Social participation and social support are strongly associated with good health and well-being throughout life. Participating in leisure, social, cultural and spiritual activities in the community, as well as with the family, allows older people to continue to exercise their competence, to enjoy respect and esteem, and to maintain or establish supportive and caring relationships.
Specialised educational institutions like Silver College offer a great example of a place where senior citizens can gain a fresh perspective and purpose after retirement. Set up by Kobe City, the College offers many part-time courses around sports, arts, outdoor pursuits, and academic research.
In Happy Active Town we have an example of mobilization in an urban high-rise community. The social catalyst sprang from deep concern over the solitary deaths of elderly neighbours alone in their apartments. HAT is an important example of a socially charged aged friendly environment where locals look out for each other. For an older person whose family support is not in the vacinity, exposure and access to a friendly support network is crucial. Local citizens encourage each other to come together for events at a central location or to visit others close by.
Mr. Yasujiro Yamaguchi is described as the perfect centenarian. A master weaver, the old man of 103 still sits at his loom and creates works of art. He attributes his health to luck, helped by staying mental physically active. The Yamaguchi family, watching closely from the sidelines, provides him supportive relationships. In turn, his children carry on his weaving legacy.
In 2002, a major study of ageing in the United Kingdom undertaken by Dr. Michael Marmot and his colleagues revealed the following:
“Ask people about ageing in our society, and everyone has a view. Most would think it widely known that older age is a time of declining mental and physical function, worse health, and economic and social dependency. The elderly are a ‘problem’. Indeed, a small number of people over the age of 65 fit this stereotype. Most do not. What is striking about the health and social circumstances of older people in society is how variable the picture is, ranging from this rather depressing stereotype to that of vigorous octogenarians, economically and socially independent, with little disability, wide social and cultural interests and much to contribute to society.”
In our fast ageing world, older people are increasingly playing a crucial role – through voluntary work, transmitting experience and knowledge, helping their families with caring responsibilities or in paid work. These contributions rely on older persons enjoying good health and societies addressing their needs.
Active ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age. It applies to both individuals and population groups.
Active ageing allows people to realize their potential for physical, social, and mental well-being throughout the life course and to participate in society, while providing them with adequate protection, security and care when they need it.
The word “active” refers to continuing participation in social, economic, cultural, spiritual and civic affairs, not just the ability to be physically active or to participate in the labour force. Older people who retire from work, even with some level of disability, can remain active contributors to their families, peers, communities and nations. Active ageing aims to extend healthy life expectancy and quality of life for all people as they age.
“Health” refers to physical, mental and social well-being as expressed in the WHO definition of health. Maintaining autonomy and independence for the older people is a key goal in the policy framework for active ageing.
At the same time, ageing takes place within the context of friends, work associates, neighbours and family members. This is why interdependence and intergenerational solidarity are also important tenets of active ageing.
The role of cities
While the world is ageing, it is also urbanizing. Over half of the global population is now urban, meaning that more older people are living in towns and cities. The proportion of the older adult population residing in cities in developed countries matches that of younger age groups – about 80% – and should continue to rise at the same pace. In low and middle income countries however, the share of older people in urban communities is expected to multiply by 16 from about 56 million in 1998 to over 908 million in 2050. By that time, older people will comprise a quarter of the total urban population in less developed countries
Why develop an age-friendly city?
Making cities age-friendly is one of the most effective policy approaches for responding to demographic ageing. One of the reasons for focusing on cities is that major urban centres have the economic and social resources to make changes to become more age-friendly and can thus lead the way for other communities. An age-friendly community benefits people of all ages.
Source: WHO (2007). Global Age-friendly Cities: A guide.
What are the characteristics of an age-friendly city?
The main chareacteristics can be summarized as follows:
- Inclusive opportunities for civic, cultural, educational, and voluntary engagement (link to Silver City College example)
- Accessible public and private transportation
- Barrier-free and enabling interior and exterior spaces
- Accessible and useful information
- Positive images of older persons
- Activities, programs and information to promote health, social, and spiritual well-being
- Social support and outreach
- Accessible and appropriate health services
- Places and programs for active leisure and socializing
- Good air/water quality
Security and independence
- Appropriate, accessible, affordable housing
- Accessible home-safety designs and products
- Hazard-free streets and buildings
- Safe roadways and signage for drivers and pedestrians
- Safe, accessible and affordable public transportation
- Supports for caregivers
- Accessible stores, banks and professional services
- Supportive neighbourhoods
- Safety from abuse and criminal victimization
- Public information and appropriate training
- Emergency plans and disaster recovery
- Appropriate and accessible employment opportunities
- Flexible work practices
What can individuals do?
Probably the single most important health message for older persons is to achieve or maintain moderate levels of physical activity. There are similarities between the deterioration that occurs with ageing and that accompanying physical inactivity. Preventive measures to reduce diet-related disease should begin early in life, but it is never too late to start, even in old age. Positive changes in lifestyle are worthwhile at every age.
Creating Resiliant and Age-Friendly Communities
Ideally, an age-friendly city can be achieved through good development policies. This involves the local authorities putting in place policies that ensure that all new development projects include measures to meet the needs of the elderly. As a result, over time cities evolve and better reflect the needs of a growing elderly population.
However, there will also be instances when redevelopment is required on a major scale and this can often be the result of a natural disaster. This was the experience of Kobe following the Great Hanshin-Awaji Earthquake.
The earthquake hit Kobe City on Tuesday January 17 1995 at 5:46 a.m causing enormous damage. The death toll from the earthquake was 6,437, with another 43,792 injured. Approximately 510,000 buildings were damaged or destroyed. The total economic loss resulting from the earthquake amounted to 9,926.8 billion (almost 10 trillion) yen (around US$100 billion).
Many elderly and disabled living in traditional housing fell victim to the earthquake. As survivors they had no choice but to move into public housing because they were unable to reconstruct their houses. This presented a major challenge for the local authorities and as of March 2004 there were 16,000 disaster restoration housing units in Kobe City (of which 10,500 units were municipal housing).
By April 2006, elderly households accounted for 48% of all households in this new accommodation, with single elderly households accounting for 41.5%. According to survey results five years after the earthquake (Ii, 2001), about 30% of the residents in the new communities said they had ‘no social contact with their neighbours’, ‘no one to go to for advice’ and ‘no enjoyment.’ They went out only ‘to do some grocery shopping’ and ‘to visit the doctor.’
Another survey found that in a high-rise housing complex in Nagata Ward, seniors over 65 accounted for 70.8% of residents. According to surveys conducted by Kobe University (Shiozaki 2002), the percentage of respondents who said they had social contact with their neighbours dropped sharply to one-fourth, from 50% before the earthquake to 30.3% at the time of moving into temporary housing, and to 12.5% when moving into the permanent housing.
The number of kodokushi (solitary deaths) in disaster restoration public housing amounted to 251, nine years after the earthquake, exceeding the 233 kodokushi in temporary housing. There were two main characteristics. First, young elderly men (55-64) formed the largest subset of victims. Second, alcohol-related problems were the main cause of death.
Experience from the Kobe earthqauke reconstruction clearly illustrates, and as the story of Happy Active Town also exemplifies, that rebuilding better is no simple process. One challenge is to rebuild the infrastructure, services and accommodation. However, another equally important challenge is how to rebuild community spirit and a sense of belonging. This takes considerably more time.
References and Relevant Links:
Minami H, et al. (2006), A Scoping Paper: Social Determinants of Health in Hyogo Prefecture and Kobe City, commissioned by the WHO Kobe Centre.
Ii, K., Kawauchi, K., Kawamura, M.(2001).Long-term support for victims after the Great Hanshin-Awaji Earthquake, CNAS Hyogo Bulletin Vol.8, 87-100.
Shiozaki, K., Nishimoto, E.(2002). One hundred lessons form the Great Hanshin-Awaji Earthquake, Creates Kamogawa.