the st louis arch is silhouetted against the sunset
Capital/Major City · Missouri

St. Louis, Missouri

Washington University's academic medicine and BJC HealthCare, plus a real city earnings tax to plan around.

Overview

St. Louis anchors Missouri's healthcare infrastructure, home to BJC HealthCare, SSM Health, and Washington University School of Medicine, a nationally recognized academic medical center. It's also where Missouri's one genuine local-tax gotcha applies directly: a 1% city earnings tax on residents, worth factoring in specifically for anyone considering the city proper over its suburbs.

Cost of Living

The St. Louis metro's median single-family home price ran around $325,000 as of May 2026, well below the national average. Kirkwood, the most popular retiree suburb, carries a median home value around $467,000 with a dense, walkable feel; more budget-conscious options exist throughout St. Louis County and St. Charles County.

Neighborhoods

Kirkwood, Clayton, Chesterfield, and Creve Coeur are the consistently safest, most retiree-popular suburbs, combining good infrastructure with strong healthcare proximity. St. Charles offers similarly safe, historic character.

Healthcare Access

Washington University School of Medicine, Missouri Baptist Medical Center, St. Luke's Hospital, and Mercy Hospital St. Louis give the metro genuine depth — among the strongest concentrations of academic and specialist medicine in this guide's Midwest coverage.

Safety

Statewide Missouri crime rankings run higher than several other Midwest states, but this needs real neighborhood context: Kirkwood, Clayton, Chesterfield, and Creve Coeur all report consistently low crime despite the state's broader reputation. Research the specific suburb rather than the statewide figure.

Climate

Four distinct seasons with real regional variation — St. Louis sits between the more severe winters of northern Missouri and the milder ones further south, plus moderate statewide tornado risk.

Best For

Retirees who want strong academic-medicine access without big-coastal-city costs, and who specifically plan around suburbs like Kirkwood or Clayton rather than the city center's 1% earnings tax.

Sources

See the Missouri state profile for full sourcing on tax treatment and healthcare.

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