptown Threads, and Mr B’s & Lady B’s, but the overall variety remains limited compared to larger communities.

Annual events like Risefest in June and Sheldon’s Annual Celebration Days on Labor Day weekend provide some cultural engagement, but these periodic activities may not satisfy retirees seeking regular cultural stimulation.

19. Dubuque, Iowa

Dubuque, Iowa, is a city with a rich history and scenic river views, attracting those interested in cultural heritage. Despite its attractions, the hilly terrain can be challenging for seniors with mobility issues, making navigation difficult.

While efforts have been made to improve accessibility, such as the addition of over 1000 feet of new paved ADA trails at the Dubuque Arboretum and Botanical Gardens in 2024, the overall topography of the city remains a concern.

Eagle Point Park offers accessible walking paths and overlooks with 8 handicapped accessible pavilions, 4 accessible restrooms, and 4 accessible picnic areas, but navigating the city’s steep inclines and uneven sidewalks may still pose difficulties for older adults, impacting their independence and safety.

20. Newton, Iowa

Newton, Iowa, is recognized for its manufacturing heritage and community events, offering a sense of community pride.

The town does offer senior living options through Newton Village, which provides a full continuum of care including independent living, assisted living, memory care, short-term rehabilitation, and long-term care. As a nonprofit organization, they focus on allowing residents to age in place with well-designed apartments, chef-inspired meals, and transportation services.

However, while Newton Village offers comprehensive senior living services, the overall healthcare infrastructure in Newton may still require residents to travel to larger cities for certain specialized medical treatments, which can be burdensome for retirees with complex health needs.

21. Des Moines, Iowa

Des Moines, Iowa, offers a vibrant urban environment with cultural attractions and amenities.

However, certain factors may make it less suitable for retirees.

One concern is the city’s crime rate. According to NeighborhoodScout, Des Moines has a crime rate of 40 per 1,000 residents, higher than the national average.

There is also a decline in healthcare infrastructure.

Methodology

To determine the worst towns for retirees in Iowa, I combined firsthand accounts with publicly shared experiences.

I also reviewed online feedback from forums, local news comments, Google reviews, and social media to identify towns frequently mentioned for issues that impact quality of life for older adults.

Sources:

• https://propertyclub.nyc/article/most-dangerous-cities-in-iowa
• https://www.areavibes.com/ia/most-dangerous-cities/
• https://eagle1023fm.com/iowas-worst-ranked-city-to-live-in-has-poverty-rate-over-25/
• https://firststreet.org/city/burlington-in/1809244_fsid/flood