In 2007, the World Health Organization (WHO) released Global Age-Friendly Cities: A Guide, which identifies eight aspects, or ‘dimensions’, of community life that overlap and interact to directly affect older adultsfootnote 12:

  1. Outdoor Spaces and Public Buildings
  2. Transportation
  3. Housing
  4. Social Participation
  5. Respect and Social Inclusion
  6. Civic Participation and Employment
  7. Communication and Information
  8. Community Support and Health Services

Discussions of age-friendliness commonly refer to the eight dimensions, and this guide recognizes the work that the WHO and other organizations (such as the American Association of Retired Persons’ [AARP] Livable Communities: An Evaluation Guide) have accomplished for age-friendly city planning.footnote 13

Outdoor Spaces and Public Buildings

The outside environment and public buildings have a major impact on the mobility, independence and quality of life of older people and affect their ability to ‘age in place.’ … The recurring themes in cities around the world are quality of life, access and safety. (WHO, Global Age-friendly Cities: A Guide, 2007: 12)

An accessible community is one where people of all abilities, including older adults, have the opportunity to participate in everyday life fully and in safety. Accessibility includes:

Indoor and outdoor spaces, both publicly and privately owned, that an individual might use as part of their daily activities, such as streetscapes, parks, grocery stores and pharmacies;

The removal of barriers that limit opportunities for individuals with disabilities to participate actively in society or to access vital health and social services.

Accessibility requires a much broader shift in awareness and attitudes and extends to questions of safety and perceptions of safety. How safe older adults feel in their communities can affect almost every aspect of their daily lives. A neighbourhood that people consider unsafe does not encourage outdoor activities or engagement with the community, limiting opportunities for physical fitness and social participation. Crime, traffic, noise and poor lighting are all safety factors, as well as social issues such as the extent of social interaction and mutual respect among citizens living in a neighbourhood. Improved community connections and awareness can enhance safety and security.

Transportation

Transportation, including accessible and affordable public transport, is a key factor influencing active aging. … in particular, being able to move about the city determines social and civic participation and access to community and health services. (WHO, Global Age-friendly Cities: A Guide, 2007: 20)

Personal mobility and transportation options determine an older adult’s mobility. Personal mobility is directly influenced by:

  • Physical and mental health status
  • Access to personal transportation
  • Proximity to important amenities.

Mobility is also indirectly affected by:

  • Perceptions of safety
  • Awareness of alternative transportation options.

At a community scale, mobility is affected by:

  • Quality and design of transportation infrastructure such as signage, traffic lights and sidewalks;
  • Access to reliable, affordable public transit; this is increasingly important when driving may become stressful or prohibitive.

Housing

Not surprisingly, people consulted by WHO in all regions have much to say on different aspects of housing structure, design, location and choice. There is a link between appropriate housing and access to community and social services in influencing the independence and quality of life of older people. (WHO, Global Age-friendly Cities: A Guide, 2007: 30)

For many older adults, aging at home is desirable. Appropriate housing models offer:

  • A diversity of prices, styles and locations;
  • Proximity to services;
  • Universal design principles that stress flexibility and adaptability to support different levels of need;
  • Modification programs for those residents who wish to remain in a home that is not suited to their future needs.

Social Participation

Participating in leisure, social, cultural and spiritual activities in the community, as well as with the family, allows older people to continue to exercise their competence, to enjoy respect and esteem, and to maintain or establish supportive and caring relationships. It fosters social integration and is the key to staying informed. … the capacity to participate in formal and informal social life depends not only on the offer of activities, but also on having adequate access to transportation and facilities and getting information about activities. (WHO, Global Age-friendly Cities: A Guide, 2007: 38)

Social participation and personal relationships are distinct but integrally linked concepts that significantly affect an older adult’s ability to age in place. Social participation is an important contributor to positive mental health and community awareness, and it involves:

  • The level of interaction that older adults have with other members of their community.
  • The extent to which the community itself makes this interaction possible.

Both social participation and personal relationships are integral to prevent isolation, and the satisfaction one derives from these encounters measures an individual’s health and well-being. The strength of personal ties (rather than the number of casual interactions that someone has experienced) is central to measuring personal relationships.

Respect and Social Inclusion

Older people report experiencing conflicting types of behavior and attitudes toward them. On the one hand, many feel they are often respected, recognized and included, while on the other, they experience lack of consideration in the community, in services and in the family. … The extent to which older people participate in the social, civic and economic life of the city is also closely linked to their experience of inclusion. (WHO, Global Age-friendly Cities: A Guide, 2007: 45)

Community attitudes, such as a general feeling of respect and recognizing the role that older adults play in our society, are critical factors for establishing an age-friendly community. Our shared attitudes toward aging can create significant social norms that may limit older adults’ capacity to achieve personal goals and maintain independence. Building positive community attitudes involves fostering positive images of aging and intergenerational understanding. It also requires you to recognize that older adults, as a broad demographic, share common experiences, but their experiences may also diverge in many ways. Our aging population encompasses several decades and demonstrates incredible diversity in terms of culture and ethnicity, sexual orientation, health and disability, education and socio-economic status, citizenship and immigration status, marital and family status, and other characteristics.

Civic Participation and Employment

Older people do not stop contributing to their communities upon retirement. Many continue to provide unpaid and voluntary work for their families and communities. In some areas, economic circumstances force older people to take paid work long after they should have retired. An age-friendly community provides options for older people to continue to contribute to their communities. (WHO, Global Age-friendly Cities: A Guide, 2007: 51)

Older adults possess a wealth of knowledge and experience that is invaluable to community planning. Civic engagement includes older adults’ desire to be involved in aspects of the community beyond their normal daily lives, such as volunteering, becoming politically active, voting or contributing to local councils. Giving older adults a meaningful role in community development, providing opportunities for lifelong learning or helping to create interesting volunteer opportunities are all critical factors for measuring civic engagement.

Personal income and affordability influence almost every area of daily life. Remaining engaged in the workforce produces obvious economic benefits and security for the individual. It also benefits employers who recognize the advantages of engaging the experienced older workforce. Achieving economic security creates opportunities for older adults to stay engaged in communities through support of local businesses or participation in programs and events.

Communication and Information

Staying connected with events and people and getting timely, practical information to manage life and personal needs is vital for active aging. … Yet the fear of missing information and of being left out of the mainstream is voiced almost everywhere. Rapidly evolving information and communication technologies are both welcomed as useful tools and criticized as instruments of social exclusion. … the central concern expressed in the focus groups is to have relevant information that is readily accessible to older people with varying capacities and resources. (WHO, Global Age-friendly Cities: A Guide, 2007: 60)

Age-friendly communities ensure that information about community events or important services is both readily accessible and communicated or delivered in formats that are appropriate and available to older adults. New communications technologies can increase access to important information about ongoing or required local initiatives to improve the daily lives of older adults. Age-friendly communities recognize the diversity within the older adult population and promote outreach initiatives to non-traditional families, people from a range of ethnocultural backgrounds, newcomers and aboriginal communities.

Community Support and Health Services

Health and support services are vital to maintaining health and independence in the community. Many of the concerns raised by older people, caregivers and service providers in the focus groups deal with the availability of sufficient good quality, appropriate and accessible care. (WHO, Global Age-friendly Cities: A Guide, 2007: 66)

Good mental and physical health is essential to quality of life and age-friendliness. Physical health includes the current state and self-awareness of an individual’s general physical well-being, nutritional status and the presence or absence of chronic and acute conditions. Mental health involves the status of older adults’ cognitive functioning, such as memory, and elements of emotional health, such as the presence or absence of feelings like confidence and self-worth or anxiety and depression. All of these factors are key determinants of one’s ability to socialize and engage in civic activities.

The health dimension also considers access to community-related services that support physical or mental well-being, and the presence or absence of health promotion or awareness initiatives aimed at creating healthy behaviours and life choices.

Haliburton County’s Age-friendly Community Experience

Making Changes One Step at a Time

What has Haliburton done?

Haliburton County is a rural community north of Toronto where older adults aged 65+ make up 28% of the population (approximately 4, 755 people). In 2007, the Haliburton, Kawartha, Pine Ridge District Health Unit and the Haliburton Highlands Family Health Team partnered to provide education, awareness and activity sessions to seniors on falls prevention. Through a county-wide survey, focus groups, and in-depth interviews, the Committee created a list of priorities for action in four areas: accessibility, housing, transportation and communications. The committee has had success in bringing about change in all four areas:

Accessibility:

  • Bench installments in public spaces
  • Arm chairs in community centers
  • More use of handrails by local businesses
  • Advice on streetscape planning
  • Support for winter snow removal on sidewalks

Housing:

  • Housing information sessions, forums and research to create a county housing strategy

Transportation:

  • Developing transportation strategies for the county

Communications:

  • Creating a more positive image of seniors, and raising older adults’ issues in radio, newspapers and other media

How did Haliburton get there?

A local Aging Well Committee was formed in 2008 to mobilize the community to be more flexible and responsive to the needs of its aging population. The committee based its vision of an Age-Friendly Community on the World Health Organization Guide for Age-Friendly Cities and Communities, along with local initiatives to plan for and promote active transportation as a way to create a healthy, active community.

2007: Falls Prevention education sessions and initiatives

2008: Goal of creating an Age-Friendly Halliburton County established

2009: Received $25,000 in funding from the New Horizons for Seniors Program

2010 – Present: Continue to work on age-friendly communities plan

What are Haliburton’s next steps?

The Committee continues to move forward to create a healthy, active, age-friendly community, by advocating for the necessary changes to prepare for the aging population. Work will continue through community consultation to provide input into future recommendations and creating and distributing a final report.

To learn from other community experiences, visit http://healthy.uwaterloo.ca/~afc/community_stories.html


Footnotes

  • footnote[12] Back to paragraph World Health Organization. (2007). Global Age-Friendly Cities: A Guide. Geneva: WHO.
  • footnote[13] Back to paragraph Kihl, M., Brennan, D., Gabhawala, N., List, J., and Mittal, P. (2005). Livable Communities: An Evaluation Guide. Washington, DC: AARP.