Research

10 best U.S. cities to die in

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Preparing for the end of life isn't always at the forefront of our minds. But the place you live actually has a huge impact on your access to end of life care, how much you'll pay and how your assets can be passed onto your heirs. In short — some cities are better to die in than others.

The Zebra looked at 50 of the most populous American cities to find which ones have the best holistic end of life services. We analyzed five main data points in our search:

  • Average funeral and end of life costs by state: This totals the average costs of a funeral and end of life costs in each state.
  • Estate taxes: Some states charge heirs estate tax on inherited assets. States without estate tax allow for a larger inheritance that doesn't require money to go to the state government.
  • Number of morticians, undertakers and funeral arrangers: This statistic looks at the number of industry professionals compared to the city's population.
  • Palliative care report card by state: This report card grades each state's hospitals based on the quality of care given to patients with serious illness. 
  • Total number of Medicare hospital beds per state: This indicates the availability of affordable hospital care statewide.

From quality of life to the flexibility of estate planning, where you live has a huge impact on what happens in your final days and beyond. See if your city makes the cut.

#1: Cleveland, Ohio

Cleveland has one of the nation's highest concentrations of funeral industry professionals; in fact, the city ranked first out of all the cities we analyzed. Ohio also does not charge an estate tax on inheritances and ranks well for palliative care.

  • Average funeral and end of life costs: $19,519
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 1.62
  • Palliative care report card: 84.8
  • Total number of Medicare hospital beds: 42,009
 cleveland

#2: Cincinnati, Ohio

Like Cleveland, Cincinnati has no estate taxes and a decent amount of statewide hospital beds. Plus, Cincinnati's population of funeral professionals is quite high, ranking fifth compared to Cleveland's first place finish.  

  • Average funeral and end of life costs: $19,519
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 1.33
  • Palliative care report card: 84.8
  • Total number of Medicare hospital beds: 42,009
 cincinatti

#3: St. Louis, Missouri

Missouri has one of the most affordable end-of-life and funeral costs across the nation. And St. Louis comes in third among all surveyed cities for the number of morticians, undertakers and funeral arrangers compared to the total population. The state ranks average for hospital beds, but does stand out for not charging any estate tax.

  • Average funeral and end of life costs: $18,724
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 1.54
  • Palliative care report card: 71.2
  • Total number of Medicare hospital beds: 21,824
 st louis

#4: Detroit, Michigan

While Michigan is just in the middle of the barrel when it comes to hospital beds and palliative care rankings, Detroit ranks eighth for its concentration of funeral industry pros. Plus, there's no estate tax in Michigan and the total funeral and end of life costs come in at just over $19,000.

  • Average funeral and end of life costs: $19,111
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 1.27
  • Palliative care report card: 75.4
  • Total number of Medicare hospital beds: 28,070
 Detroit

#5: Kansas City, Missouri

Kansas City has an above average concentration of morticians, undertakers and funeral arrangers. On top of that, its location in Missouri lends to lower end of life and funeral costs, plus no estate taxes. On the down side, palliative care in the state ranks 32nd on our list. 

  • Average funeral and end of life costs: $18,724
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 1.07
  • Palliative care report card: 71.2
  • Total number of Medicare hospital beds: 21,824
 Kansas City MO

#6: Pittsburgh, Pennsylvania

Pittsburgh comes in next largely thanks to the second highest population of funeral professionals in the city. Although Pennsylvania has average palliative care ratings and hospital beds, state residents don't need to worry about estate taxes.

  • Average funeral and end of life costs: $21,862
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 1.6
  • Palliative care report card: 76.6
  • Total number of Medicare hospital beds: 35,450
 Pittsburgh

#7: Virginia Beach, Virginia

The state of Virginia ranks in the top 10 for best palliative care quality. Paired with no estate tax, Virginia Beach slides into the number seven spot thanks to a relatively high proportion of funeral professionals. 

  • Average funeral and end of life costs: $21,648
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 0.96
  • Palliative care report card: 86.5
  • Total number of Medicare hospital beds: 19,438
 Virginia Beach

#8: Richmond, Virginia

Like its neighbor to the east, Richmond residents don't have to worry about estate tax while also enjoying well-rated palliative care services. And the concentration of funeral service providers is just slightly less than in Virginia Beach.

  • Average funeral and end of life costs: $21,648
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 0.95
  • Palliative care report card: 86.5
  • Total number of Medicare hospital beds: 19,438
 Richmond

#9: Indianapolis, Indiana

Indiana is another state with no estate taxes and below average end of life costs. Plus, Indianapolis has a solid concentration of morticians to choose from. On the care side, however, both the palliative care report card and number of hospital beds for Indiana were below average.

  • Average funeral and end of life costs: $19,347
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 0.84
  • Palliative care report card: 76.7
  • Total number of Medicare hospital beds: 19,581
 indianapolis

#10: Los Angeles, California

Los Angeles rounds out our list largely thanks to the many hospital beds in the state of California. Palliative care is also above average here, and LA also has a higher concentration of funeral pros compared to many other cities. While there's no estate tax in California, the state's end of life costs are among the highest at over $32,000.

  • Average funeral and end of life costs: $32,611
  • Estate taxes: No
  • Concentration of morticians, undertakers, and funeral arrangers: 0.83
  • Palliative care report card: 77.3
  • Total number of Medicare hospital beds: 79,919
 los_angeles

Methodology

The Zebra pulled five data points to analyze the top 50 MSAs (by population) in the U.S. State data was used when MSA data was not available.  

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