These Cities Offer the Highest Quality of Life

The three best-rated cities are all located in Spain. They have in store some of the best healthcare services, great travel and leisure options, and — no surprise — a sunny climate. They are also all very safe places.

Top Findings

Of all cities, healthcare is the most affordable in #1 Valencia.
In #2 Málaga, expats find the best climate and weather.
#3 Madrid shines with the best leisure options worldwide.
#49 Dublin, #48 Rome, and #47 Nairobi make up the bottom 3 for Quality of Life.

The Top 15

Methodology

The Quality of Life Index covers 21 rating factors across five subcategories: Environment & Climate, Healthcare, Leisure Options, Safety & Security, and Travel & Transit. Expats were asked to rate each factor on a scale from one (very bad) to seven (very good). This resulted in a ranking of 49 cities with a minimum sample size of 50 respondents per destination.

#1 Valencia: Where Expats Can Easily Stay in Shape

The highest-rated destination in the Quality of Life Index (1st), Valencia lands among the top 10 in all five subcategories, too. It does best in the Healthcare Subcategory (2nd), where it ranks very well for the affordability (1st), availability (3rd), and quality of medical care (4th).

In fact, Spain’s healthcare system is internationally acclaimed. According to the European Observatory on Health Systems and Policies, Spain has the highest life expectancy in the EU, and social inequalities in health are less pronounced than in many other countries. Indeed, in Valencia, 82% find it easy to access all the kinds of healthcare services they need (vs. 65% globally).

Spain’s third-biggest city, located on the Mediterranean Sea, also does exceptionally well in the Travel & Transit Subcategory (3rd). Almost all (98%) appreciate the travel opportunities, compared to 84% globally. And within the city, 97% find it’s easy and safe to get around on foot and/or by bicycle (vs. 77% globally). Public transportation also makes it among the top 10 in terms of affordability (9th). A US-American expat explains: ”I love the relaxed lifestyle, the easy and economical travel opportunities, the weather, my good friends, and the health care.”

In addition to great travel options, expats in Valencia benefit from the city’s superb Environment & Climate (5th). They especially enjoy the climate and weather (95% happy vs. 62% globally) and the urban environment (94% vs. 67% globally). As a popular tourist destination, Valencia also offers excellent Leisure Options (3rd). The city ranks 1st worldwide for its opportunities for recreational sports, and 94% enjoy the culture and nightlife (vs. 68% globally).

A last positive point is that expats feel safe in Valencia. In fact, 94% rate their personal safety positively (vs. 83% globally). And an impressive 86% say they can openly express their opinions (vs. 65% globally).

#2 Málaga: Sunny Days & Great Leisure Options

A vibrant city on the sunny coast of Southern Spain, runner-up Málaga (2nd) is the place expats enjoy most for its climate and weather (1st). Not surprisingly, the city also makes it into the top 10 for its natural environment (8th), which includes nature, scenery, and wildlife. What’s more, 89% appreciate Málaga’s air quality (vs. 66% worldwide). All these factors boost the city into the top 5 in the Environment & Climate Subcategory (4th).

Expats also praise the fact that it’s easy and safe to get around on foot and/or by bike (94% vs. 77% globally). The car infrastructure (11th) is another highlight, and the city makes it among the top 10 in the Travel & Transit Subcategory (8th). A Norwegian expat explains: “The climate makes it possible to spend so much more time outdoors, and the destination offers so many social opportunities — restaurants, cafes, beach bars! From where we live, it is only a short distance to other exotic destinations.”

Málaga also offers the 2nd best Leisure Options. Almost all respondents (94%) adore the city’s opportunities for recreational sports (vs. 75% globally). Also, 92% enjoy the culture & nightlife (vs. 68% globally), and another 92% love the culinary variety and dining options (vs. 77% globally).

Healthcare (10th) is another strong point for Málaga. Four in five (80%) are happy with the quality of medical care (vs. 70% globally). And while the city places in the bottom half for political stability (31st), 79% appreciate that they can openly express their opinion (vs. 65% globally).

#3 Madrid: The Place with the Best Culture & Nightlife

Ranking 3rd out of 49 for its Quality of Life, Madrid is the number one city for Leisure Options (1st). It’s the place with the best culture and nightlife (1st), as 96% love that about Madrid (vs. 68% globally). Spain’s capital also ranks among the top 10 for culinary variety and dining options (4th) and opportunities for recreational sports (7th).

Continental Europe’s second-largest city after Berlin also offers excellent public transportation, both in terms of affordability (5th) and availability (7th). Outside the city walls, 96% love the opportunities to travel (vs. 84% globally). Overall, Madrid ranks 5th in the Travel & Transit Subcategory. “I feel safe here as a single woman, and I’m free to travel as much as I choose. The gastronomy is excellent, and the social life here reminds me of New York City,” says a Panamanian expat.

Expats in Spain’s most populous city also feel that Healthcare (8th) is one of the best, as the city ranks 2nd for its affordability. An impressive 76% find it easy to access all kinds of healthcare services needed (vs. 65% globally). Madrid’s respondents also feel that their Safety & Security (14th) poses no problem, and that they can freely express their opinions, a factor for which the city ranks 6th worldwide.

The only aspect where the Spanish metropole doesn’t make it into the top 10 is for its Environment & Climate (16th). Although it has the second-highest number of trees in the world (after Tokyo), expats rank the city less favorably for air quality (32nd) and for government policies to protect the environment (24th).

The Bottom 3: Dublin, Rome & Nairobi

Ending up in 49th and last place in the Quality of Life Index, Dublin also ranks last for Healthcare (49th). More than half (56%) say they cannot access all the kinds of healthcare services they need, almost three times the global average of 19%. The Irish capital also ranks last for quality of medical care (49th) and second to last (48th) for its affordability. What’s more, expats in Dublin experience safety worries, as 22% rate their personal safety negatively, almost three times more than the global average (8%). “The underfunding of schools and medical infrastructure will hamper this society in the long run,” says an expat from Bulgaria.

Moreover, Dublin lands among the bottom 5 when it comes to Travel & Transit (46th) and Leisure Options (46th) — especially the available culinary variety and dining options have few fans (46th). Only 55% are satisfied with the availability of public transportation (vs. 73% globally) and only 56% with its affordability (vs. 71% globally).

Situated on the east coast and divided by the River Liffey, Dublin charms expats with its natural environment, making it into the top 10 for this factor (10th). However, the cold and rainy climate and weather (42nd) doesn’t allow for as much exploration of the surroundings as they would like.

Ranking second to last (48th) in the index, Rome also places second to last in the Travel & Transit Subcategory (48th). Italy’s capital offers the poorest infrastructure for cars (49th), and the second least available public transportation options (48th) like buses and trains. Expats cannot get around easily via bike or on foot either (24% unhappy vs. 13% worldwide), and only 36% are satisfied with the urban environment like green spaces or noise levels (vs. 67% globally). In addition, expats find Rome the second most difficult place to access green goods and services like renewable energy (48th).

Ranking Rome among the bottom 3 for political stability (47th), 13% rate their personal safety negatively as well (vs. 8% globally). Healthcare (37th) is also problematic: only 44% find it easy to access all the kinds of healthcare services they need (vs. 65% globally).

Nairobi (47th) rounds out the bottom 3. It performs last for Travel & Transit (49th). For example, 40% of expats find it difficult to get around on foot and/or by bicycle (vs. 13% globally). Kenya’s capital also ranks among the bottom 3 for car infrastructure (47th) as well as the availability (46th) and affordability (43rd) of public transportation.

But what expats are especially worried about is their personal safety: only 47% give this factor a positive rating (vs. 83% globally), placing Nairobi among the bottom 5 (45th) for Safety & Security. “There can sometimes be safety issues, as is the case in most big cities. But when you're aware of the threats, you can manage your day-to-day life accordingly,” says a US expat.

Healthcare, both in regard to its quality (42nd) and affordability (43rd), leaves a lot to be desired. On the brighter side, at least not a single expat (0%) has something negative to say about the mild and tropical climate and weather (vs. 18% globally), and 97% enjoy the natural environment (vs. 84% globally) with its forests, rivers, and surrounding mountains. But, Nairobi nevertheless ranks in the bottom 10 for urban environment like green spaces and noise levels (42nd).