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Developing Age-Friendly Cities and Communities in Australia


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The aim of the study is to present case studies and assess the impact of political, policy, consultative, and research processes used to implement Age Friendly Cities (AFC) initiatives in Australia. A review and interpretation was conducted based on public documents, community consultations, survey analyses, and participant observation. Governments in Australia have drawn on World Health Organization (WHO) concepts to establish AFC initiatives. In Melbourne, state political leadership established Positive Ageing plans that have reinforced local government actions. In Canberra, a baseline survey and an Older Persons Assembly were followed by modest positive ageing plans. In Sydney, a State Ageing Strategy developed a whole-of-government plan that has yet to be incorporated into budget processes. AFC initiatives in Australia have had promising and varied starts with some aims to benefit disadvantaged older people. Notwithstanding the potential benefits, AFC influence on mainstream actions of government has been limited by uncertain political commitment and growing fiscal austerity. © The Author(s) 2014.
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Journal of Aging and Health
2014, Vol. 26(8) 1390 –1414
© The Author(s) 2014
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DOI: 10.1177/0898264314532687
Developing Age-Friendly
Cities and Communities
in Australia
Hal Kendig, PhD1,2, Anne-Marie Elias, MA3,
Peter Matwijiw, MA4,5, and Kaarin Anstey, PhD1,2
Objective: The aim of the study is to present case studies and assess
the impact of political, policy, consultative, and research processes used
to implement Age Friendly Cities (AFC) initiatives in Australia. Method:
A review and interpretation was conducted based on public documents,
community consultations, survey analyses, and participant observation.
Results: Governments in Australia have drawn on World Health
Organization (WHO) concepts to establish AFC initiatives. In Melbourne,
state political leadership established Positive Ageing plans that have
reinforced local government actions. In Canberra, a baseline survey and an
Older Persons Assembly were followed by modest positive ageing plans.
In Sydney, a State Ageing Strategy developed a whole-of-government plan
that has yet to be incorporated into budget processes. Discussion: AFC
initiatives in Australia have had promising and varied starts with some aims to
benefit disadvantaged older people. Notwithstanding the potential benefits,
AFC influence on mainstream actions of government has been limited by
uncertain political commitment and growing fiscal austerity.
1The Australian National University, Canberra, Australia
2ARC Centre of Excellence in Population Ageing Research (CEPAR)
3New South Wales Government, Ashfield, Australia
4ACT Government, Canberra, Australia
5University of the Sunshine Coast, Canberra, Australia
Corresponding Author:
Hal Kendig, PhD, Professor of Ageing and Public Policy, Centre for Research on Ageing,
Health, and Wellbeing (CRAHW), College of Medicine, Biology and Environment, The
Australian National University, Bldg. 62A Eggleston Rd., Canberra, Australia.
532687JAHXXX10.1177/0898264314532687Journal of Aging and HealthKendig et al.
Kendig et al. 1391
age friendly, Canberra, Sydney, Melbourne, WHO
Developing Age-Friendly Communities in Australia
The World Health Organization’s (WHO; 2007) Global Network of Age
Friendly Cities (AFC) recognizes that local areas and communities can have
a major bearing on the health and well-being of older people. It builds on
initial applied research designed to give voice to older people’s own priorities
and stimulate action that can enable active ageing defined as “the process for
optimizing opportunities for health, participation, and security in order to
enhance quality of life as people age” (WHO, 2002). In 2007, the WHO iden-
tified eight areas of urban living that could make a community “age friendly.”
These are outdoor spaces and buildings, transportation, housing, social par-
ticipation, respect and social inclusion, civic participation and employment,
communication and information, and community support and health services.
More recently, the initiative has incorporated additional concepts such as life-
long learning and sustainability. The AFC Guide (WHO, 2007) aims to stim-
ulate a “bottom-up participatory approach” for assessing needs and
opportunities for advocacy, community development, and policy improve-
ments in a variety of locales.
The Global Network of AFCs was established in 2010 and it has applied
the AFC concepts to stimulate engagement between cities wishing to become
better places for older people (WHO, 2013). An Age Friendly checklist of
actions was produced to facilitate evidence-based processes of “continual
improvement.” A first Planning Stage of 1 to 2 years includes involving older
people, conducting a baseline assessment of age-friendliness, and developing
a 3-year action plan with indicators by which to monitor progress. Further
stages focus on Implementation (3-5 years), Progress Evaluation, and
Continual Improvement including information-sharing across the global
AFC Network. Cities that agree to implement the program can become part
of the Global Network and share information. The AFC designation is renew-
able after 3 years, subject to demonstrable progress. Over recent years, WHO
has welcomed a broader range of approaches and encouraging innovation
among members of the Network.
As of October 2013, the WHO Age Friendly City and Communities
Network had 145 members across 22 countries. Australian participation
includes the cities of Boroondara and Warnambul in the State of Victoria,
Canberra in the Australian Capital Territory (ACT), Melville in Western
Australia, and Unley in South Australia.
1392 Journal of Aging and Health 26(8)
International and Australian Literature
There is a small but growing literature on the development of the AFC
approach. Plouffe and Kalache (2010) summarized the collaborative research
effort across 33 countries—including focus groups with older people, care-
givers, and service providers—by which WHO ascertained features of AFC.
No systematic differences were found in the identified themes between
developed and developing countries, although developed countries generally
reported more positively. Beard and Petitot (2010) reviewed theoretical mod-
els and international evidence finding that features of the neighborhood
including socio-economic status are consistently associated with a wide
range of health and well-being indicators. They suggest plausible directions
for interventions in the social and physical environments while cautioning
that further evaluations are required.
An international review (Phillipson, 2010) underscores the global signifi-
cance of ageing and urbanization in developing as well as developed coun-
tries, and the significance of neighborhood change for processes of social
exclusion. Buffel, Phillipson, and Scharf (2012) have critically reviewed the
diverse urban literature underpinning age-friendly approaches and tensions
and contradictions in the debates. They suggest the value of moving from ask-
ing “What is an age-friendly city?” to asking “How age-friendly are cities?”
taking account of the “complexities of cities as sites of interlocking and con-
flicting commercial, social, and political interests” (p. 597). A British Academy
policy report reviewed evidence on the influence of urban environments as
social determinants of health and health inequalities among older people
(Kendig & Phillipson, 2014). It concluded that local area impacts on mobility,
social connectedness, psychological distress, and economic well-being are
accentuated among older people who are disadvantaged in terms of poor
health, socio-economic vulnerability, and ethnic and language difference.
In the U.S. literature, Scharlach and Lehning (2013) have considered age-
friendly communities as a form of social capital that can promote social
inclusion. They review extensive evidence on ways in which physical and
social infrastructure can enable older adults to pursue lifelong activities, meet
their basic needs, and maintain significant relationships. Public health
research and policies are recognizing the significance of neighborhood envi-
ronments for healthy ageing and the potential for interventions to enhance
successful ageing, particularly among minority groups (Santarino, 2013;
Yen, Michael, & Perdue, 2009). The World Economic Forum featured “age-
friendly” approaches to address inequalities through inclusive and integrated
design and infrastructure within a broader political framework (Beard,
Kalache, Delgado, & Hill, 2011). At the time of publication, a special issue
Kendig et al. 1393
“Age Friendly Cities and Communities Around the World” was published by
the Journal of Ageing and Social Policy (2014).
An Australian based review (Lui, Everingham, Warburton, Cuthill, &
Bartlett, 2009) conceptualized the age-friendly discourse along dimensions
from top-down to bottom-up governance, and in terms of the physical and
social environments; they present a range of models for age-friendly com-
munities as well as Australian policy directions for more positive approaches
to ageing. Another Australian study reviewed international evidence on the
ways in which physical and mental health of older people are associated with
perceptions of social cohesion, social networks, safety, physical disorder, and
other aspects of neighborhood quality (Pearson, Windsor, Crisp, Butterworth,
& Anstey, 2012). It reported findings from a survey of older people in
Canberra that found high levels of neighborhood satisfaction and health and
well-being. Positive perceptions of the physical environment were generally
associated with physical and mental health, while perceptions of social cohe-
sion were associated with social networks/support and loneliness, as well as
physical and mental health. More negative neighborhood perceptions and life
outcomes were reported among those disadvantaged by living alone, poor
health, not driving, and not having family nearby. The report concludes that
policy actions enhancing neighborhood quality can contribute to broader
strategies to assist older Australians to age well in place.
Objectives and Methods
This article aims to contribute to the international understanding of the devel-
opment and implementation of AFC policy approaches through case studies
in Canberra, Melbourne, and Sydney where the authors have had direct expe-
rience as participant observers. The discussion focuses on disadvantaged
(minority) groups including migrants with poor English capacities, those on
low incomes, people with mobility limitations, non-homeowners, and
Aboriginal Australians. The objectives are as follows:
a. To chart the diverse ways in which AFC developments have emerged
through political, consultative, research, and policy processes in three
Australian State and Territory contexts with varying degrees of WHO
b. To present evidence on the ways in which older disadvantaged groups
and other older residents experience Canberra as an AFC city in terms
of the domains prescribed in the WHO planning process.
c. To assess AFC-related plans and strategies in the three cities in terms
of their policy directions and inclusion of disadvantaged groups.
1394 Journal of Aging and Health 26(8)
d. To consider political and policy factors that may have facilitated or
impeded age-friendly actions particularly within the mainstream
activities of State and local governments.
The multi-methods investigation draws on public documents, community
consultations, survey analyses, and participant observation by the authors
during these developments; key informants and web searches confirmed and
extended the document review and interpretation. Kendig, a University
researcher now based in Canberra, had previously worked with the New
South Wales (NSW) government on its State Ageing Plan and in Victoria as
a researcher during the early Positive Ageing policy developments. At the
time of writing Elias served as Senior Policy Adviser to the NSW Minister for
Ageing and Minister for Disability Services, responsible for developing and
implementing the State Ageing Plan. She previously served as the Policy
Officer for the NSW Council on the Ageing. Prior to working with the ACT
Government Matwijiw had served as Manager of the Office for Senior
Victorians during their early AFC developments and then as Manager of the
Productive Ageing Centre of National Seniors Australia based in Canberra.
Both Elias and Matwijiw have worked with multi-cultural communities. As a
University researcher, Anstey led the Baseline Survey on Canberra as an AFC
and she serves on the ACT Ministerial Advisory Council on Ageing (MACA).
It is important to recognize the governmental and population contexts
within which age-friendly initiatives have been developed in the Australia
federal systems of government. The national government (Commonwealth)
is in a fiscally dominant position with its control of income taxes and other
major revenue sources. It has direct responsibility for income support, aged
care, and employment policies; it shares revenue with State governments;
and it makes specific “tied” grants to other tiers of government as well as
voluntary organizations. State governments have constitutional authority for
service provision and land use regulation but their revenue streams are lim-
ited and variable. Local government, which operates under the delegated
authority of State governments, have very limited resources, and a primary
focus on property-related regulations and services. The ACT, which contains
the planned city of Canberra, is a single instrumentality acting as a State and
local government with additional responsibilities as the national capital (sim-
ilar to the U.S. District of Columbia)
Sydney and Melbourne are Australia’s dominant cities formed during the
19th century followed by successive waves of development including exten-
sive suburban growth over the post-WWII (World War II) era. As shown in
Table 1, their populations exceed four million, and they have ageing popula-
tions and large overseas born populations. Canberra was developed as a
Kendig et al. 1395
planned city, mainly over the last 40 years, and it also has an ageing popula-
tion but it is much smaller, more affluent, and has low density. In all three
cities, small minorities of older people are Aboriginal or public tenants.
The State of Victoria
The Australian context for AFC can be traced back to the 1990s when various
state and national governments sought to develop more positive and evi-
dence-based policies on ageing and health (Kendig & Browning, 2010). The
State of Victoria has in many respects been at the forefront of these efforts.
The State has been conducive to AFC developments because it has a relative
strength of local government represented by the Municipal Association of
Victoria (MAV); an influential Victorian Health Promotion Foundation
(VicHealth) attentive to social determinants of health inclusive of age groups
over the life span; and the active participation by the Council on the Ageing
Victoria (COTA Vic) and a range of voluntary agencies.
In the late 1990s, a Liberal (conservative) State government set a valuable
political context for AFC developments. Its progressive Minister of Health
led development of The Victorian Positive Ageing Strategy out of a growing
Table 1. Population Profiles of the ACT (Comprising Mostly of Canberra),
Melbourne, and Sydney.
ACT Melbourne Sydney
Population sizea356,586 3,999,982 4,391,674
Aboriginala (%) 1.44 0.45 1.25
Country of birth not Australiaa (%) 28.6 36.7 40.1
Median agea (in years) 34 36 36
65 years and olderb (%) 10.5 12.9 12.7
Projected population size 2050b492,121 7,398,222 7,186,862
65 years and over in 2050b (%) 20.0 21.8 19.7
Median household incomea (AUS$
per week)
1,920 1,333 1,447
Population densitya (per sq. km) 160 (450 in Canberra) 540 381
Fully detached housea (%) 72.8 72.6 60.9
Note. These figures are from the 2011 Australian census except where noted as 2050
projections. ACT = Australian Capital Territory; ABS = Australian Bureau of Statistics.
aABS (2013).
bABS (2008).
1396 Journal of Aging and Health 26(8)
awareness that policy concerning older people needed to extend beyond
health and services to also address social determinants and consumer groups
including community-based actions. The Parliamentary Inquiry Into
Planning for Positive Ageing (Victorian Government, 1997), produced after
public consultation with communities and researchers, included a chapter
“Creating an Aged-Friendly Victoria.” The chapter invoked the United
Nations call for “A Society for all Ages” inclusive of older people following
principles of enabling independence, participation, care, self-fulfillment, and
dignity. Other chapters examined health and positive ageing issues specifi-
cally for men, women, minority groups, non-English speaking background
(NESB) groups, Kooris and Torres Straight Islanders (Aboriginal people),
and those in rural areas; socio-economic vulnerabilities were detailed for
women and NESB groups.
AFC Initiatives
There was minimal action on positive ageing plans over a number of years as
Victorian government action on ageing concentrated on health and care ser-
vices, and policy momentum was disrupted by a change of government. AFC
developments received renewed impetus in 2004 when the WHO leader who
established the Active Ageing and AFC programs visited Melbourne to pres-
ent on healthy ageing for the World Health Promotion Conference. His meet-
ings with the State Office on Ageing, VicHealth, and COTA Vic reinforced
ongoing community and research advocacy for the AFC approach. The State
was invited to become an early partner in developing the WHO AFC pro-
gram. Modest funding for pilot AFC initiatives was provided under the 2005-
2009 “Positive Ageing in Local Communities” project. The University of
Melbourne and COTA Vic with the City of Maribyrnong conducted an AFC
survey and focus groups, with the MAV later involved. The City (along with
Melville in Western Australia) was part of the foundation WHO development
of its Age Friendly City guide launched in 2007 and it now has a 2004-2016
Action Plan on Ageing Well The 2010-2020 plan for an “age-friendly”
Victoria was a core part of the Positive Ageing Strategy (MAV, Victorian
Government, & COTA Vic, 2009).
As another Victorian example, the municipality of Boroondara (a rela-
tively affluent local government in a middle suburban area) became one of
Australia’s first AFC cities after having committed to a 5-year Active Ageing
Strategy (2009-2014). The Creating an Age Friendly Boroondara Strategy
(City of Boroondara, 2012) focuses on key issues identified by national
research as well as local community concern. These include social isolation
Kendig et al. 1397
and the value of social connections, the potential for health promotion, and
older people’s desires to continue contributing, to remain independent, and to
age well in their homes.
An independent review of local government’s increasing use of the WHO
Age Friendly Cities Guide (MAV et al., 2009) concluded that Council staff
and older people themselves saw value in the WHO checklist. The AFC
approach was viewed by Councils as valuable particularly for address “whole
of government” concerns for ageing and older people across program areas
(e.g., inclusive of housing and transport) and across levels of government.
Age-friendly principles have been adopted by increasing proportions of
local governments through Victoria with support from COTA Vic and further
evaluations were planned with the University of Melbourne. All local author-
ities are required to have Municipal Public Health and Wellbeing Plans, and
these are informed by the VicHealth Social Determinants of Health frame-
work. However, with another change of state government in 2010, a number
of early initiatives lapsed. Broader interest in AFC developments was
renewed in 2011 by a COTA Vic workshop including local Councils and the
Director of the WHO Department of Ageing and Life Course.
Disadvantaged Minority Groups
Parliamentary leadership in Victoria has placed a strong emphasis on diver-
sity and community consultation in age-friendly initiatives. A recent inquiry
into participation of Victorian Seniors (Parliament of Victoria, 2012) had a
specific focus on empowerment and recognizing diversity in terms of gender,
families, locality, income and socio-economic background, cultural and lin-
guistic background, and Aboriginal seniors.
Attention to disadvantaged older people in Victoria is being led by advo-
cates who extend well beyond local government. A review by Monash
University and the Ethnic Communities Council of Victoria (Radermacher,
Feldman, & Browning, 2008) found that language barriers and lack of acces-
sible information are key barriers to service provision for older people from
Culturally and Linguistically Diverse (CALD) backgrounds (see also
Federation of Ethnic Communities’ Councils of Australia, 2010). The
Brotherhood of St Laurence, a leading community advocate for social justice,
produced a discussion paper for a local council on the complementarity of
“Child Friendly” and “Age Friendly” Cities initiatives with intergenerational
projects and a policy framework including federal and State government (Carr,
Kimberley, & Biggs, 2013). Wintringham Housing Limited (2013), a voluntary
aged care organization, takes an empowering and enabling approach to provid-
ing supportive accommodation for older people at-risk of homelessness.
1398 Journal of Aging and Health 26(8)
Current Directions
After the 2010 change of government, the Victorian Government’s Family
and Community Development Committee (Parliament of Victoria, 2012) rec-
ommended that the State Government itself join the Global Age Friendly
Cities Network as well as support local government initiatives. Building on
earlier developments, it specifically recommends action improving transport
accessibility through “whole-of-journey” approaches; improved housing
options for ageing in place; and planning for secure and accessible outdoor
spaces and buildings. The Government’s response to this report was limited,
however, including the recommendation to appoint a part-time Commissioner
on Ageing and set up a new State Advisory Committee (Parliament of Victoria
Family and Community Development Committee, 2013). The MAV and the
Council on the Ageing subsequently have attempted to drive AFC efforts fur-
ther by hosting a Positive Ageing Forum
The State Government is beginning to recognize that its infrastructure
strategy can align with age-friendliness as it encourages infill development in
transport junctions and corridors. The 2013 Parliamentary report recom-
mends an AFC approach within current urban planning guidelines focusing
on transport, housing, and rural and remote areas. The implementation chal-
lenge is substantial, however: the Liveability and Sustainability objectives in
the Metropolitan Planning strategy (Victorian Government, 2012) made little
mention of either ageing or spatial inequalities. AFC actions have been left
largely to voluntary organizations such as the Brotherhood of St Laurence
and academic reports to make the case for more equitable and age-friendly
urban growth, for example, Hansen (2012) and Ozanne and Biggs (2014). In
the 2012 State election campaign, the Council on the Ageing called for com-
mitments to what it termed to be the “The Three Pillars of an Age Friendly
Victoria”: ensure equity and social inclusiveness, whole of government strat-
egies, and improve health and well-being, with a focus on active ageing and
Canberra, which is located in the ACT in southern NSW, contrasts sharply with
Melbourne and Sydney given its smaller size and more affluent population but
it too has an ageing population (Table 1). The urban infrastructure consists
mainly of low-density neighborhoods clustered around town centers controlled
under a central planning authority with a leasehold system (Kendig, 2000).
Kendig et al. 1399
During the late 2000s, the ACT Government followed the lead of other
States by directing their Office for Ageing (OFA) to develop an ageing strat-
egy that would give attention to specific actions that would benefit older
people (ACT Government, 2008). During 2009, the Government worked
with the ACT Ministerial Advisory Council on the Ageing (MACA) and its
community representatives to develop a discussion paper on key issues fac-
ing older Canberrans, convene public forums with stakeholders, and seek
further feedback and consultations (ACT Government, 2009c).
Age-Friendly Initiatives
At the end of 2009, the Minister on Ageing launched the ACT Strategic
Plan for Positive Ageing 2010-2014: Towards an Age Friendly City (ACT
Government, 2009a). In the media release on the plan, the Minister com-
mented on the importance of respecting older people and supporting their
active participation in community life (ACT Government, 2009b). The
Strategic Plan set seven goals that drew on community consultations and
aligned with the WHO Age Friendly Checklist. Implementation of the first
action plan, covering early 2010 through mid-2011 included the establish-
ment of a Canberra Age Friendly Cities Network comprised of representa-
tives from each ACT Government agency in partnership with the ACT
Ministerial Council on the Ageing. The Baseline Survey of Canberra as an
age-friendly city (Centre for Mental Health Research, 2011) was con-
ducted, and the first ACT Older Persons Assembly held on the International
Day of Older Persons. These initiatives were given added momentum by a
May 2010 visit by the Director of the WHO Department of Ageing and the
Life Course.
In reporting on the first Action Plan to June 2011, the ACT MACA con-
cluded that progress on the strategic plan had been “very good” for one cat-
egory (Health and Wellbeing) and “good” for the remaining six. It noted
progress in implementing a public transport smartcard system for bus travel
(“MyWay”), a Seniors Card increasing access to affordable events and activi-
ties such as Grandparent’s Day, and an online senior’s information portal.
Areas noted as requiring “further consideration” included developing a
whole-of-government approach to cultural awareness and provision of inter-
preter assistance for older people.
Canberra was invited to join the WHO Global Network of Age Friendly
Cities effective January 2012 and it has closely followed the recommended
AFC strategy. Later in the year, the ACT government responded to recom-
mendations adopted at the ACT Older Persons Assembly (ACT Government,
2012b). Positive ageing initiatives included the ACT Government’s 2012 Tax
1400 Journal of Aging and Health 26(8)
Reform Plan aimed to support ageing in place for pensioners, a targeted assis-
tance website, and a Retirement Villages Act. Already in place were the
Seniors Information On-Line portal and the ACT Seniors Grants and
Sponsorship program.
A new Positive Ageing Action Plan 2012-2014 (ACT Government, 2012a)
drew on findings from the Age Friendly City Survey and recommendations
from the 2011 Older Persons Assembly and was developed further under the
guidance of the Canberra Age Friendly City Network. Priority areas in the
plan were Information and communications; Health and well-being; Respect,
valuing, and safety; Housing and accommodation; Support services;
Transport and mobility; and Work and retirement. Actions for each of these
areas were reported to June 2011 and lead agencies and performance indica-
tors were set.
The Plan addresses issues related to disadvantaged groups. For example,
it sets goals to develop flexible housing options, affordable rental options,
address safety and security issues in public housing and provide emergency
housing for older adults who become homeless. It presents some strategies to
reduce social isolation and increase community engagement.
Disadvantaged Groups and the Baseline Age Friendly Cities
After the launch of the first ACT Strategic Plan on Positive Ageing, it became
clear that an evidence base was lacking for developing Canberra as an AFC.
Hence, the Australian National University was invited to conduct the ACT
Age Friendly Cities Survey to obtain baseline data on “age-friendliness”
(Centre for Mental Health Research, 2011). The 2011 survey could be used to
report on disadvantaged minority groups because the sample was large (2,000
aged 65 years and above) and it focused on the eight domains that the WHO
(2007) had nominated as central to defining AFC. The general satisfaction of
the older community with most aspects of the city was found to be high. Fully
73% had Internet access at home, reflecting the relatively high standard of
living and high socio-economic status in Canberra. However, as highlighted
below the survey identified disadvantaged groups experiencing difficulty
with Canberra as a place to live:
Problems with transport were reported by 35% of those living in pub-
lic housing and 24% of those living alone.
Of those living in public housing, 32% reported wanting modifica-
tions made to their housing, as did 22% of those receiving income
Kendig et al. 1401
Those living in public rental accommodation or from NESBs were
more likely to report feeling unsafe in their homes and to have greater
difficulty accessing information about health and services.
Social engagement was found to be most difficult for those lacking
resources in terms of mobility, poor quality neighborhoods, and
Women, those living in rental accommodation, living alone, on income
support and who report physical disability were most likely to report
feeling socially isolated.
Problems with access to health services were reported disproportion-
ately by those who lived in public housing, had physical disabilities,
were older, lived alone or who received the pension.
Of those living in public housing, 24% reported experiencing elder
abuse compared with 6% of those not included in a disadvantaged
The ACT Survey thus identified relatively small groups of older adults
who were multiply disadvantaged and experienced difficulties in the gener-
ally affluent city. These groups are at risk of social disengagement, isolation,
and poor physical and mental health due to difficulties in accessing services
and connecting socially. These issues are, to some extent, being addressed in
the ACT Strategic Plan for Positive Ageing.
Future Directions for the ACT
Strategies are now underway for all Strategic Priority Areas in the 2010-2014
plan, including a review of community and public transport, and the promo-
tion of Liveable/Universal Design in housing. A national AFC Conference in
late 2013, with community and national representation and international
speakers, will be followed by another Older Person’s Assembly during 2014.
Another major Age Friendly City Survey is planned for 2016, with the aim of
monitoring change and bringing ongoing evidence into policy development
and implementation.
Australia’s largest city, Sydney, is located in the State of NSW. While NSW
has not been involved directly in the AFC initiative, the 2012 NSW Ageing
Strategy, as reviewed here, shares many of the AFC objectives. The strategy
1402 Journal of Aging and Health 26(8)
and its implementation have been driven by the political commitment of a
Government as it was elected in 2011.
While still in Opposition, the current Premier and Minister on Ageing had
begun hosting annual Seniors Roundtables with stakeholders. The new
Minister for Ageing and Minister for Disability Service had a strong commit-
ment and his soon-to-be Senior Policy Adviser had extensive experience in
consumer advocacy on ageing and multi-cultural policies. They aimed to be
responsive to the community and private sectors with initiatives that would
move beyond the previous government’s long-term ageing plan (NSW
Government, 2009).
Plan Development
The new Coalition Government government’s NSW 2021: A plan to make
NSW number one (NSW Government, 2011a) committed to develop a strat-
egy to address population ageing and support seniors to actively and indepen-
dently participate in the life of their community (Goal 25). The new Minister
and his adviser began driving what was to become the Government’s Ageing
Strategy to his Cabinet colleagues and senior policymakers, seeking their
personal as well as political commitments.
In September 2011, the Minister hosted another Ageing Roundtable bring-
ing together leaders and experts on ageing from across government, aca-
demia, and non-government sectors to set directions for the new strategy.
Participation by the Premier, Treasurer, and key cabinet ministers under-
scored the significance of population ageing as a shared concern. Themes for
the Ageing Roundtable were drawn from state, national, and international
frameworks on population ageing. These included the NSW Treasury Long-
Term Fiscal Pressures Report (NSW Government, 2011a) and the UN Madrid
Action Plan on Ageing as well as the WHO Age Friendly Cities guide. The
roundtable produced a summary paper (NSW Government, 2011b) outlining
key themes and discussion points for consultation with Cabinet Ministers,
government, and non-government (private and community) sectors and the
wider community.
Public consultations were held across the State including targeted meet-
ings with service providers, people with a disability, their families and carers,
Aboriginal, CALD, and GLBTI (gay, lesbian, bisexual, transgender, and
intersex) communities. Written and oral submissions were sought. A discus-
sion paper on the consultation findings was translated into community lan-
guages for the Arabic, Assyrian, Chinese, Greek, Italian, and Vietnamese
populations. A common theme among the minority groups was feelings of
vulnerability and invisibility, suggesting the need for an inclusive approach
Kendig et al. 1403
in planning and designing information and services. Migrants with low
English language proficiency reported communication as their major lifelong
disadvantage. Aboriginal older people also felt isolated and disadvantaged in
accessing mainstream services. In GLBTI communities, there is the ageing of
the “out and proud” generation. The NSW Ageing Strategy aims to be inclu-
sive and consider the specific needs of diverse communities.
The NSW Ageing Plan
The State released its whole-of-government, whole-of-community NSW
Ageing Strategy, in July 2012. At the Launch, the Minister stated,
This is a great opportunity to realise the benefits of an ageing population and to
harness the contribution of seniors in our communities. Equally important will
be empowering people to plan ahead for the future they envisage in their later
years. (NSW Government, 2012)
The strategy articulates a vision for achieving positive ageing through
empowering people to make contributions and lead active, healthy, and
rewarding lives from mid-age onward. It focuses on participation, livable
communities, discrimination, security, and dignity. It extends to broader con-
cerns such as enabling ageing people to live healthy, active, and socially con-
nected lives including community contributions. Developing skills in
computing and mobile phones was a particular focus.
The plan aims to make mainstream government services, including land
use planning and public transport, more responsive to and appropriate for
older people. It requires that all main departments—including Treasury,
Family and Community Services, Housing, Health, Planning and
Infrastructure, Local Government, Police and Justice, Education, and
Communities—identify priorities for ageing and older people and then to be
accountable for achieving them. Responsible Ministers were to nominate five
strategies for inclusion in the Strategy; drafts are to be circulated for com-
ment across portfolios and for external accountability; and formal consulta-
tion concludes with formal sign off at the Director General level.
The Ageing Strategy was devised to achieve concrete results within the
first year and then annually on an ongoing basis. Described as a living docu-
ment, it commits to new actions over time. Central to this strategy is the
ongoing participation by the Premier and Treasurer and the establishment of
a senior Interdepartmental Committee (IDC) with external representatives to
enhance transparency and rigor in implementation. NSW Treasury’s “2011
NSW Long-Term Fiscal Pressures Report—NSW Intergenerational Report”
1404 Journal of Aging and Health 26(8)
(NSW Government, 2011b) adds to the evidence base and impetus for whole
of government approaches.
The NSW Government MACA provides important representation from
diverse communities, academia, and the ageing sector. The chair, a recog-
nized community leader, plays a pivotal role in supporting the Minister and
the Ageing Strategy. She regularly engages with Cabinet Ministers, serves on
the IDC to implement the Ageing Strategy, and facilitates MACA participa-
tion across government committees and councils, and participation by private
sector representatives.
The Strategy commits to community involvement at a local level through
direct consultation with older people, advocates, and service providers. The
aim is to establish an ongoing platform for intergenerational discussion, life
span development, and shared effort between agencies and across sectors.
Action is specifically sought appropriate to seniors (65 and above) and those
in their middle years (45 and above) as well as the general population. The
Strategy adopts a vision that “people in NSW experience the benefits of liv-
ing longer.”
Implementation of the Strategy, now in the early stages, aims to build public
and private partnerships in priority areas. Examples include the following:
An initial dialogue, hosted by the Minister on Ageing and the Treasurer,
was conducted on “Business, boomers and beyond” attended by more
than 50 private sector representatives. Further targeted dialogues were
planned to encourage private sector responsiveness and partnerships
in housing, tourism and leisure, employment, and financial products
and services.
A State grants programs has been established to help Councils with
local partnerships with the property, design, and planning sectors to
enhance age-friendly building design, neighborhoods, and public
transport. Councils would be required to incorporate this work under
their Integrated Planning and Reporting Framework. Case studies
were planned to showcase best practice in age-friendly urban renewal
and local government design and implementation.
A range of actions were designated to widen housing choices and
affordability particularly for the growing numbers of private tenants
on low incomes. State planning policies and metropolitan strategies
were to be reviewed to take account of the needs of seniors. Planning
incentives and public–private partnerships are being investigated.
Kendig et al. 1405
Action is under consideration to improve transport options on behalf
of the many older people who had made what in Australia is termed
the “sea change or tree change” to rural areas in their late 50s and early
60s and subsequently found themselves isolated in their 70s and 80s
due to inadequate community transport. Improved linkages between
public, private, and community transport are being pursued through
input into the Long Term Transport Master plan for NSW and the
Australian Government’s Accessible Transport Standards targets.
Active and healthy ageing strategies are being encouraged at the com-
munity and local government level through joint planning and partner-
ing with peak organizations, health promotion agencies, and
government. Refocusing an existing Department of Sport and
Recreation grants program is planned to enable participation of local
communities in improving facilities for older people.
The NSW Seniors Card program is being expanded to provide
better access to government and local community information and
Action to enhance IT capacities of older people include low cost train-
ing at community colleges. A Tech Savvy Seniors program is under-
way through partnership with Telstra (the national telecommunications
The Strategy addressed financial and psychological abuse by estab-
lishing a prevention helpline and resource center in partnership with a
non-government organization (NSW Government, 2013).
Actions for people in their middle years aim to increase their resources for
later life. These include removing barriers to workforce participation, improv-
ing workers compensation laws and community education on critical deci-
sion-making concerning work, housing, finance, social connections, health,
and lifestyle. The strategy aims to improve access to subsidized training pro-
grams particularly for returns to work by those who lost their jobs, women
returning to work, and those without formal qualifications.
NSW Directions
The NSW Government has recognized that leadership and commitment
(political, bureaucratic, and community) are key to the Strategy’s success.
The Minister for Ageing, MACA, and the OFA drive the strategy’s imple-
mentation through an IDC and through submissions to government inquiries
and consultations on key reforms, policies, and plans. The OFA engages
with other agencies to support the implementation of actions toward the
1406 Journal of Aging and Health 26(8)
NSW Ageing Strategy. Treasury is leading new analyses and annual moni-
toring of the age distributions of public expenditure to guide whole of gov-
ernment approaches.
In summary, leadership by the Minister on Ageing and his Senior Policy
Adviser has been crucial to establishing the NSW Ageing Strategy that aims
to make the wider community and mainstream sectors more “age friendly”
and bring new stakeholders to the opportunities presented by an ageing popu-
lation. A major challenge in implementation arose when the charismatic
Minister Andrew Constance was promoted to the Finance portfolio and his
Senior Advisor was appointed to a senior communications position in the
Department of Family and Community Services. The 2013-2014 State
Budget released in May 2013 did not include major ageing initiatives in line
with the NSW Ageing Strategy. However, at the time of publication Minister
Constance had just been promoted further to serve as the State Treasurer
where he could have a major influence on further directions.
Implementation and Directions
This article has examined varied ways in which WHO age-friendly thinking
has led to AFC policy initiatives in three Australian cities. In Melbourne and
Sydney, charismatic State Ministers of Health, supported by committed advi-
sors, made the initial breakthrough in establishing new AFC approaches
focused on empowerment, the opportunities of ageing, inclusion of disadvan-
taged groups, and enabling local solutions. In Melbourne AFC, developments
were facilitated by strong local governments and an influential health promo-
tion foundation. In Canberra, the AFC approach followed the lead of other
States yet proceeded to quickly follow the prescribed WHO methodology and
be designated as an AFC, with actions facilitated by the ACT Territory gov-
ernment having both State and local government responsibilities. At critical
stages, these developments were stimulated by leadership from the WHO
Department of Ageing and the Life Course.
The early adoption of a range of AFC strategies and policy directions has
been followed by difficult and problematic experiences in implementation. In
Victoria, many of the original “policies” did not move very far beyond state-
ments of values and aspirations; over 15 years they have been re-worked as
governments changed and then re-presented particularly in the lead up to
State elections. There have been tensions between AFC as preventive health
approaches contrasted with community development and approaches. In
Canberra, bureaucratic planning processes led to modest practical actions
extending established community support approaches. In NSW, action on
ambitious plans slowed notably after the change of Minister and his Senior
Kendig et al. 1407
Advisor. Local government, notably in Victoria, is proving to be a suitable
auspice for pursuing actions within its limited responsibilities and resources
such as accessible outdoor spaces, civic participation, and local land use
planning; some advocacy and coordination is also feasible. However, given
the strong spatial basis of social deprivation (Gong et al., 2012) and Councils’
limited resource base, local governments on their own can do little to redress
social inequalities, cultural diversity, and minority concerns between advan-
taged and disadvantaged communities.
Modest AFC developments to enhance communication and access for
older people have been achieved through information and IT developments in
Canberra and Sydney, in partnerships across departments and with the private
Efforts to increase age-friendliness in the powerful health portfolios have
proven to be problematic. In NSW, the Health Department has had only mod-
est involvement in the Ageing Strategy, apparently because cross-portfolio
developments could divert attention and resources away from its core health
service responsibilities and constituencies. The dilemma is that the many
promising health promotion initiatives require action outside the health sys-
tem. Other departments such as Transport and Sports and Recreation face
difficulties re-directing attention and resources from traditional responsibili-
ties to younger people to make them more appropriate for older people.
An efficient and accessible city, economizing on public and private invest-
ment, potentially can also be an age-friendly one, thus recognizing the poten-
tial value of AFC developments for wider policy purposes including more
sustainable cities. Many of the age-friendly features of Canberra can be attrib-
uted to its people-friendly initial planning decades earlier; further infill devel-
opment and increased densities can widen local housing choices, improve
accessibility, and make better use of infrastructure. However, as is being found
in all three cities, community gains through age-friendly planning are long
term while the local and immediate political costs can be acute. Government
decisions on development inevitably take account of economic interests and
their own financial positions as well as opposition from existing residents—
including older people who are ageing in place. In Victoria, as Ozanne, Biggs,
and Kurowski (2014) are finding, taking account of ageing and older people in
planning “greenfields” corridors development is problematic given the imme-
diate priorities accorded to housing young families and the pressures of prop-
erty interests, generational interests, and implicit ageism. A barrier to
successful implementation of AFC strategies at all levels of government is a
tight fiscal environment combined with organizational inertia and established
community expectations. In NSW, it is recognized that the State government’s
constrained budget require difficult political and bureaucratic processes of
1408 Journal of Aging and Health 26(8)
setting priorities and re-allocations as set out in the State Ageing Plan. To
inform these efforts, Treasury is working to identify age distributions of
expenditure within departments. However, it is difficult to achieve the politi-
cal and community will required to drive a whole of government, whole of
community approach inclusive of the private sector. Existing departments and
constituencies with strong functional program accountabilities, such as in
health and transport, are not easily convinced to cut-back established commit-
ments and to re-allocate resources to new areas such as ageing. Nonetheless,
over the longer term, there is a strong case for recognizing that a stronger
focus on older people in the mainstream activities of government could
improve efficacy, efficiency, and equity, for example, through prevention and
community alternatives to hospitalization in the health portfolio.
A major opportunity for the AFC approach is to better align the actions of
national, state, and local government. Centrally planned national policies in
Australia can face difficulties in responsiveness to and coordination within
local communities. The interplay between national and local developments is
complex: Local innovation can be the spawning ground for national initia-
tives while national developments requires local implementation appropriate
to diverse communities, equity attention to disadvantaged groups, and scope
for leadership by older people and their representatives. In this context, the
Age-Friendly approach has potential to contribute “ground up” representa-
tions and locale-based implementation for national developments including
the following:
The Government’s Advisory Panel on Positive Ageing is charged “to
lead a national dialogue on ageing issues, improve coordination of
policy design across portfolios, and work with the Government on
implementation and design of ageing policy” (Australian Government,
n.d.). Priorities for 2013 include housing, lifelong learning, mature age
employment, volunteering, philanthropy and seniors, and the digital
Living Longer, Living Better reforms will implement new aged care
paradigms enabling independence and well-being at home, inclusive
of cultural diversity and disadvantaged group (Australian Government
Department of Health and Ageing, 2012).
The Australian Human Rights Age Discrimination Commissioner’s
actions for positive approaches to ageing in the workforce, care pro-
grams, and the community (Australian Human Rights Commission,
The potential for life span and ageing approaches in national preven-
tive health programs inclusive of older people, although developments
Kendig et al. 1409
to date focused on young people and chronic disease (Kendig &
Browning, 2011).
The Department of Human Services’ developments appropriate to dif-
ferent stages of people’s lives, including “one stop” centers in the
community and websites for Internet access tailored to older people
(Australian Government, 2013).
Having a local dimension linked to national policy arguably is becoming
more important as the Australian government has been centralizing responsi-
bilities and resources relative to State governments. This situation contrasts
with the United Kingdom where more national policies are devolving to rela-
tively powerful local authorities and Canada where Provinces continue with
significant authority in their federal form of government. Devolved action
can contribute in addressing the highly variable environmental context of
ageing and it has particular promise to address diversity and enable more
Research Directions
Applied research has proven to be helpful in AFC implementation. In Victoria,
modest pilot surveys set AFC directions and follow-up evaluations have con-
firmed the value of the WHO Age Friendly Checklist protocols (after modifi-
cation to make them more user friendly). In Canberra, the comprehensive
2011 baseline survey directed attention to priority action areas particularly
for disadvantaged groups. However, even large and good quality surveys
have limitations in identifying the needs of small disadvantaged groups that
are different from the mainstream (Quine & Browning, 2007).
Obstacles in translating research into policy are illustrated by an ethno-
graphic study of homeless men in NSW, conducted a decade before the 2011
Ageing Strategy, that identified specific actions that would empower them
and promote their health (Quine, Kendig, Russell, & Touchard, 2004). While
these findings were considered by a State Task Force on ageing and commu-
nity health, on which one of the authors served, efforts to establish local ini-
tiatives in integrated action across health and other portfolios have proved to
be too difficult for the responsible State departments.
More fundamental research is required to understand the impact of local
environments on older people (Buffel et al., 2012; Scharlach & Lehning,
2013). Critical examination of the “eight petals” of action areas specified in
the WHO AFC could provide evidence as to the value of these AFC concep-
tualizations and their impacts and their potential for improvements particu-
larly for disadvantaged people Australian research has pointed to the potential
1410 Journal of Aging and Health 26(8)
value of research that examines the physical and mental health consequences
of perceptions of neighborhoods. Understanding the ways in which important
features of neighborhoods cluster together and change can inform better
urban policies. Comparative research across different forms of cities and
nations can shed light on ways in which socio-economic and cultural context
can influence age-friendly outcomes.
In summary, the language and arguments of the WHO Age Friendly Cities
movement are contributing more widely to initiatives in Australia that
potentially can empower disadvantaged older people and develop social
and physical environments that enhance their participation and well-being.
They are bringing to more public attention the positive potential of older
people and developing wider options for action on the “improvability” of
ageing experiences. The AFC approach can reinforce recognition of ageing
as a lifelong social process with accumulating inequalities between social
groups and areas. It provides a way ahead for whole of government and
whole of society action that can address to complexity of interconnected
policy areas and disadvantaged groups. The AFC aspirations are potentially
beneficial for more equitable and sustainable cities for all age groups but
implementation requires strong and sustained political leadership that artic-
ulates AFC messages and overcomes challenges from a range of private and
public interests.
We wish to acknowledge the leadership of Dr John Beard and Dr Alex Kalache in
leading the WHO Age Friendly Cities initiative including their contributions to
Australian developments. Dr. Ranmalee Eramudugolla conducted data analyses, Nina
Lucas assisted with editing, and Associate Professor Elizabeth Ozanne provided
advice on Victorian initiatives. Valuable input was received from a range of individu-
als from advocacy groups, Government, and Universities. Dr. Yvonne L. Michael and
Dr. Irene Yen, guest editors, and anonymous referees provided valuable advice.
Authors’ Note
The views and interpretations in this article are those of the authors and not necessar-
ily those of any other parties.
Declaration of Conflicting Interests
The authors declared no potential conflicts of interest with respect to the research,
authorship, and/or publication of this article.
Kendig et al. 1411
The authors disclosed receipt of the following financial support for the research,
authorship, and/or publication of this article: Research support was funded by the
ARC Centre for Research in Population Ageing Research (CEPAR).
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... While it is "a comprehensive tool" that identifies-through its bottom-up, participatory approach-"significant dimensions of older adults' lived experience that impact on quality of life" (McDonald et al., 2021: 20), recent research has highlighted a number of other challenges and shortcomings pertaining to the Guide. Notably, despite its aspiration for global applicability, there is little recognition or accommodation of the diversity of places and different geographical contexts (Kendig et al., 2016(Kendig et al., : 1410McDonald et al., 2021: 20). Likewise, there are questions about the Guide's ability to recognise and reflect the cultural and socioeconomic diversities of older persons and their communities (Kendig et al., 2016(Kendig et al., : 1410McDonald et al., 2021: 2). ...
... Notably, despite its aspiration for global applicability, there is little recognition or accommodation of the diversity of places and different geographical contexts (Kendig et al., 2016(Kendig et al., : 1410McDonald et al., 2021: 20). Likewise, there are questions about the Guide's ability to recognise and reflect the cultural and socioeconomic diversities of older persons and their communities (Kendig et al., 2016(Kendig et al., : 1410McDonald et al., 2021: 2). This may lead to questions of inequity as to who has access to initiatives if financial, physical, language, political and other barriers are not identified and appropriately addressed. ...
... It also needs to recognise the very political nature of policymaking (age-friendly focussed or not). For example, Kendig et al. (2016Kendig et al. ( : 1410 note that the guide ignores the need for initiatives' ability to attract sustained political leadership. This is especially so for governments that run in relatively short-term cycles (such as the 3-to 4-year terms in the case of Australian governments). ...
This paper reflects on whether and how the World Health Organization (WHO) inspires age-friendly policymaking across different levels of government. This is done via a case study in which we analyse the policies of Australia's three-tiered federated government system against the WHO's eight core age-friendly cities domains. Findings suggest that membership of the Global Network of Age-Friendly Cities and Communities did not appear to overtly inspire the development of age-friendly policies across Australian governments. Content analysis shows there is an overwhelming policy focus on care and support services, with little attention to cultural diversity. This reflects an outdated portrayal of debilitation in later life and a lack of recognition of how diverse circumstances impact the ageing process and corresponding support needs. Our findings also reveal the challenges of a three-tiered federated system, where varying financial and authoritative capacities have influenced how different governments acknowledge and respond to population ageing. Notably, local governments—the main level of implementation targeted by the WHO—are invariably constrained in developing their own age-friendly policies and may opt to adopt those of higher levels of government instead. These challenges will likely impact other resource-limited governments in responding to the needs of their emerging ageing populations.
... The WHO age-friendly cities approach has been influential in guiding policy in Australia and Perth was an early adopter of the approach, having been involved in the Age-Friendly Cities pilot project in 2006 (Alidoust and Bosman, 2016;Kendig et al., 2014). Since then the age-friendly cities movement has influenced policies and initiatives operating at different scales and across different sectors of government (Atkins, 2016). ...
... Older people should not only be the beneficiaries of age-friendly communities, but they should help to define and shape them (Buffel, 2015). This is especially important at the local scale where local governments play a critical role in enabling this (Kendig et al., 2014). However, effective community participation and negotiation are also needed at higher scales, around matters of density, urban form and infrastructure development, amongst others. ...
Since the post-World War II years, in many industrialized countries, such as Australia and New Zealand, urban growth has been in the form of suburban expansion typified by sprawl, low-density development and car dependency. On this sprawling urban form, population ageing is now unfolding as the so-called ‘Baby Boomer’ cohort (those born between 1945 and 1965) reaches retirement and beyond. Evidence is mounting that car-orientated urban forms, with widely dispersed housing, and scattered commercial and cultural resources, present barriers to active ageing and ageing in place. An observed trend in many sprawling cities, however, is that areas experiencing the highest ageing growth rates are in peripheral metropolitan areas, posing unique challenges for an ageing population. Planning for ageing in sprawl, not just ageing in place, is therefore becoming critical. This chapter reflects on the implications of ageing in low-density, sprawling cities that pose greater challenges for age-friendly planning. The focus is on ageing in Australia explored through a case study of Perth, Western Australia, an example of a rapidly growing, medium-sized Western city that is actively pursuing an age-friendly planning agenda. It explores how spatial planning is shaping the urban form through the prism of the age-friendly movement with specific focus on transport and housing.
... Collaboration in general has been described as an overarching characteristic of AFCIs (Menec et al., 2014;Plouffe & Kalache, 2011), but there is little discourse on the specifics of its implementation. Similarly, engaging diverse organizational entities, such as elected officials and older residents, in age-friendly initiatives has been described as key to AFCI implementation (Gallagher & Mallhi, 2010;Greenfield, 2018;Kendig et al., 2014;Menec et al., 2014;Sun et al., 2017). Yet, the relationships among these entities and what specifically they do together as part of an AFCI remains less clear. ...
Multi-sectoral collaboration is widely considered essential for age-friendly community change; however, there has been little empirical research to describe the ways in which organizations interact as part of age-friendly community initiatives (AFCIs). We conducted a qualitative descriptive study using data from multiple waves of semi-structured interviews with core teams of eight grant-funded AFCIs in the north-eastern U.S. We employed iterative, inductive coding to systematically describe ways in which AFCI core teams described working with other organizational entities. Findings indicated two overarching themes: (a) helping each other (giving and receiving linking, informational, and instrumental assistance), and (b) doing something together (organizing community events, planning collaborative projects, participating in meetings). We discuss the implications of this characterization for guiding research, evaluation, and policy to optimize AFCI implementation and impact across diverse settings.
... In a similar study, Kendig et al. studied development of aging cities and communities in Australia. They analyzed the impact of political, advisory, and research processes in developing age-friendly cities in Melbourne, Canberra, and Sydney in Australia (Kendig et al., 2014). Garon et al. also reported three stages of identifying the elderlies' social needs, planning based on the local model, and implementing the plan through collaborative efforts to develop an age-friendly city (Garon et al., 2014). ...
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The World Health Organization (WHO) introduced the age-friendly city as a response based on the challenges of demographic aging to maintain participation of the older adults in society. The purpose of this study was to assess the status of age-friendly city indicators from the viewpoints of older adults living in Kashan City, Iran. The cross-sectional study was conducted among 379 seniors in Kashan in 2020. The study tool was a questionnaire measuring the age-friendly indicators designed by Zarghani and colleagues, according to the criteria set by the WHO. Data were analyzed by SPSS and t-test was run to compare the indicators’ mean scores with those of the desired standard. The mean (standard deviation) of the social, communicational, cultural-recreational, and health-care indicators were 2.34 (0.82), 2.02 (0.78), 2.13 (0.79), and 2.56 (0.94), respectively. In comparing the desirability of the four indicators with the desired standard, no significant difference was observed only in the health-care indicator (p > .05) and in the other indicators; a significant difference was observed which indicates the low desirability of the social, communicational, and cultural-recreational indicators. So, the authorities are suggested to create welfare for the older adults.
The accelerated growth of cities and urban populations over recent decades and the complexity and diversity of urban areas demands proficient spatial affordance assessment especially for the vulnerable sections of the society. Lately machine learning and computer vision models have become highly competent in analyzing urban images for assessing the built environment. This study harnesses the potential of computer vision techniques to assess the age-friendliness of urban areas. The developed machine learning model utilizes Google’s Street View images and is trained using lived experience-based image ratings provided by elderly participants. Newly assigned urban images are accordingly rated for their level of age-friendliness by the model with an accuracy of 85%. This paper elaborates upon the associated literature review, explains the data collection approach and the developed machine learning model. The success of the implementation is also demonstrated, confirming the validity of the proposed methodology.
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Population aging is one of the most significant demographic transformations of the 21st century, since aging brings about changes in the functional capacity of the human being. Over the years, the level of independence and autonomy for carrying out daily activities diminishes, and, thereby, the relationship of the elderly with the environment changes as the person ages, directly affecting the mobility and life quality of this population. In 2007, the World Health Organization (WHO) published the document "Global age-friendly cities: A guide", which presents some strategies for promoting active aging and for the place of residence of the elderly. It proposes that the city´s structure and the public policies directed towards this public shall be integrated with the community´s life. In order to understand how the concept of an age-friendly city has been applied to evaluate cities in different countries, a systematic review was carried out in the Scopus database, based on articles published between 2015 and 2021. The analysis of 38 articles has made it possible to identify that the study field of the quality of the urban environment for the elderly population is new, calling for deeper studies, which includes the development of more adequate methods for evaluating this profile in the cities. The articles analyzed deal with the concept in different ways, but one of the main similarities is related to the use of the method of data collection through interviews and, in spite of using the tool indicated in the document, none applied the methodology proposed by the WHO.
Holding large conferences and events usually encourages the corresponding government to upgrade the host city. For this process, incorporating additional costs to increase accessibility for the elderly is a feasible means for a city to develop in an age-friendly manner. Providing evidence-based reports to policy makers is conducive to implementing the policies of age-friendly cities. This study used the scenario method to simulate the effect of promoting the "age-friendly cities" strategy on residents' psychological capital and social engagement (SE). We found that promoting the construction of age-friendly cities can significantly improve residents' psychological capital and SE and that residents from all age groups can benefit. This paper provides an economical means to influence policymakers through evidence-based reports in promoting the development of age-friendly cities.
Problem, research strategy, and findings The world’s population is aging at a rapid rate, yet many local built and social environments are not well suited to support older adults. Australia exemplifies the demographic–environmental disconnect because it is one of the world’s most suburban nations and has one of the proportionally largest baby boom generations. In this research we examined the relationship between built and social environments with respect to older adult vulnerability in Greater Melbourne (Australia). We found that neighborhoods with lower levels of built environment support also had lower levels of social infrastructure. The spatial imbalance across the region was most pronounced when considering the spatial distribution of older adults aged 85 years and older. Our analysis of policymaker interviews revealed a marked disconnect between the scale and scope of the challenges of suburban aging and the state and local government response. Limitations of the study included the operationalization of built environment and social infrastructure variables. Takeaway for practice Age-friendly planning and design cannot be limited to the “easier stuff” such as communication and information, social participation, and respect and inclusion. Suburban built environments require more effort and investment in transportation, housing, and outdoor spaces and buildings to support the physical and mental wellbeing of older adults aging in place. Walkable suburban neighborhoods with high levels of accessible social infrastructure will help build community connections and encourage older adult physical activity and social engagement.
Resumen El sistema actual de salud debe transformarse para responder a las necesidades reales de la población mayoritaria que atiende, la población mayor: adaptar el hospital a sus necesidades y no al revés. Ese es el objetivo del Hospital Universitario Infanta Leonor: «Hospital amable para la persona mayor». El proyecto se constituyó como un proceso dentro del mapa de gestión por procesos del hospital. Se definieron 4 subprocesos sobre los que se sustentan todas las actividades y tareas: la asistencia sanitaria (prevención del deterioro funcional, prevención del delirium y detección del anciano frágil), la formación, el entorno y sus estructuras y la implicación del paciente y sus familiares. El liderazgo corresponde al servicio de geriatría que coordina un equipo transversal de referentes del proyecto. Las acciones se sustentan en la evidencia científica, son rigurosas, evaluables y deben auditarse. El objetivo final es cambiar mentalidades, rutinas y hábitos establecidos para hacer del hospital un lugar más amable para la persona mayor.
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.
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The world is currently experiencing two major demographic transitions: the ageing of populations, particularly in low and middle income countries, and urbanization. This paper briefly summarizes current theories on how the urban environment may influence the health and quality of life of an older person, reviews epidemiologic studies that have investigated this relationship, and highlights urban initiatives that foster active and healthy ageing. The review identified an extensive body of research consistent with an association between the health of an older person and the physical, social and economic environment in which they live. However, most research in this field has been cross-sectional, and interpretation has been difficult due to numerous methodological limitations, particularly the risk of social selection biases. More recently, a growing number of longitudinal studies have identified associations consistent with previous cross-sectional research, adding weight to these findings. In the last two years alone, at least thirteen new longitudinal studies examining these issues have been reported, with ten having positive findings. Unfortunately, few of these studies can yet point to specific pathways that may be amenable to intervention. Concurrent with this research, a number of sizable programmes have been developed to make urban environments more supportive of older people. Both theory and the epidemiologic evidence appear to justify the optimism of these initiatives, although little evaluation has yet been undertaken of their impact.
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Developing environments responsive to the aspirations and needs of older people has become a major concern for social and public policy. This article aims to provide a critical perspective on what has been termed 'age-friendly cities' by shifting the focus from questions such as 'What is an ideal city for older people?' to the question of 'How age-friendly are cities?' This approach, it is argued, might be more suited to deal with the complexities of cities as sites of interlocking and conflicting commercial, social, and political interests. This theme is developed by examining: first, the main factors driving the age-friendly debate; second, constraints and opportunities for older people living in urban environments; third, options for a critical social policy; and, fourth, examples of involving older people in the development of age-friendly environments. The article concludes with a brief summary of current tensions and contradictions in the age-friendly debate.
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At the same time as cities are growing, their share of older residents is increasing. To engage and assist cities to become more "age-friendly," the World Health Organization (WHO) prepared the Global Age-Friendly Cities Guide and a companion "Checklist of Essential Features of Age-Friendly Cities". In collaboration with partners in 35 cities from developed and developing countries, WHO determined the features of age-friendly cities in eight domains of urban life: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services. In 33 cities, partners conducted 158 focus groups with persons aged 60 years and older from lower- and middle-income areas of a locally defined geographic area (n = 1,485). Additional focus groups were held in most sites with caregivers of older persons (n = 250 caregivers) and with service providers from the public, voluntary, and commercial sectors (n = 515). No systematic differences in focus group themes were noted between cities in developed and developing countries, although the positive, age-friendly features were more numerous in cities in developed countries. Physical accessibility, service proximity, security, affordability, and inclusiveness were important characteristics everywhere. Based on the recurring issues, a set of core features of an age-friendly city was identified. The Global Age-Friendly Cities Guide and companion "Checklist of Essential Features of Age-Friendly Cities" released by WHO serve as reference for other communities to assess their age readiness and plan change.
Synthesising the social capital and ageing-friendly communities literature, this paper describes how efforts to make communities more ageing-friendly can promote social inclusion among older adults. Making existing communities more ageing-friendly involves physical and social infrastructure changes that enable older adults to pursue lifelong activities, meet their basic needs, maintain significant relationships, participate in the community in personally and socially meaningful ways, and develop new interests and sources of fulfilment. Such efforts can enhance bonding, bridging and linking capital, and thereby promote social inclusion. The authors discuss the link between ageing-friendly communities and social inclusion, and provide examples of programmes with potential to change existing communities into ones that promote the social inclusion of older adults.
The Ageing in the Growth Corridors Project was initiated as a partnership between the University of Melbourne and the Department of Health in the North West Metropolitan Region of Melbourne, Australia. It involved a research team working with six project officers appointed to stimulate development in relation to an aging population in the sprawling outer metropolitan growth corridors. This article identifies the key lessons learned in terms of project implementation relating to attitudinal and structural barriers to the development of an age-friendly environment in areas of rapid urban growth. The findings illustrate some of the dilemmas raised by competing program conceptions, a dynamic and changing federal/state policy context, and local resource and strategic management constraints. The partnership with the university, nevertheless, provided a point of stability and continuity for the project officers in implementing their mandate.
This paper presents innovative applications of spatial microsimulation techniques to develop estimates of the small area distribution of deep economic disadvantage and relative economic advantage among Australians 55 years and older, combining data on disposable income, main source of income, and housing tenure. The spatial microsimulation model produces synthetic small area measures of economic disadvantage and advantage among older people that are multidimensional. This approach recognises that income levels alone may not adequately capture the complexity of relative advantage and disadvantage among older people. We particularly focus here on addressing and investigating the limits of spatial microsimulation modelling, describing and testing a number of possible methods for validating the synthetic estimates and identifying ongoing challenges and opportunities in the estimation of older adults' economic characteristics at a small area level. We find that, once we have adjusted the benchmarks to better match our research and excluded from our analysis small areas for which the modelling is unable to produce accurate results (often because of small sample sizes or unusual population characteristics), we are able to accurately match our synthetic estimates with known small area data, with Pearson's R values between 0.95 and 0.98. Our final results show substantial small area differences in economic advantage and disadvantage among older Australians and point to the need for understanding the geographic aspects of diversity in the older population. Such an understanding will allow for the development and appropriate targeting of policy responses to the needs of older people of modest economic means. Copyright (c) 2011 John Wiley & Sons, Ltd.
In Australia, 13 per cent of the population were aged 65 and over in 2002, and this proportion is expected to rise to 25 per cent by the year 2050. Over the next 50 years people aged 80 years and over will constitute the most rapidly growing population group, and these patterns of population ageing are reflected worldwide. In order to design effective programmes and policies for our ageing populations, we need to provide a sound evidence base. Through participation in research older people can help provide this evidence base. Not only can older people provide data about their levels of health and functioning to assist health and social planners, but they also can provide us with their perspectives on the lived experience of ageing, thus contributing to society’s understanding of the ageing process and old age. As noted by Browning, Minichiello and Kendig (1992, p. 164), ‘The better we understand the underlying processes of ageing, the better the chance that preventative action will be taken to preserve health and vitality in old age.’