Two trends are converging -- urbanization and aging. Significant investments are being made to make cities sustainable, less congested, competitive, even smarter. While laudable goals, cities are complex socio-technical systems that are designed to support people, their activities (economic as well as social) and ultimately quality of life. Today Americans over 65-years-old comprise 13 percent of the population. In a few short years one in five people will be over 65 with many aging-in-place in the city while others will 'retire' to urban enclaves putting new demands on the metropolitan physical, service and social infrastructure. How well are cities and their leaders anticipating the new needs of an aging society?
This question is not new. Worldwide there are discussions of achieving 'livable communities,' 'age-friendly cities' and other kinder and gentler approaches to aging and urban living. However, aging and the city can no longer be defined as only an issue that is 'good' to do. The rapid aging of the population calls for action and urgency. Responding to 'needs' that are evolving into 'demands' is an issue of pure politics. Does anyone believe that the next generation of 'old' comprised of the largest and loudest generation -- the baby boomers -- will be as polite and patient as their parents?
Mayors and other urban leaders must reframe the question of how 'friendly' their city is to older residents to is my city implementing age-ready plans, policies and investments today to respond to the certainty of demographic change and related demands tomorrow?
Here are three dimensions that urban leaders should use to assess their state of age-readiness:
Physical accessibility to transportation and public facilities has garnered the most attention from policymakers. The Americans with Disabilities Act has certainly improved accessibility, however, regulations generally make access to transit and public facilities possible but not necessarily easy. Age-readiness is about managing 'friction'. The 'friction' of travel or accessing a building can limit the desire to travel or engage even if physical access is possible. Truly accessible transport includes system schedules and destinations desired by older people. Public buildings are age-ready when they are accessible and provide signage and information to ease navigation. Moreover, public spaces, such as parks, must be perceived as safe enough to walk, exercise and play. Easy and seamless access as well as use should be the goal addressing the needs of older adults and improving the quality of life of everyone at every age.
Current public services for older people are generally underfunded or underprepared for the diversity of future demands. Private providers are nascent and many non-profits are fragmented. New partnerships must emerge to develop new services and build service delivery capacity.
Few of today's 'senior centers,' for example, are likely to meet the onslaught of needs let alone expectations of the new urban old. What types of home services will be necessary to assist an aging population where 30 percent of couples over 60-years-old live alone -- or where 40 percent of older women live solo. Are emergency services and local hospital trauma units prepared for the unique medical challenges associated with an older adult who has fallen or been in a traffic accident (e.g., multiple chronic conditions, countless medications)?
Age-readiness will require that city leaders leverage the creative synergy that puts Starbucks under the roof of Barnes & Noble Booksellers to rethink community centers and adult day care. How might Walgreens' foray into home health services become a basis for partnership with visiting nurses and community health services to improve access to care while driving foot traffic to the store? Can the senior housing industry evolve from viewing their business as being solely within their walls to becoming a platform of services that extends into the community providing expanded service capacity while building a pipeline to their properties for those who may eventually choose or need their care?
Healthy aging is engaged living -- a person has to have a reason to get up in the morning. Likewise, a robust social network is critical to quality living. Cities, by definition, provide population density, but being close to your neighbor does not necessarily mean you know them.
The range and richness of work, volunteer and social opportunities for older people is a key success factor for the age-ready city. No single institution, public or private, will be capable of providing adequate engagement. Employers will need incentives to encourage full and part-time employment. Non-profits and religious organizations will be critical to providing volunteer as well as social opportunities. Moreover, many older adults may provide the human capital to deliver meals, provide care and alternative transportation.
There are countless committees and commissions addressing age and the city. Metrics of 'livabilty' and cross-national case studies are being developed. Papers are being written and symposiums are being held. Despite the richness of discussion, decision-makers must ask if there are investments being made today. Changes to infrastructure, novel institutional arrangements and expanded services will take time to develop and implement to respond to an older population with unprecedented cultural and income diversity. In the United States one of the estimated 77 million baby boomers are turning 67 every 7 to 8 seconds. We can no longer be just friendly, it is time to be ready. Tick-tock, tick-tock urban policymakers, business innovators and NGO leaders -- is your city age-ready?
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