Special Report

Best and Worst Cities for Nurses

Michael B. Sauter

Detailed Findings

The best cities for nurses are mostly located in California, where wages of nurses tend to be substantially higher, even when adjusted for the state’s relatively high cost of living. In seven metropolitan areas in California, registered nurses earn the cost of living-adjusted equivalent of over $100,000. The median annual salary for registered nurses working across the United States is $70,000.

At the other end of the spectrum, nurses in some metropolitan areas are paid relatively poorly. In Florence-Muscle Shoals, Alabama, the typical registered nurse earns $54,347 a year after adjusting for cost of living, or about $15,600 less than the the occupation’s national median annual salary.

The health care sector in California is thriving. While past increases do not guarantee future growth, they are still a sign of healthy demand for nursing jobs in these areas. Six of the 10 metropolitan areas in which employment in health care and social assistance increased the most between 2010 and 2016 are in the state.

For many of the metropolitan areas we identified as being the worst for nurses, health care employment has barely increased, and in some cases is on the decline. In the Parkersburg, West Virginia, metropolitan area, employment in the sector has declined by 43% between 2010 and 2016.


To determine the best and worst cities for nurses, 24/7 Wall St considered employment and salary figures for both registered nurses, as well as licensed practical and licensed vocational nurses, from the Bureau of Labor Statistics’ Occupational Employment Statistics program for 2017. In our index, we considered the following factors: 1. The wages of nurses in a city compared to wages of nurses across the country. 2. The wages of nurses in a metropolitan area adjusted for cost of living. 3. The share of nurses out of overall area employment compared to their share nationwide 4. Health care employment growth compared to other metropolitan areas. Cost of living data came from the Bureau of Economic Analysis, and is for 2015.