Often time as people get older they gravitate back to there house of religion and migrate to places that have better access to health care. For many that means moving to metro areas.

I am 78 and don't plan to move south or short term it in the winter months. We did move from an unincorperated rural village in a rural township to a town of 4,000 this fall. That is big enough for me. I do know many retired farmers and other retirees from our area that have moved south either southeast or southwest.
As to large metro? Most state they are in gated type living areas and they don't notice the large complex much at all
Housing is cheaper
Many hardly drive much as they use golf carts to move around
There are large senior type centers in many areas where they can do many things
taxes are lower on housing and compared to WI no state tax
A lot of those states rely heavily on sales tax and fees, these retirees buy a lot less then younger working people do
Most are on Medicare and many places have very good geriatric health care facilities
There are a lot of senior discounts they can and do utilizes
They also state by not being exposed to the cold and damp they have far fewer aches, pains and joint issues at their age.
Many stay very active in many ways and don't miss our area near as much as they figured they would. They have made lots of new friends and most of the younger relatives still up north travel to see them to get out of the cold for a bit.
The demographic studies indicate that these areas will continue to grow at a far, far faster rate then the rest of the country.

Bryce

I live in SW AR and went to Iowa last week to pick up a dog. I cant figure out why anyone would want to be up there in the winter time

It’s the skunk logic we live up here because other people won’t and I’m ok with that. LOL

^^^^^^ This. Spent decent chunk off end of my career running strategic analysis within healthcare organizations. Quality and access varies greatly by regions. Many large metro areas have top tier specialists BUT that doesn’t necessarily mean easy access to those resources for end users. On other hand many rural areas have a great deficit of even primary care health providers let alone specialists but that’s not universal. What you tend to find is quality and access is reflected by a combination of what specific healthcare organizations are prominent in an area and the strategic relationships they have with research institutions/universities