Age-friendly Cities And Communities Research Articles

FORGING A PATH TO DEVELOPING AGE-FRIENDLY CITIES AND COMMUNITIES IN GHANA: ISSUES AND RECOMMENDATIONS

Abstract The World Health Organization in 2007 launched the Age-friendly Cities and Communities (AFCC) initiative in an effort to make cities around the world more attuned to the needs of older adults. While AFCC initiatives have mostly been undertaken in developed societies around the world, developing countries appear to be excluded in this effort, as there is little to show for in the quest to creating AFCC. One of such countries is Ghana, where the proportion of older adults is expected to increase exponentially in the next decade, thereby heightening the need for AFCC. Utilizing a multiple case study approach, this paper synthesizes the procedures and findings of 16 case studies from around the world published on the eight domains of WHO’s Age-friendly Cities Framework, to make a case for developing AFCC in Ghana. Five important considerations were identified as fundamental to the effort to developing AFCC in Ghana: 1. Strengthening traditional views/perceptions on aging and older adults; 2. Involving key players in age-friendly efforts; 3. Responding to the complex interplay of needs and demands of older adults; 4. Designing policies and social programs to stimulate and enable cities and communities in Ghana to become age-friendly; 5. Developing validated instruments to assess the age-friendliness of cities and communities in Ghana. Designing and implementing AFCC require long-term commitment and devoting considerable resources to the cause. The paper concludes by discussing a culturally-appropriate model and policy recommendations to facilitate the move toward building age-friendly communities and age-inclusive cities in Ghana.

Can living in an age-friendly neighbourhood protect older adults’ mental health against functional decline in China?

Little is known about how and to what extent living in an age-friendly neighbourhood buffers the negative impact of older adults’ functional decline on their mental health in China. This longitudinal study advances our knowledge of the Age-Friendly Cities and Communities (AFCC) framework by unravelling the enabling and compensatory roles of age-friendly neighbourhoods from a cumulative perspective. Empirically, it examines the buffering effects of eight domains of neighbourhood environment on the relationship between functional abilities and depressive symptoms among older adults in Chinese rural and urban contexts, using data from the China Health and Retirement Longitudinal Study. Results of latent growth curve models indicate that living in an age-friendly neighbourhood environment significantly buffers the negative impacts of expected functional declines in the future. Enabling domains of neighbourhood environments play a stronger buffering role in the relationship between functional decline and depressive symptoms than compensatory domains. Cumulative effects of age-friendly neighbourhood environments reduce the rate at which depressive symptoms increase over time. It further investigates the differences between rural and urban environments in the enabling and compensatory roles of age-friendly neighbourhoods in combating geriatric depressive symptoms. Transportation and social participation are found to significantly reduce depressive symptoms in rural neighbourhoods, while infrastructure for communication and information is found to be related to rapid increase in depressive symptoms in urban neighbourhoods. Our findings inform policymakers about how to efficiently allocate public resources to improve mental health outcomes among older adults with functional decline in both rural and urban Chinese contexts.

Age-Friendly Community Interventions for Health and Social Outcomes: A Scoping Review.

To address the numerous challenges associated with aging, increased attention has been given to the development of age-friendly cities and communities (AFCC) to promote healthy aging and social participation. However, limited evidence exists for addressing both health and social needs through the AFCC framework. We address this gap by conducting a scoping review of the interventions that target both health and social outcomes within the purview of the AFCC framework. The results showed that many of the successful interventions used a partnership model and behavioral change theories to inform the program design and implementation. The results also indicated that social participation and engagement played a key role in making the interventions successful. However, the results revealed that the literature is dominated by person-focused approaches. Future research should focus more on evaluating environmental-focused interventions and develop a holistic framework that combines both person- and environment-based approaches to healthy aging.

TOWARD STRUCTURAL CHANGE: ADVANCING PRAXIS ON AGE-FRIENDLY CITIES AND COMMUNITIES

Abstract The global age-friendly cities and communities (AFCC) movement has inspired leaders across the public, private, and academic sectors to re-imagine how environments can better support long and healthy lives. There is growing recognition, however, of structural and other constraints that impede the translation of AFCC aspirations into systematic, comprehensive, impactful, and sustainable action. This paper will describe the importance of researchers’ engagement in AFCC praxis to better support the movement toward structural change for aging equity and healthy aging. The paper will present a case example of academic researchers’ long-standing involvement in collaborative efforts toward the development and sustainability of age-friendly community initiatives in New Jersey. The case will emphasize the importance of creating synergies across research, teaching, and service activities; cultivating coordinated AFCC efforts across the mico, meso, and macro levels; and developing sustainable structures for deliberate inter-organizational and multi-sectoral partnerships toward short- and long-term goals.

Challenge to promote a city that is friendly for the elderly: A joint research "The Ageing in Place in Cities" between Manchester Urban Ageing Research Group, the University of Manchester, UK and Advanced Research Center for Geriatric and Gerontology (ARGG), Akita University, Japan

In Japan, the ageing population is increasing, and the issue of "the declining birthrate and increasing ageing population", "population declining", and "extending healthy life expectancy" have been taken up in various academic fields, but they are still unsolved in the term of effective methods. Currently, in each region of Japan unlike big cities such as Tokyo and Osaka, there is the shortage of medical doctors, hospitals, living supportive infrastructure of roads, communications, public transportation, banks, post offices, and supermarkets, etc. All the necessary infrastructure is collapsing, and the current situation is becoming apparent in population declining villages of Japan. Will our country become more concentrated in big cities in the future? In particular, it is the elderly living in the community who are directly affected by these factors. In this article, we would like to introduce the history and recent activities of "Age-friendly cities and communities (AFCC)" led by the World Health Organization (WHO), and also introduce the efforts of "The Ageing in Place in Cities" project by Manchester Urban Ageing Research Group, the University of Manchester, UK, Akita City Hall, and Advanced Research Center for Geriatric and Gerontology (ARGG), Akita University, Japan.

Cross-National Perspectives on Aging and Place: Implications for Age-Friendly Cities and Communities.

The age-friendly cities and communities (AFCC) agenda has led to a range of policy initiatives aimed at supporting aging in place for older people. While there is case study evidence of how people age across urban contexts, there has been little research exploring cross-national understandings of age-friendly places among older people. The objective of this article is to identify the place experiences of older people living across cities and communities in India, Brazil, and the United Kingdom and to discuss implications for the AFCC agenda. A total of 300 semistructured interviews were undertaken with older people across 9 cities and 27 communities in India, Brazil, and the United Kingdom. The data were analyzed using thematic analysis undertaken by each national team and then discussed and revised at collaborative workshops with researchers from each of the 3 country teams. The data capture the ways in which place is constructed from the perspective of older people drawing upon social, community, and cultural dimensions of aging across diverse urban environments. We explore how older people negotiate place in the context of their everyday life and identify the relational and interconnected ways in which place attachment, belonging, and identity are constructed. Age-friendly interventions need to attend to the changing physical, social and cultural dimensions of aging and place. Integrated place-making practices are required to support older people to age in the right place across rapidly transforming urban contexts globally.

Achieving Sustainable Urban Development with an Ageing Population: An “Age-Friendly City and Community” Approach

The ageing population tends to be seen as a burden of cities’ future development. Thus, the public funds for older residents’ wellbeing are at risk of being cut back under the economic austerity due to the prevalent neoliberalism policy atmosphere. However, some cities set good examples to turn their older citizens into active contributors to sustainable urban development (SUD) by developing age-friendly cities and communities (AFCC). Taking Hong Kong as an example, this study aims to raise a strategy for policymakers, especially at the municipal level, to incorporate the concept of AFCC in SUD. Data were retrieved for our analysis from a published report of the Hong Kong Public Policy Research Fund project. A total of 15 AFCC and SUD policy factors were identified by using factor analysis. The correlations between these policy factors were evaluated and visualised in a synergetic effect network. According to the network, this study indicates that developing the silver hair market can be a suitable entry point to realise SUD by adopting an AFCC development. Isolation prevention, social sustainability and low-energy-consumption development are the supportive policy factors for the silver hair market. Specifically, respect, discrimination prevention, communication and information, age-friendly facilities, environmental safety and public transportation accessibility are five AFCC policy factors incorporated in the policy integration to enhance older residents’ wellbeing further. This study is an innovative attempt to develop a comprehensive model for the synergy between sustainable urban development and an age-friendly city and community using a correlation network. This study also provides a reference for other city governments to respond to population ageing positively.

Exploring the Sustainability of Age-Friendly Initiatives in a Canadian Province.

Based on the World Health Organization Age-Friendly Cities and Communities (AFCC) framework, the government of Manitoba, Canada, launched a province-wide age-friendly initiative in 2008. The objective of this study was to explore the sustainability of the AFCC initiative more than a decade later. The study was guided by conceptualizations of sustainability as multidimensional and dynamic, composed of 4 aspects (continued capacity, institutionalization, continued benefits, and development/adaptation), and an ecologic perspective that highlights the importance of contextual influences, and their change over time, on AFCC activities. The study involved a qualitative, multiple case study design. Semistructured interviews were conducted in 2020 with a key informant from each of 52 AFCC. Interview data were analyzed deductively, guided by the sustainability framework and an ecologic perspective. Census data were used to describe the demographic characteristics of AFCC. We identified 6 groups of AFCC initiatives that varied in degree from the most to the least sustainable: active, in hiatus, reorganized, stalled, discontinued, and never got off the ground. Both local community factors (e.g., lack of capacity) and broader contextual factors, such as demographic changes and provincial legislations, influenced initiatives' sustainability. AFCC initiatives can range in their degree of sustainability and can wax or wane over time. Ongoing external support for AFCC (e.g., from provincial or state government) to promote the vision of age-friendliness and to address lack of capacity (e.g., to assist with community assessments) could help with the long-term sustainability of initiatives.

The Impacts of the Neighborhood Built Environment on Social Capital for Middle-Aged and Elderly Koreans

The purpose of this study was to investigate the relationship between the neighborhood built environment (NBE) aspects of age-friendly cities and communities (AFCCs) and social capital in the Korean context. We described and compared age differences when analyzing misfits of AFCC NBE and impacts on social capital. We collected the data (N = 1246) from two Korean communities; our multiple and binary logistic regression outcomes show that AFCC NBE aspects such as outdoor spaces, transportation, and housing are significant predictors of different subcategories of social capital. For the older group, the outdoor spaces misfit was significant for all three subcategories of social capital, but transportation and housing misfits were significant for the social trust and reciprocity index scores. For the middle-aged group, the outdoor spaces misfit was significant for social networking and participation, and a transportation misfit was significant for participation and social trust and reciprocity. Fewer misfits or better fits of outdoor spaces and transportation encouraged more networking, participation, social trust, and reciprocity. Dwelling type was important to predict social capital, especially for the older group. The present study confirmed the importance of AFCC NBE in predicting social capital and unique factors in the Korean context.

The Effect of Neighborhood Experiences on Positive Mental Health Among Community-Dwelling Older Adults

Given reduced life spaces, the neighborhood often functions as a social venue for older adults. Yet how these everyday social spaces affect older adults’ psychosocial wellbeing remains largely unknown. Drawing on the GRP-CARE Survey data, this paper examined the relation between neighborhood experiences and positive mental health. Participants were 601 community-dwelling Singaporeans aged 50+ who lived in public housing neighborhoods. Neighborhood experiences were measured using the four-factorial, 16-item OpenX scale (Gan, Fung, Cho, 2019); positive mental health was measured using a six-factorial, 19-item scale (Vaingankar et al., 2011). Both scales have good psychometric properties and had been validated. Path analysis between relevant factors of both scales was conducted using Stata, within a theorized model of causation from neighborhood environment to social factors to psychosocial health. Age, education, ethnicity and sex were controlled for. Multiple linear regression analysis showed a strong, positive association between neighborhood experiences and mental health (p=0.000) even after controlling for personal traits (operationalized as depressive symptoms, GDS) in addition to sociodemographic variables. Path analysis showed that two distinct neighborhood health processes mediated this association. These were (1) the potential for a sense of community in the neighborhood improved emotional support, and (2) having better neighborly friendships improved interpersonal skills. These neighborhood health processes provide us with new lenses to understand older adults’ everyday experiences of their neighborhoods. Community-based interventions to improve older adults’ psychosocial wellbeing may be developed to facilitate these processes. Spatial and programmatic implications will be discussed in relation to age-friendly cities and communities (AFCC).

Prisons, Older People, and Age-Friendly Cities and Communities: Towards an Inclusive Approach.

This original and ground-breaking interdisciplinary article brings together perspectives from gerontology, criminology, penology, and social policy to explore critically the nature and consequences of the lack of visibility of prisons, prisoners, and ex-prisoners within global research, policy and practice on age-friendly cities and communities (AFCC), at a time when increasing numbers of people are ageing in prison settings in many countries. In addition, the COVID-19 pandemic continues to pose challenges in the contexts both of older peoples’ lives, wellbeing, and health, and also within prison settings, and thus it is timely to reflect on the links between older people, prisons, and cities, at a time of ongoing change. Just as there is an extensive body of ongoing research exploring age-friendly cities and communities, there is extensive published research on older people’s experiences of imprisonment, and a growing body of research on ageing in the prison setting. However, these two research and policy fields have evolved largely independently and separately, leading to a lack of visibility of prisons and prisoners within AFCC research and policy and, similarly, the omission of consideration of the relevance of AFCC research and policy to older prisoners and ex-prisoners. Existing checklists and tools for assessing and measuring the age-friendliness of cities and communities may be of limited relevance in the context of prisons and prisoners. This article identifies the potential for integration and for cross-disciplinary research in this context, concluding with recommendations for developing inclusive research, policies, and evaluation frameworks which recognise and include prisons and older prisoners, both during and after incarceration.

Environmental and Psychosocial Interventions in Age-Friendly Communities and Active Ageing: A Systematic Review.

Background: The academic literature contains little information regarding the interventions that create age-friendly cities and communities in order to promote active ageing. Objectives: A systematic review was carried out to determine the available empirical evidence in relation to the characteristics, content and effectiveness of interventions aimed at improving environmental and psychosocial risk factors for older people, from the perspective of age-friendly communities and the promotion of active ageing. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, the studies retained in this review were identified through a systematic search of the academic literature in selected electronic databases including Web of Science and Scopus. Independent critical appraisal and data extraction were conducted by two reviewers. The checklist was used to assess the quality of the articles. Findings: The search identified 1020 potentially eligible documents, of which 11 satisfied the established criteria. Non-exhaustive practices prevailed over rigorous investigations, with a high proportion of studies observed to be of low methodological quality and at high risk of bias. This reflected the predominance of uncontrolled interventions. Environmental interventions were focused on reducing risk and adapting the everyday environmental setting, while psychosocial interventions prioritised social strategies (behavioural changes, promotion of participation) and training. Interventions were more effective in certain domains of age-friendly cities and communities such as transportation and housing, followed by increased participation as a lifestyle-related behavioural change. The inferred changes were associated with providing information and enhancing skills; modifying access, barriers, exposures, and opportunities; enhancing services and support; continuity and effectiveness of changes over time; and modifying policies based on the bottom-up approach of age-friendly cities and communities (AFCC). Discussion and conclusion: Interventions focused on personal and organisational aspects might have positive effects in the longer term. However, fewer changes would be observed in interventions revolving around changing lifestyles owing to the impact of complex multi-causal factors. The relative effectiveness in terms of health calls into question the design of interventions and the supposed “friendliness” of certain communities. There is a need to encourage sound longitudinal research aimed at providing key knowledge for the implementation and evaluation of public policies, and to encourage age-friendly community programmes to promote active ageing.

Neoliberal rationality and the age friendly cities and communities program: Reflections on the Toronto case

This article examines how neoliberalism works through the Age Friendly Cities and Communities (AFCCs) program through reflections on the Toronto case. While AFCCs appear to expand the social contract between senior citizens and the state, research illustrates discrepancies between program aims and implementation, relating gaps to cost cutting associated with neoliberal austerity. Drawing on Brown's (2015) work, I posit instead that neoliberalism does not just affect the implementation of AFCCs through economic policies of austerity but operates as a governing rationality that can economize the very design of the program. Specifically, I examine how the neoliberal techniques of benchmarking, governance, devolution and responsibilization operate through the AFCC program in Toronto. This analysis offers insight into the problems that plague AFCCs in Toronto and more broadly, including how neoliberalism works to more fundamentally change the social contract. At the same time, this analysis highlights tensions, forms of discontent and even dissent with neoliberalism that can create openings for alternative governing rationalities that expand the social contract to take root.

How Can the Lived Environment Support Healthy Ageing? A Spatial Indicators Framework for the Assessment of Age-Friendly Communities.

The Age-Friendly Cities and Communities Guide was released by the World Health Organization over a decade ago with the aim of creating environments that support healthy ageing. The comprehensive framework includes the domains of outdoor spaces and buildings, transportation, housing, social participation, respect and inclusion, civic participation and employment, communication and information, and community and health services. A major critique of the age-friendly community movement has argued for a more clearly defined scope of actions, the need to measure or quantify results and increase the connections to policy and funding levers. This paper provides a quantifiable spatial indicators framework to assess local lived environments according to each Age-Friendly Cities and Communities (AFC) domain. The selection of these AFC spatial indicators can be applied within local neighbourhoods, census tracts, suburbs, municipalities, or cities with minimal resource requirements other than applied spatial analysis, which addresses past critiques of the Age-Friendly Community movement. The framework has great potential for applications within local, national, and international policy and planning contexts in the future.

AGEING IN AN UNEQUAL WORLD: IMPLICATIONS FOR AGE-FRIENDLY CITIES AND COMMUNITIES

The World Health Organisation (WHO) Age-Friendly Cities and Communities (AFC) agenda has become a key policy driver for delivering urban environments that support older people to age in place. The movement has led to positive interventions at a city and community level alongside evidence of effective partnership working. Despite this, there are challenges in terms of how best to address widening societal inequalities in old age, where access to the resources and supports to age well are often compromised.The aim of this paper is to explore the implications of these inequalities on the agefriendly cities and communities agenda with specific reference to the challenges and opportunities to ageing in place. In doing so we reflect on different forms of inequality that impact older people (spatial, social and political), and the role of intersectionality in understanding the multiple forms of disadvantage that impact the ageing process.We draw out some specific recommendations for moving forward with the AFC agenda which are important if coordinated approaches to addressing ageing in place are to be achieved: challenging ageing inequalities and place; supporting rights within the context of ageing and the city; co-production and AFC; and integrated working and AFC. Addressing these key areas are integral to ensuring that the supports are in place at a city and community level to provide the opportunities and structures to support older people to age in place.Keywords: ageing in place, age-friendly cities and communities, inequality, place, intersectionality.

Age-Friendly Approaches and Old-Age Exclusion: A Cross-City Analysis

Developing ‘Age-Friendly Cities and Communities (AFCC)’ has become a key part of policies aimed at improving the quality of life of older people in urban areas. Despite this development, there is evidence of rising inequalities among urban elders, and little known about the potential and limitations of the age-friendly model to reduce old-age exclusion. This article addresses this research gap by comparing how Brussels, Dublin, and Manchester, as three members of the Global Network of AFCC, have responded to social exclusion in later life. The article combines data from document analysis and stakeholder interviews to examine: first, the age-friendly approach and the goal of reducing social exclusion; and second, barriers to developing age-friendly policies as a means of addressing exclusion. The paper suggests that there are reciprocal benefits in linking age-friendly and social exclusion agendas for producing new ways of combatting unequal experiences of ageing in cities.

Emerging evolution trends of studies on age-friendly cities and communities: a scientometric review

AbstractPopulation ageing, together with urbanisation, has become one of the greatest challenges throughout the world in the 21st century. Approximately one million people turn 60 each month worldwide. By 2050, more than 20 per cent of the global population is predicted to be 60 years old or above. Thus, an increasing need is evident for age-friendly communities, services and structures. Numerous studies on age-friendly cities and communities (AFCCs) have been conducted over the past decade. The large volume literature makes it necessary to figure out key areas and the evolution trends of studies on AFCCs. Therefore, this paper aims to provide a comprehensive review of existing literature pertaining to AFCCs. A total of 231 collected publications are analysed and visualised by CiteSpace. According to the keywords and document co-citation networks that are generated, the foundation, hot topics and domains of AFCC research are grouped. Three major themes, namely the characteristics of AFCCs, the application of the World Health Organization's framework in urban and rural areas worldwide, and the measurement of cities’ and communities’ age-friendliness, are identified. In addition, a roadmap of AFCC research is developed. The results of this research will therefore benefit researchers and practitioners.

Age-friendly cities and communities: a review and future directions

AbstractThe unprecedented increase in the ageing population, coupled with urbanisation, has led to a vast number of research publications on age-friendly cities and communities (AFCC). However, the existing reviews on AFCC studies are not sufficiently up-to-date for AFCC researchers. This paper presents a thorough analysis of the annual publication trend, the contributions of authors and institutions from different countries, and the trending research themes in the AFCC research corpus through a systematic review of 98 publications. A contribution assessment formula and thematic analysis were used for the review. The results indicated a growing AFCC research interest in recent times. Researchers and institutions from the United States of America, Canada, United Kingdom and Hong Kong made the highest contribution to the AFCC research corpus. The thematic analysis classified the AFCC research corpus into four main themes: conceptualisation; implementation and development; assessment; and challenges and opportunities. The themes indicate the current and future research patterns and issues to be considered in the development of AFCC and for interested researchers to make proposals for future research. Future directions are proposed, including suggestions on adopting new assessment methods and instruments, collaboration and cross-nation comparative research, considering older adults as place-makers and conducting a prior participatory analysis to maximise the participation of older adults.

Why and How Have Korean Cities Embraced the World Health Organization’s Age-Friendly Cities and Communities Model?

ABSTRACT This study examined forces leading Korean cities to join the WHO Global Network of Age-Friendly Cities and Communities (AFCC) and implement the WHO guidelines, from the perspectives of multiple streams theory and policy transfer theory. We conducted interviews with stakeholders from six member cities and identified relevant themes using directed content analysis. Political motivation was the strongest factor in seeking Network membership, but the lack of political motivations after gaining membership resulted in lackluster local implementation efforts. The national capital cities may need to take a stronger leadership role to encourage the expansion of the WHO AFCC Network in Asia.

Benches as Materialisations of (Active) Ageing in Public Space: First Steps towards a Praxeology of Space

In its promotion of “active ageing” through Age-Friendly Cities and Communities (AFCC) and the Global Network on AgeFriendly Cities and Communities (GNAFCC), the World Health Organization has developed a vision of ageing that links socio-spatial environments to personal lifestyles and community support. Approaching age-friendly environments from a “doing” perspective shifts our focus from such ideals to social practices, materialisations, and representations produced. Regularly referred to in AFCC discourse, public benches offer a great illustration for such materialisations. This article asks: what do benches tell us about the way ageing is framed and shaped in the AFCC discourse? How do benches themselves exhibit agency in it? Theoretically based on Lefebvrian social theory and critical gerontology, our reflexive article explores promotional/policy documents supporting AFCC worldwide, “good practices” shared by GNAFCC, and a series of European field observations around AFCC and benches and, finally, personal observations of ageing in public space around benches. Drawing on the Lefebvrian differentiation between representational benches, representations of benches, and social practices of benches, we show how benches can be considered as a socio-technical “assemblage” able to: 1) forge ambivalent representations and solutions for “active ageing” in public space, 2) illustrate, beyond the symbolic of space, the symbolic difficulties of “real” participative and multi-stakeholders governance promoted through “age-friendliness”, and 3) explore everyday life practices of “spatial expulsion” of “ageing in public space” for older adults. In conclusion, we suggest a major shift for the AFCC program by finding inspiration in African practices of “ageing in public space”.