10 Best Small Cities for Nurses With Big Student Loan Debt

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Although nurses shell out less money than doctors to pay for their medical schooling, they’re often just as stressed out about how to pay for it.

About 7 in 10 nurses take out student loans to pay for their graduate program, according to a 2017 report from the American Association of Colleges of Nursing. What’s more, 50% stated their biggest concern after graduation was figuring out how to repay their loans.

But relocating can often help struggling borrowers get a handle on student loan payments, especially if they can combine low costs of living with a healthy salary and job demand.

So if you’re a nurse looking to jump-start your debt payoff journey, check out the following best small cities to live in and work in when paying off student loans.

10 best small cities for nurses paying off student loans


To help nurses figure out whether relocating to a smaller city might be worth it, we first wanted to be able to answer the following questions:

  • What annual salary can a nurse expect to earn?
  • How much demand is there for nurses?
  • How far will a nurse’s salary go when paying for goods and services?

We relied on three data points from the Bureau of Labor Statistics (BLS) to help formulate our answers to the three questions.

  • Average annual wage: The median pay for registered nurses nationally in 2017 was $70,000, according to the BLS.
  • Location quotient: The location quotient compares the employment of nurses in a city to the average for the nation. If a city reports a location quotient greater than 1.0, which is the national average, nurses are more likely to be in demand in that city. Cities with marks below 1.0 are less likely to offer as many employment options.
  • Regional price parity: Price parity refers to varying costs of goods and services in cities, which in turn affects the purchasing power of your wages (or how much you can actually buy with your paycheck). If a city’s regional price parity is less than 100, which is the average, goods and services are less expensive in that city (so a large paycheck will go further). If a city reports a mark greater than 100, goods and services are more expensive there.

Here are the top 10 small cities that received the highest marks in these areas:

1. Bay City, Michigan

The first of two Michigan cities atop our rankings, Bay City comes with the benefit of a lower cost of living. In fact, thanks to the city’s regional price parity, the purchasing power of the average annual wage for a nurse jumps to $78,020, according to the BLS.

  • Average annual wage: $69,360
  • Location quotient: 1.42
  • Regional price parity: 88.9

2. Saginaw, Michigan

Like their neighbors in Bay City, Saginaw nurses can take advantage of the Michigan State Loan Repayment Program. It provides a maximum of $200,000 over eight years to help nurse practitioners repay their loans.

  • Average annual wage: $66,030
  • Location quotient: 1.58
  • Regional price parity: 89.4

3. Greenville, North Carolina

Despite being the most populous small city on our list, Greenville reported a relatively high demand for registered nurses. In fact, it recorded the highest location quotient of any city in our top 10.

  • Average annual wage: $63,130
  • Location quotient: 2.02
  • Regional price parity: 88.4

4. Johnstown, Pennsylvania

Johnstown nurses can look into receiving help repaying their debt via the Pennsylvania Primary Care Loan Repayment Program. It awards up to $60,000 to full-time nurse practitioners in exchange for two years working in an underserved area. Contact the program to stay abreast of application periods.

  • Average annual wage: $62,120
  • Location quotient: 1.69
  • Regional price parity: 87.2

5. Cumberland, Maryland

Aside from being paid well, nurses in Cumberland can take advantage of the Janet L. Hoffman Loan Assistance Repayment Program. In exchange for treating low-income and underserved residents, nurses can receive up to $30,000 in aid over three years if they have debt totaling $75,001 or more.

  • Average annual wage: $65,010
  • Location quotient: 1.36
  • Regional price parity: 88.2

6. Florence, South Carolina

Combine a relatively high demand for nurses with a low cost of living and, boom, you have a city that’s conducive to paying off your student loans.

The cost of goods and services in Florence is so low, in fact, that the average salary of $60,470 has a purchasing power of $70,725, according to the BLS.

  • Average annual wage: $60,470
  • Location quotient: 1.85
  • Regional price parity: 85.5

7. Duluth, Minnesota

Duluth cracked our top 10 because it reported strong marks in each of the three data categories under consideration.

Here’s a fourth reason for its rise up the rankings: the Minnesota Health Care Loan Forgiveness program. It offers repayment assistance of up to $20,000 over four years to nurses who work at least two years in a nursing home.

  • Average annual wage: $66,780
  • Location quotient: 1.38
  • Regional price parity: 91.7

8. Hanford, California

The lone West Coast city among our top 10, Hanford made up for its relatively higher cost of living with an equally impressive salary. In fact, of the 334 small, midsized, and large cities we reviewed, Hanford reported the 13th-highest annual average wage.

Plus, Hanford (and other California) residents can look for assistance via the state’s Bachelor of Science Nursing Loan Repayment Program. Recipients may receive up to $10,000 after agreeing to a one-year obligation practicing direct patient care at a qualifying facility in California.

  • Average annual wage: $91,340
  • Location quotient: 1.56
  • Regional price parity: 95.5

9. Alexandria, Louisiana

You might scoff at Alexandria’s relatively low salary, but the BLS gave this small city in Louisiana a purchasing power of $67,355, thanks to its lower cost of living.

Residents can access the Louisiana State Loan Repayment Program if they work in rural or inner-city communities or for a nonprofit. It awards a maximum of $45,000 over three years.

  • Average annual wage: $59,070
  • Location quotient: 1.89
  • Regional price parity: 87.7

10. Eau Claire, Wisconsin

Although not as mighty as Milwaukee or Madison, Eau Claire represented Wisconsin well by rounding out our top 10. The smaller city reported high marks across the board and also boasts the state’s Health Professions Loan Assistance Program, which offers up to $100,000 in repayment aid.

  • Average annual wage: $66,500
  • Location quotient: 1.42
  • Regional price parity: 92.3

Should you move to a smaller city?


Chances are you don’t already live or work in one of the top 10 best small cities for nurses paying off student loans, but it’s worth considering the benefits of such a move. After all, your location affects the amount of disposable income you can put toward student loan repayment.

Sure, your salary, job prospects, and cost of living vary from city to city. But you’ll also want to compare differences between states. There are many state-based loan forgiveness programs for nurses, for example.

Similarly, you might target smaller cities within states that have no income tax. That way, you can take home more of your paycheck.

Say you moved to Sherman, Texas, which ranked 15th among our top small cities for nurses. You might see a pay increase, more job demand, and a lower cost of living — but you’d also appreciate Texas being one of nine states without an income tax.

Like refinancing or consolidating your loans, moving to a smaller city is a potential repayment tool. It could be the right choice if it helps you pay down debt faster. And, hey, you could always return to the big city once you’re debt-free.

Top 25 small cities for nurses


In case your city fell outside the top 10 but still ranked highly, consider our top 25:

Rank City Annual mean wage Location quotient Regional price parity
1 Bay City, Mich. $69,360 1.42 88.9
2 Saginaw, Mich. $66,030 1.58 89.4
3 Greenville, N.C. $63,130 2.02 88.4
4 Johnstown, Pa. $62,120 1.69 87.2
5 Cumberland, Md. $65,010 1.36 88.2
6 Florence, S.C. $60,470 1.85 85.5
7 Duluth, Minn. $66,780 1.38 91.7
8 Hanford, Calif. $91,340 1.56 95.5
9 Alexandria, La. $59,070 1.89 87.7
10 Eau Claire, Wis. $66,500 1.42 92.3
11 Rome, Ga. $56,250 2.35 82.2
12 St. Cloud, Minn. $79,700 1.17 93
13 Asheville, N.C. $62,030 1.62 92
14 Battle Creek, Mich. $63,460 1.24 90.5
15 Sherman, Texas $60,130 1.74 91.5
16 Redding, Calif. $89,960 1.55 98.6
17 Flint, Mich. $64,920 1.57 93.8
18 Kalamazoo, Mich. $64,200 1.36 92.7
19 Huntington, W.Va. $55,140 2.01 86.7
20 Wenatchee, Wash. $74,290 1.36 96.3
21 Lewiston, Idaho $60,960 1.38 91.7
22 Dothan, Ala. $54,410 1.8 85
23 Cape Girardeau, Mo. $51,990 2.32 82.8
24 Albany, Ga. $60,910 1.09 85.1
25 Danville, Ill. $62,050 1.03 79.4

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Our team at Student Loan Hero works hard to find and recommend products and services that we believe are of high quality and will make a positive impact in your life. We sometimes earn a sales commission or advertising fee when recommending various products and services to you. Similar to when you are being sold any product or service, be sure to read the fine print understand what you are buying, and consult a licensed professional if you have any concerns. Student Loan Hero is not a lender or investment advisor. We are not involved in the loan approval or investment process, nor do we make credit or investment related decisions. The rates and terms listed on our website are estimates and are subject to change at any time. Please do your homework and let us know if you have any questions or concerns.