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Building Smart Healthy Inclusive Environments for All Ages with Citizens

Authors:
  • AFEdemy, Academy on age-friendly environments in Europe BV

Abstract

The paper provides an introduction to the public discourse around the notion of smart healthy inclusive environments. First, the basic ideas are explained and related to citizen participation in the context of implementation of a “society for all ages” concept disseminated by the United Nations. Next, the text discusses selected initiatives of the European Commission in the field of intergenerational programming and policies as well as features of the COST Action NET4Age-Friendly: Smart Healthy Age-Friendly Environments (SHAFE). The following sections are focused on studying and discussing examples of projects and methodologies that have been aimed at: empowering facilitators of smart healthy inclusive environments, empowering citizens to deal with health emergencies, and supporting older people’s voices. The conclusion covers selected recommendations for entities of public policy on ageing (ageing policy) as well as potential directions for further research.
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
1
Building Smart Healthy Inclusive Environments for All Ages with Citizens
Willeke van Staalduinen 1, Carina Dantas 2, Joost van Hoof 3,4, Andrzej Klimczuk 5
1 AFEdemy, Academy on Age-Friendly Environments in Europe BV, Buurtje 2, 2802 BE
Gouda, The Netherlands willeke@afedemy.eu
2 SHINE 2Europe Lda, Rua Camara Pestana, Lote 3-1 DF, 3030-163 Coimbra, Portugal
carinadantas@shine2.eu
3 The Hague University of Applied Sciences, Johanna Westerdijkplein 75, 2521 EN Den
Haag, The Netherlands j.vanhoof@hhs.nl
4 Wrocław University of Environmental and Life Sciences, ul. Grunwaldzka 55, 50-357
Wrocław, Poland
5 SGH Warsaw School of Economics, al. Niepodległości 162, 02-554 Warsaw, Poland
aklimcz@sgh.waw.pl
https://www.afedemy.eu, https://shine2.eu, http://www.hhs.nl, http://www.sgh.waw.pl
Abstract. The paper provides an introduction to the public discourse around the notion of smart
healthy inclusive environments. First, the basic ideas are explained and related to citizen
participation in the context of implementation of a “society for all ages” concept disseminated
by the United Nations. Next, the text discusses selected initiatives of the European Commission
in the field of intergenerational programming and policies as well as features of the COST
Action NET4Age-Friendly: Smart Healthy Age-Friendly Environments (SHAFE). The
following sections are focused on studying and discussing examples of projects and
methodologies that have been aimed at: empowering facilitators of smart healthy inclusive
environments, empowering citizens to deal with health emergencies, and supporting older
people’s voices. The conclusion covers selected recommendations for entities of public policy
on ageing (ageing policy) as well as potential directions for further research.
Keywords: Age-friendly cities and communities, Citizen participation, Inclusive
environments, Intergenerational Programmes and Policies, Smart Healthy Age-Friendly
Environments (SHAFE), Society for all ages
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
2
Introduction
Smart, healthy, and inclusive environments can help improve and support independent living
throughout the course of life, regardless of age, gender, health status, disabilities, cultural
differences, and personal choices. In order to develop and design these environments, it is of
the utmost importance to include the people who are to live in these designed surroundings and
should ideally accept the use of the proposed solutions. In this contribution, we explore several
approaches to citizen participation in order to create smart healthy inclusive solutions and
environments, including solutions, programs, schemes, products, and services for all ages. The
methodologies of involvement and engagement are acknowledged, andif appropriate
success factors and lessons learned are identified. At first, a short overview of the smart healthy
age-friendly environments (SHAFE) notion is given. This is followed by a paragraph on
citizens’ participation in the context of implementation of a “society for all ages” concept
promoted by the United Nations. Thereafter, several projects are presented, methodologies of
participation highlighted, results described, and conclusions drawn.
Defining the Smart Healthy Inclusive Environments
The challenges of various sectors, such as the information and communications technologies
(ICTs) sector, the building and urban planning industry, health and social care, as well as those
of citizens and their communities, are interlinked. Responding to these challenges will foster
awareness and support the creation and implementation of smart, healthy, and inclusive
environments for present and future generations that enable them to learn, grow, work,
participate in society and enjoy a healthy life, benefiting from the use of digital innovations,
accessibility solutions and adaptable support models in the European context.
The local community is the physical, social, and cultural ecosystem closest to people, which
is built on relationships of trust, sharing, solidarity and intimacy, where people find social,
cultural and identity references, socialise and live their daily lives. The objective conditions of
the environment (maintenance, accessibility, mobility, safety, and comfort) affect the quality of
life and well-being of citizens, particularly in the context of environmental challenges such as
climate change and thus affect the whole community.
Thus, smart healthy inclusive environments, also described as smart healthy age-friendly
environments (SHAFE), require a comprehensive approach that optimises the design of social
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
3
and physical environments, which is supported by digital tools and services, which allows
providing better health and social care as well as promotes not only independent living but also
equity and active participation in society. This approach follows the United Nations’ line-up,
with the Sustainable Development Goals (SDGs) intended to be achieved by the year 2030 [1],
stating that sustainable environments for all ages represent the basis for ensuring a better future
for the entire world population and addressing most of the growing issues of the ageing
population. They are in particular related to Goal 3 (“Ensure healthy lives and promote well-
being for all at all ages”) and Goal 11 (“Make cities inclusive, safe, resilient and sustainable”)
and can be understood as an approach broader than other ideas used in the literature such as
ambient assisted living (AAL), smart and age-friendly cities and communities (SAFCC), and
“ageing in place 2.0” (AIP2.0) [2].
Citizen Participation in the Context of Implementation a “Society for All Ages” Concept
In order to develop the above mentioned inclusive, smart, and healthy environments, citizen
involvement and cooperation is particularly important. Having people’s voices heard during the
conceptualisation and design phases of the development of the living environment fit the
objectives of the intergenerational policies related to the United Nations concept of “society for
all ages” and its implementation by the World Health Organization’s (WHO) Global Network
on Age-Friendly Cities and Communities (GNAFCC). Citizen participation clearly pertains to
the distinguished domains of age-friendliness described as buildings and housing, social
participation, and social inclusion [3, 4].
Van Hoof et al. [4] took the widely used concept of the “ladder of citizen participation” by
Arnstein [5] as a starting point in shaping various roles that citizens can play. Arnstein described
eight roles for citizens, varying from nonparticipation (in forms such as manipulation and
therapy) through tokenism to citizen power. Tokenism is divided into informing (about citizen’
rights, but often the one-way flow of information), consultation (e.g., ask for opinions in
surveys, neighbourhood meetings or hearings), and placation (citizens are granted a limited
degree of influence in boards or commissions). Higher levels of participation grouped under
the notion of citizen power are divided into partnership (shared planning and decision-making
responsibilities through structures such as policy boards), delegated power (some degree of
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
4
control is transferred to citizens), and citizen control (participants or residents can govern a
programme or an institution and be in full charge of policy and managerial aspects).
Additional research on citizen participation by Van Hoof et al. [4] showed that involvement
is not automatically a guarantee for success. For example, due to a limited number of active
participants, lack of required skills to participate or not representing the target group, success
can be rather limited. Van Hoof et al. further identified the factors that impact the participation
of citizens in a positive manner, such as the provision of regular feedback, the full commitment
of the involved organisations, and the usage of understandable and inclusive language. Having
these observations in mind, the following sections are providing discussions and examples of
various approaches to citizen participation related to SHAFE.
Selected Initiatives of the European Commission in the Field of Intergenerational
Programming and Policies
In 2012, the European Commission announced the European Year for Active Ageing and
Solidarity between Generations and took the initiative to launch a bottom-up approach to
involve citizens and organisations’ actions and opinions in the field of public policy on ageing
(ageing policy) [6]. It led to the creation of the European Innovation Partnership on Active and
Healthy Ageing (EIPonAHA) [7]. At first, it was well-received, and many parties joined the
network. Over the years, the broad interest slowly faded but the main challenges recognised
remained unsolved, for example, the need for scaling up and transferring across the countries,
regions, and communities the best practices and solutions such as social innovations and
technological innovations in ageing [8, 9]. Nevertheless, several networks that had their origin
in the EIPonAHA, such as the Stakeholders Network on Smart Healthy Age-Friendly
Environments (SHAFE) [10] and the Reference Sites Collaborative Network [11], still continue
to operate.
To bring the European Union (EU) citizens’ involvement alive again, the European
Commission, at the beginning of the year 2021, launched a new cooperation network titled the
Active and Healthy Living in the Digital World. This network is a part of the Futurium platform
that started already in the year 2011 as a foresight project aimed at participatory policymaking,
crowdsourcing of ideas, and discussing EU policies [12]. One of the dedicated areas within this
emerging network is dedicated to age-friendly environments.
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
5
On a different note, the President of the European Commission, Ms Ursula von der Leyen,
also at the beginning of the year 2021, took the initiative to launch a bottom-up approach
initiative: co-designing the New European Bauhaus [13]. The New European Bauhaus proposes
to focus the conversations on the places that EU citizens inhabit and on the relationship with
natural environments beyond the built space. It is a practical approach to discover beautiful,
sustainable, and inclusive ways of living and to use them to inspire our way forward. EU
citizens are invited to join the conversation and are asked to share their thoughts on future
environments and places to be like. Moreover, if it was their neighbourhood, how should that
look like, feel like, and work like.
COST Action NET4Age-Friendly: Smart Healthy Age-Friendly Environments
The concept behind SHAFE has inspired several projects and initiatives, including one of the
most recent initiatives supported by the European Cooperation in Science and Technology:
NET4Age-Friendly (2020-2024; COST Action 19136), which is an international
interdisciplinary network on health and well-being in an age-friendly digital world focused on
the promotion of social inclusion, independent living, and active and healthy ageing in society.
Participating scholars, practitioners, and stakeholders from the business and third sector
work in four thematic groups on user-centred inclusive design, integrated health and well-being
pathways, digital solutions, and large-scale sustainable implementation, and on impact and
sustainability (including policy development, funding forecast, and cost-benefit evaluations).
In order to synthesise and critically examine the results of these four themes and existing
practices of SHAFE, a fifth working group will develop a reference framework with guidelines,
standards, and practices (success factors and lessons learned) [14].
The main purpose of described COST Action is to build and nurture local, regional, or
national ecosystems in each participating country. Ecosystems consist of citizens, public
authorities, businesses, non-governmental organisations (NGOs), and research and
development entities. These ecosystems aim to foster the implementation of SHAFE with the
support of the above-mentioned working groups.
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
6
Empowering Facilitators of Smart Healthy Inclusive Environments
Erasmus+ is the EU’s programme to support education, training, youth, and sport in Europe in
multinational consortia [15]. These areas are key to support citizens’ personal and professional
development. High quality, inclusive education and training, as well as informal and non-formal
learning, ultimately equip participants of all ages with the qualifications and skills needed for
their meaningful participation in a democratic society, intercultural understanding, and
successful transition in the labour market. Within the frame of Erasmus+, training and education
is developed to empower facilitators to implement smart healthy inclusive environments in their
community.
Projects such as “Hands-on SHAFE” [16], “Educational game BIG” [17], “Bridge the Gap!”
[18], and “DESIgn for all methods to cREate age-friendly housing” (DESIRE) [ 19] supported
by the Erasmus+ programme include adult learners in the field of inclusive environments.
“Hands-on SHAFE” aims to deliver online training packages for informal learning experiences
and hands-on tools to improve the skills of people of all ages and especially seeks to enable
persons with lower skills or qualifications to choose and implement SHAFE in their own homes
or neighbourhoods. In this way, the project fosters and promotes social inclusion for people of
all ages and genders, including people with cognitive or physical impairments or disabilities. It
also aims to enable citizens to become innovators and trailblazers in their own neighbourhoods
or to become entrepreneurs in the field of SHAFE services and products.
The educational game “Building Inclusive environments for all Generations” (BIG)
elaborates further on the training about SHAFE by developing an online game. The player can
meet and solve the challenges of characters during the play, such as inaccessible housing for a
wheelchair, loading goods in a car while taking care of a child, or visiting a restaurant with
impaired sight. The project will also develop a workshop methodology to use the game in joint
training settings.
The “Bridge the Gap!” project focuses on the training of older people to create and improve
their own living environments to support independent living and participation in society. On
the one hand, the training offers traditional means to advocate their interests. On the other hand,
it will mainly focus on the capacity building of older adults to use digital skills. Such digital
actions include accessing social media, building online advocacy accounts, or sharing photos
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
7
to express to stakeholders and decision-makers specific local needs to improve the local living
environment.
The DESIRE project is developed by an international partnership involving four countries
working on a design for all (D4ALL) concept applied to age-friendly housing. DESIRE aims
to provide professionals in the building industry as well as furniture and home furnishings sector
with the tools and skills to apply D4ALL methods as an integral part of the design process, with
the aim to create or adapt age-friendly housing as a solution for the well-being, comfort and
autonomy of older adults or people in situation of dependency at home. The project will develop
an innovative training course on D4ALL to meet the emotional, cognitive, and social needs of
older adults while driving new opportunities in the habitat sector, fostering interactions and
knowledge exchange in the design process between cross-cutting fields such as science, social
sciences, and arts.
Empowering Citizens to Deal with Health Emergencies
Erasmus+ project “STEP_UP” [20] intends to develop a training tool for social care and
community stakeholders, where they are introduced to the impact of behaviours in the spread
of a pandemic or emergency situation and trained, through gaming strategies, to prevent and
cope, being empowered to protect and promote well-being in their communities.
The core of this project will be an educational game, which can also be used as a recreational
game for the common public. In “STEP_UP,” the players will play with the aim to stop a
pandemic from spreading. A list of measures will be displayed, and the player needs to learn
about them in order to be able to choose those that would help to impede the virus spread
without damaging the economy or causing societal anger. This game will also help people better
understand and follow governmental measures and set aside evidence-based information and
facts from myths, fake news, and other forms of misinformation or disinformation.
Case Study of Supporting Older People’s Voice: Senior-Friendly the Hague
Since 2015, the municipality of The Hague is a member of the WHO’s Global Network on Age-
Friendly Cities and Communities [21]. Member cities of GNAFCC follow a 5-year cycle of
planning, implementation, and evaluation in order to make their respective city or community
age-friendly. The Hague recently finalised their first cycle by performing a broad survey among
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
8
older people (65+) to express their opinions on the age-friendliness of the city. Overall, the
older citizens of The Hague value the age-friendliness of their city as well as perceives it as
sufficient. They give high scores to their own homes. On the contrary, outdoor spaces and
buildings were scored significantly lower. People in the situation of having a lower income,
health and mobility issues are less satisfied.
In order to better involve older adults in local policymaking, the municipality facilitates
three ways of citizens involvement. At first, it subsidizes the overarching Older People’s
Council of The Hague (in Dutch: Stedelijke Ouderencommissie; SOC) [ 22-24]. Secondly, it
facilitates and supports the building and maintenance of a local ecosystem titled the Knowledge
Platform Age-Friendly The Hague. In this platform, older citizens, scholars, public health
administration, municipal policymakers, and social enterprises (social small and medium-sized
enterprises; SMEs) meet on a regular basis to exchange ongoing research and to look for
cooperation opportunities in the field of the municipal Action Plan Age-Friendly The Hague
(2020-2022). The final support to hear the voice of older people in The Hague is the fostering
of the active involvement of an older people’s panel: a broad panel of at least 1,500 older adults
(out of 77,000 people aged 65 and over) who can be consulted on a large variety of municipal
topics.
Conclusion: Citizens’ Participation in Smart Healthy Inclusive Environments Explored
From this broad overview of fieldwork, it has been possible to explore various perspectives of
inclusive environments, their challenges, and the needs to be addressed. Some of the lessons
learned in the various projects include that citizen participation is fully recognized as essential
(Table 1). However, a long way is still necessary to make it structured, constant, and
comprehensive.
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
9
Table 1. The Comparison of Selected Initiatives of Citizen Participation Related to the
Implementation of a “Society for All Ages” Concept
Initiatives
Strengths
Weaknesses
Challenges
European
Commission’s
Initiatives
- Combining bottom-up
and top-down
approaches to ageing
policy
- Focus on combining
population ageing with
digitalisation processes
and the development of
diverse environments
- Unclear monitoring
and evaluation of results
- Dependent on funding
programmes with
priorities on specific
sectoral policies (e.g.,
ICT and AI-focused
economic entities)
- Scaling up of the best
practices and policy
transfer across the
countries, regions, and
communities
COST Action
NET4Age-
Friendly
- Bottom-up
international and
interdisciplinary
network
- Providing support in
the form of guidelines,
standards, and practices
- Establishing
sustainability for the
network after the
project period
- Building multilevel
ecosystems with a
quadruple helix of
citizens, public
authorities, companies,
and researchers
Projects:
“Hands-on
SHAFE,”
“BIG,”
“Bridge the
Gap!,” and
“DESIRE”
- Delivering training
packages and tools
related to age-friendly
homes or
neighbourhoods
- Entrepreneurship
promotion
- Limited scale of
innovative solutions
- Further dissemination
and development of
schemes
Project
“STEP_UP”
- Empowering citizens
to deal with health
emergencies
- Monitoring and
evaluation of results
after the COVID-19
pandemic
- Extending focus on
the fight with
misinformation or
disinformation
Senior-
Friendly The
Hague
- Broad set of initiatives
to involve older people
in implementation and
governance of age-
friendly city’s idea
- Establishing
sustainability of the
older people’s council,
the knowledge platform,
and an older people’s
panel
- Citizens’ involvement
is dependent on their
socioeconomic status
Source: own elaboration.
The call for active citizenship and ownership of the transformation of society is, on the one
hand, a gift to the citizens. Nevertheless, at the same time, this call is also a burden in terms of
commitment and involvement, which currently, not all are prepared to deliver. To overcome
these barriers, learning experiences focusing on older adults in Erasmus+ training activities and
W. van Staalduinen, C. Dantas, J. van Hoof, A. Klimczuk, Building Smart Healthy Inclusive
Environments for All Ages with Citizens, [in:] I.M. Pires, S. Spinsante, E. Zdravevski, P. Lameski
(eds.), Smart Objects and Technologies for Social Good: 7th EAI International Conference,
GOODTECHS 2021, Virtual Event, September 1517, 2021, Proceedings, Springer International
Publishing, Cham 2021, pp. 255263, https://doi.org/10.1007/978-3-030-91421-9_19.
10
games as well as knowledge platforms and ecosystems do support the awareness of older adults
to uptake and realise their own lives in their environments. The initiatives that foster more active
citizenship and those who call for the participation of several age and societal groups are at the
core of this citizen empowerment need, essential to create a better and fairer society for all. This
development just started.
Acknowledgements. This publication is based upon work from COST Action CA19136 “Inter-
national Interdisciplinary Network on Smart Healthy Age-friendly Environments,” supported
by COST (European Cooperation in Science and Technology). For more details go to:
www.net4age.eu The publication received financial support in the form of an ITC Conference
Grant awarded by the COST Action CA19136 to Andrzej Klimczuk.
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ResearchGate has not been able to resolve any citations for this publication.
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Aging policy transfer, adoption, and change
  • C Dantas
  • W Van Staalduinen
  • A Jegundo
  • J Ganzarain
  • S Ortet
Dantas, C., van Staalduinen, W., Jegundo, A., Ganzarain, J., Ortet, S.: Aging policy transfer, adoption, and change. In: Gu, D., Dupre, M.E. (eds.) Encyclopedia of Gerontology and Population Aging: Living Edition, pp. 1-6. Springer, Cham (2020). https://doi.org/10.1007/ 978-3-319-69892-2_216-2