The Global Age-Friendly Community Movement: A Critical Appraisal

PART I

Equity and Sustainability

PART I ADDRESSES ONE OF the major criticisms of the age-friendly movement—that it falls short in addressing the political and economic conditions that favor the privileged position of certain segments of the older adult population and fails to benefit those challenged by lower incomes and other associated forms of difference such as race, ethnicity, gender, and geography.

We start with the big picture. Tine Buffel and Chris Phillipson (chapter 1) ground an understanding of the age-friendly movement within the broadest context of global changes affecting not only older adults but multiple populations. Moreover, they trace the influence of these forces (migration, crime, industrialization and deindustrialization, disinvestment in certain urban spaces, privatization of public space, and others) to the neighborhood level. They surface and reveal the structural inequities particularly burdensome on elderly individuals and groups—inequities not typically addressed through soft, more passive calls for livability that fall short in the face of austerity-driven policies. While acknowledging the pertinence and contributions of environmental gerontology as a platform for age-friendly research, they argue for a more effective extension of the research into policy and action.

This necessary linkage between theory and action is well demonstrated by Sharon A. Baggett (chapter 2), who seeks to embed age-friendly work within the broader context of theories of urban change. She extends Buffel’s and Phillipson’s focus on the right to the city and reviews significant traditions in urban studies such as the just city, urban citizenship, and models of community change such as exemplified by the Industrial Areas Foundation. While she is not reliant on environmental gerontology as a theoretical platform, she, refreshingly, uses the concept of urban citizenship to develop a practical outcome of municipal policy influence actually led by older adults and people with disabilities in alliance. Moreover, she does not assume that without training, any group of citizens can effectively mount a social change effort. She describes a project developed with Jennie Todd that equips older adults with a knowledge base that elevates their capacity to converse with planning technocrats, city leaders, and the general public. Moreover, she effectively demonstrates the power of identifying the common strengths and challenges faced not only by older adults but by another marginalized group—people with developmental and cognitive disabilities. With this, Baggett and Todd provide an innovative model for an alliance between elders and people with disabilities, a major limitation of current advocacy efforts in both aging and disability silos.

Insofar as both chapters 1 and 2 emphasize the importance of access to public spaces as a matter of social justice and equity, in chapter 3 Suzanne H. Crowhurst Lennard provides a practical segue into the manner in which the design of those spaces can, in fact, lead to improvements in the quality of social life and mental health of both older adults and children. She provides a comprehensive overview of the genius of public spaces in old world cities, where plazas, piazzas, squares, and parks support a rich and vibrant social life across generational differences. Moreover, she provides an incisive critique of public spaces (if they exist at all) in a post-automobile, privatized world.

Alan DeLaTorre (chapter 4) extends the discussion of equity by building a bridge to the sustainable development movement, which, within the field of planning, is more pervasive than the age-friendly thread. He argues that attention to issues across the life span has not been a prime feature of the sustainable development movement, but that doing just that—incorporating an age-friendly approach—will strengthen the sustainability movement itself. He demonstrates how the use of green building technologies, durable materials, and accessibility and affordability features of housing for seniors is a central value totally aligned with the movement toward more sustainable communities. In his research he documents this blind spot in the sustainability movement and, as a positive contribution, describes the work in Portland, Oregon, meant to integrate these two major movements through public policy. If the age-friendly movement is to gain traction within the much larger field of urban planning and design, the Portland initiative points to the necessary elements.

1 CREATING AGE-FRIENDLY COMMUNITIES IN URBAN ENVIRONMENTS

Research Issues and Policy Recommendations

Tine Buffel and Chris Phillipson

Introduction

TWO MAJOR FORCES ARE SET to shape the quality of daily life in the twenty-first century: population aging on the one side and urbanization on the other. Both have become dominant concerns for public policy, with significant implications for all types of communities—from the most isolated to the most densely populated. By 2030, two-thirds of the world’s population will be residing in cities; at that point many of the major urban areas in the developed world will have 25 percent or more of their populations aged sixty and over. Katz, Altman, and Wagner (2008: 474) view the present century as the urban age, one that is unfolding at a dizzying pace and with a scale, diversity, complexity, and level of connectivity that challenges traditional paradigms and renders many conventional needs and practices obsolete. Cities are now regarded as central to economic development, attracting waves of migrants and supporting new knowledge-based industries (Burdett and Hall 2017). However, the extent to which the new urban age will produce age-friendly communities, creating opportunities for older people as well as strengthening ties across different age and social groups, remains uncertain. Such concerns may also be linked with the emergence of conflicts within urban space arising from inequalities in access and influence among different social and generational groups.

This chapter examines some of the research and policy issues that arise from attempts to build age-friendly communities. The discussion begins by reviewing some of the factors driving the age-friendly debate, with a focus on issues relating to urban change and population aging. The chapter reviews some of the research literature available for assessing age-friendly issues, focusing on debates in environmental gerontology and urban sociology. The chapter then provides a critical assessment of some of the limitations of the age-friendly debate before moving to a consideration of some alternative policy options and recommendations.

Factors Influencing the Development of the Age-Friendly Approach

Although aging and urbanization can rightly be viewed as major trends for the present century, they have been separated in the field of research. This has happened despite urging from pioneer researchers of urban society such as Lewis Mumford (1956) that we should be seeking age integration rather than age segregation in our cities. Against this, the direction of policy over the postwar period appears to have been largely in the opposite direction, with the focus on developing age-segregated provision such as sheltered housing (in the United Kingdom in the 1950s and 1960s) through to retirement communities and the more recent evolution of urban retirement villages. An alternative approach, however, has stressed the importance of developing what has been termed by the World Health Organization (WHO 2007) as age-friendly communities. Accordingly, it should be normal in an age-friendly city for the natural and built environment to anticipate users with different capacities instead of designing for the mythical ‘average’ (i.e. young) person. An age-friendly city emphasizes enablement rather than disablement; it is friendly for all ages and not just ‘elder-friendly’ (WHO 2007: 72; see also Fitzgerald and Caro 2014; Buffel, Handler, and Phillipson 2018). In 2010, the WHO launched the Global Network of Age-Friendly Cities in an attempt to encourage implementation of policy recommendations from the 2006 project. By 2018 there were over six hundred participating cities and communities across thirty-seven countries worldwide.

A number of factors may be cited as influencing the development of the age-friendly approach: first, the global impact of demographic change, with a wide range of housing and community needs emerging among those aged fifty and over (Menec et al. 2011); second, the policy goal of supporting people in their own homes for as long as possible—the idea of aging in place (Wiles et al. 2012); third, awareness of the impact of urban change on the lives of older people, notably in areas experiencing social and economic deprivation (Buffel, Phillipson, and Scharf 2013); and fourth, debates about good or optimal places to age, these stimulated by the growth of retirement housing and recognition of what has been termed naturally occurring retirement communities (Scharlach and Lehning 2013).

The drive to create age-friendly cities may also be placed in the context of attempts to improve the quality of life for people living in urban environments. This was reflected in new perspectives influencing urban development over the course of the 1990s and early 2000s—for example, ideas around sustainable (Satterthwaite 1999) and harmonious cities (UN-Habitat 2008). The former raised questions about managing urban growth in a manner able to meet the needs of future as well as current generations. The idea of harmonious development emphasized values such as tolerance, fairness, social justice and good governance (UN-Habitat 2008), these regarded as essential principles of urban planning. Such themes were also influential in the elaboration of ideas (as noted above) associated with lifetime homes and lifetime neighburhoods (Department of Community and Local Government 2008; Atlanta Regional Commission 2009), which emerged alongside recognition of the need for more systematic interventions to support population aging at a community level. The key issue behind the lifetime concept was an understanding that effective support for older people within neighborhoods would require a range of interventions linking different parts of the urban system—from housing and the design of streets to transportation and improved accessibility to shops and services.

These developments took place against a backdrop of radical change affecting many urban environments. Among the most important of these have been widening economic inequalities within cities (Wacquant 2008; Burdett and Hall 2017); the impact of rural migration on urban environments and the displacement of traditional sources of support for older people (Lloyd-Sherlock, Barrientos, and Mase 2012); the influence of economic globalization and the rise of world cities (Sassen 2012); and, finally, increasing inequality between cities affected by either rapid industrialization or deindustrialization in the case of many medium-sized cities (Hall 2014). As will be argued at different points in this chapter, such developments have received only limited acknowledgment within the age-friendly movement, hence the need for the critical perspective developed in this chapter. Moreover, much of the debate about age-friendly cities remains disconnected from the pressures on vulnerable groups given the range of changes affecting cities. While the dominant approach has been toward encouraging what came to be termed aging in place (Wiles et al. 2012), the places in which older people were aging often proved hostile and challenging (Buffel et al. 2013). The next section of this chapter examines this point in relation to research in the field of environmental gerontology, reviewing findings that highlight the pressures on developing an age-friendly approach within urban environments.

Environmental Gerontology and Age-Friendly Cities

An important disconnect in the age-friendly debate has been with trends in the field of environmental gerontology, an approach that has emphasized the need for an in-depth understanding of both the objective and subjective processes of aging individuals interacting with their physical-social settings (Wahl and Oswald 2010). Four different approaches have contributed to the advancement of environmental gerontology (Peace et al. 2007; Wahl and Oswald 2010; Phillipson 2011): integration versus segregation debates in the field of housing; theoretical models examining the person-environment fit; research on place attachment and the construction of identity; and studies examining the impact of neighborhood and community change.

Work relating to housing provided the initial focus for research on environmental issues, with studies in the 1950s and 1960s using this topic to explore arguments around age integration versus age segregation (Kleemier 1956). Such debates reflected two competing theories that dominated research in social gerontology during this period—activity and disengagement theory (Havighurst and Albrecht 1953; Cumming and Henry 1961), each presenting contrasting views about the extent to which older people wish to be integrated into or segregated from mainstream society. An additional factor influencing this work, however, was the rise of retirement communities in North America, from the 1950s onward. Such developments raised several questions about the (dis)advantages of same-age communities, especially regarding security, social, physical and mental well-being, and recreational facilities. This debate was subsequently extended through research exploring the benefits of different types of age mix within residential settings for friendship formation and social integration (Rosow 1967).

By the 1970s, researchers shifted their focus to examining the reasons why some physical contexts achieved a better fit with the needs and abilities of older residents than others, with the Press Competence (PC) model (Lawton 1980) emerging as a dominant framework for understanding person-environment relationships. The underlying assumption of this approach is that individual behavior is a result of congruence between the demand character of the environment (environmental press) and the capabilities of the person to deal with that demand (personal competence) (Lawton 1980; see also Wahl and Oswald 2010). Personal competence is generally recognized as a characteristic of the individual, typically defined as internal (e.g., personality, physical and mental health, skills, and cognitive ability) and external (e.g., financial status and social networks), and is viewed on a continuum from low to high. Environmental press examines the contextual demands of the environment, such as aesthetic appearance, walkability, amenities, and fear of crime, and how people respond to these based on their competence level (Lawton 1980). As with personal competence, environmental press is measured on a scale from low to high. With this approach, individuals with low competence encountering strong environmental press are more likely to have maladaptive behavior compared with those showing high competence encountering weak environmental press, where behavior is likely to be adaptive or positive. The PC model has been especially influential in showing how mismatches between personal needs and environmental options to fulfill these needs can undermine well-being and mental health (Wahl and Oswald 2010).

New approaches emerged through the 1980s and 1990s focusing on experiential perspectives relating to aging and the environment (Rowles 1978, 1983; Rubinstein and Parmelee 1992). These raised issues about the meanings associated with places such as the home and neighborhood. In contrast to earlier perspectives that focused mainly on the role of the objective, physical-spatial environment, research on place attachment addresses affective, cognitive, and behavioral ties that people develop with their physical surroundings, thereby transforming space into place (Peace et al. 2007; Wahl and Oswald 2010). More recent work has focused on the importance of neighborhood and community change for understanding the dynamics of aging in place. Such themes have been developed through, for example, work by Scharf et al. (2002, 2005) in deprived urban communities in England. The researchers took the concept of social exclusion—the extent of participation or no participation in mainstream institutions—to explore issues facing older people in deprived urban communities. The authors identified five forms of social exclusion relevant to the circumstances of older people living in inner-city areas: exclusion from material resources, social relations, civic activities, basic services, and neighborhood ties. Linking theoretical ideas about space and place with the concept of social exclusion, Scharf et al. (2005) suggested that attachment to the environment might be compromised or diminished by structural challenges affecting communities, these increasing the vulnerability of older people aging in place. This approach has been further developed with studies examining the impact of gentrification on aging populations living in urban environments (Ogg 2005; Phillipson 2007; Burns, Lavoie, and Rose 2012).

Community studies involving older people suggest that they may be especially affected by processes associated with social exclusion. Research suggests that older people derive a strong sense of emotional attachment from both their home and the surrounding community (Phillipson et al. 2001; Rowles and Chaudhury 2005; Buffel et al. 2013). Indeed, Rowles (1978: 200) suggests that selective intensification of feelings about spaces might represent a universal strategy employed by older people to facilitate maintaining a sense of identity within a changing environment. While this may be possible in relatively secure and stable neighborhoods, some residential settings impede the maintenance of identity in old age. The argument, which requires detailed empirical testing, is that this is much more likely in certain types of urban environments than in others or in rural areas. It may, for example, be especially the case in the zones of transition marked by a rapid turnover of people and buildings and in unpopular urban neighborhoods characterized by low housing demand and abandonment by all but the poorest and least mobile residents (Rogers and Power 2000; Newman 2003). Disadvantaged urban neighborhoods, and the people who reside in them, may also be prone to institutional iso-lation (Gans 1972) as services and agencies withdraw, resulting in restricted access to basic facilities such as grocery stores, telephones, and banking (Scharf et al. 2002).

Urban areas also host a growing number of first-generation migrants who experience especially acute problems of poverty and poor housing. The study by Scharf et al. (2002) found that almost eight out of ten older Somali migrants and nearly seven out of ten older people of Pakistani origin found it very difficult to manage on their current incomes. Many of them had to cut back on essentials, including food, and had to limit their social activities. Similarly, Becker (2003: 135) highlighted the precariousness of the living conditions of older migrants living in inner-city neighborhoods in Northern California. This study found that many older people belonging to minority ethnic groups lived in rooms without bathrooms or kitchens, and many others lived in overcrowded apartments. The neighborhoods in which they lived were areas with a long history of illegal activities such as drug dealing, prostitution, and gambling, these presenting challenges to create a sense of home in old age (see, further, Buffel et al. 2013).

High rates of crime in deprived neighborhoods may also contribute to feelings of insecurity in old age (Smith 2009; Livingston, Bailey, and Kearns 2010). The experience of crime and the perceived risk of criminal victimization may act as psychological barriers that deter older people from leaving their homes, especially after dark (Scharf et al. 2002). Evidence from the Belgian Aging Studies (De Donder et al. 2012) demonstrates that neighborhoods with poor physical environments and limited access to services also increase feelings of insecurity. Conversely, older people who enjoy living in their neighborhood and who influence the design of their neighborhood (e.g., through political participation) express fewer problems relating to lack of safety and security. Pain (2000: 365) makes the point here that fear of crime should be seen as inseparable from a range of social and economic problems concerned with housing, employment, environmental planning and social exclusion.

Critical Issues for Developing Age-Friendly Cities

Building on the review of the research literature, what are some of the main challenges to be faced in respect to building age-friendly environments? Several issues can be identified. First, as Golant (2014: 13) observes, it is important to ask whether communities have acquired the structural capacity—that is, resources and opportunities—to accommodate the needs and goals of their aging populations and to help improve their physical and psychological well-being. In fact, as already highlighted, many of the neighborhoods in which older people live may have been destabilized through global economic change. Where this is the case, interventions may be required that raise the level of resources within communities before age-friendly policies can begin to be implemented. Developing a related theme, Scharlach (2012: 28) observes that social policy and discourse regarding the needs of older persons pay little attention to quality of life, social integration, community participation, and other non-economic outcomes of helping elders to remain in familiar homes and neighborhoods. Reflecting on this, he argues for a shift from the traditional focus around aging in place to one of aging in community (see, further, Stafford 2009).

Second, greater attention needs to be given to the tension between the social needs associated with old age and the private ownership of public space. Logan and Molotch (cited in Zukin 2010) make the point here that city dwellers want to enjoy the use-values of their communities and homes, but developers are interested in maximizing exchange values—in making money. This disconnect has become especially important in the context of meeting the needs of groups—notably older people—for whom the neighborhood plays a central role in shaping the quality of daily life (Gardner 2011). Tonkiss (2005: 74) makes the point that the political economy of the city is not confined . . . to questions of who owns what, but with how this spatial economy is regulated in terms of access, exclusion and control.

Third, implementing the age-friendly approach may encounter obstacles arising from policies associated with economic austerity (Clark 2014). Here, there are significant pressures to reduce funding for the type of activities associated with the WHO model. Buffel et al. (2014) highlighted this in their assessment of age-friendly policies in Brussels and Manchester—both members of the WHO Global Network. In the case of the former, recessionary pressures meant that the council had been unable to increase public spending on community health and social care in line with increases in demand. A consensus had emerged that more investment was required to improve support to carers, as well as develop more flexible and culturally sensitive services in response to the challenges posed by increasing diversity in the older population. In the case of Manchester, plans to promote age-friendly neighborhoods have been affected by budget cuts that reduce public services such as libraries, information and advice centers, and day care facilities for groups such as older people. Threats to services may lead to a public perception that the age-friendly brand is unrealistic and unlikely to be implemented given restrictions on public