WUNRN
As the World’s Older Population Increases, Can Cities Handle the Influx + Needs of Older Women?
Many older women will be struggling financially, says Lisa Warth, coordinator of the World Health Organization’s Global Network of Age-Friendly Cities and Communities. “Women often outlive their husbands and face their oldest age as widows,” she says. “Women often have a lower income in old age than men and are more likely than men to be affected by poverty. Living alone, they are at a higher risk of social isolation and loneliness.”
Japan may have
the market on the world’s oldest population, but some European nations are
right behind. These women survived the 2011 tsunami in Japan and moved in
prefab homes supplied by the government after the disaster.- April 22, 2015 -
Passblue
By Amy Wu – PassBlue - July 27, 2015
A trio of megatrends that could
radically change the makeup of cities around the world is about to converge.
“You have two
very powerful trends,” says John Wilmoth, director of the United Nations Population Division. “There’s aging of
population and there’s an urbanization that’s taking place. It’s not only
movement to cities, but it’s the growth to cities relative to the rural areas.
From 1950 to 2050, it’s a change from one-third urban and two-thirds rural. A
hundred years later it has flipped.”
The facts are
clear: More than half the world’s population lives in cities, the aging
population — those 60 and over — will be increasingly dominated by women and
Europe and North America will soon have the highest population of older people
globally. Some countries, like Germany, may be better prepared for the influx
of aging citizens than others.
The United
States, falling in the cohort of rich countries with an increasing aging
population, is not gearing up on a large scale for this arrival at the federal
level, despite a gradually aging baby boomer population. Instead, cities
themselves are taking the initiatives, like New York and Portland, Ore., in
carrying out new policies.
Moreover,
ballooning aging populations are mainly affecting cities in developed countries
in the near future. Developed countries will have to contend with large aging
populations eventually, as longevity increases and fertility rates remain high
in places like sub-Saharan Africa and South Asia. At the very least,
current bare-bones public services in the developed world will need to be
enhanced.
The UN
estimates that the number of people age 60 and over will double in 10 years,
from 600 million now to 1.2 billion by 2025, and to 2 billion by 2050. From
2000 to 2050, the proportion of the world’s population over 60 years old will
double to 22 percent.
By 2050, 66
percent of the world’s population will live in urban areas, up from 54 percent
in 2014, UN data shows. The highest growth will occur in China, India and
Nigeria, according to the 2014 revision of the World Urbanization Prospects by
the UN Population Division, reinforcing the need for developed countries to
begin addressing infrastructure and provision of social services soon.
Large cities
will not be the only metropolises affected. Wilmoth says that urban growth
includes small and medium-size cities with populations from 250,000 to 500,000.
This expansion has resulted in a “shift in the private and public sector to
create systems to provide for the needs of older people,” he adds, noting the
long-term care industry.
Aging and
urbanization is in many respects an evergreen issue. Nearly two decades ago, in
1998, UN-Habitat, a program that
promotes optimum urban development, held a conference titled “Aging and
Urbanization: Challenges and Opportunities,” ahead of the 1999 UN International
Year for Older Persons.
But as the
world inches further into the 21st century, the trends are becoming more pronounced,
demanding fuller attention and faster solutions. Cities need to be prepared for
the requirements of an older population, which involves a lengthy checklist
ranging from transportation to health care. In 2016, UN-Habitat will hold
a conference looking
at these issues through urbanization and sustainability themes.
Despite the
continuing fears, are cities even beginning to prepare for the intersecting
trends? Take, for example, the US and its fast-aging baby boomers. The US is
not in the top 10 aging
nations, as reported by PassBlue, because of its young immigrant
population, but it falls into the top 20 countries, where the growing number of
aging people is perceived to be a major concern by its own citizens, according
to a 2013 Pew Research Center survey.
In the US, the
population of people 60 years old and over will leap to 112 million in 2050,
nearly double from 56.9 million in 2010, says the US Department of Health and
Human Services’ Administration for Community Living.
Women
Predominating in the US
In 2050, the
number of women age 60 and over in the US is projected to be 54.2 percent,
compared with 45.8 percent for men, as women generally outlive men.
In the US, a
woman’s life expectancy is 81 years old, compared with 76 for men. Women are
expected to be in better physical shape than men, says a report, “Older Americans 2012: Key Indicators of Well Being,” published
by the Federal Interagency Forum on Aging-Related Statistics, an entity
established in 1986 by the National Institute on Aging, the National Center for
Health Statistics and the Census Bureau to connect government agencies focused
on relevant data.
Women in the
US have become more financially independent, which means that they have more
say on how they want to spend their time as they grow older, says William Frey, a
demographer with the Brookings Institution.
Yet many older
women will be struggling financially, says Lisa Warth, coordinator of the World Health Organization’s
Global Network of Age-Friendly Cities and Communities. “Women often outlive
their husbands and face their oldest age as widows,” she says. “Women often
have a lower income in old age than men and are more likely than men to be
affected by poverty. Living alone, they are at a higher risk of social
isolation and loneliness.”
Warth adds
that “Tackling women’s needs in old age starts with ensuring that women have
equal opportunities in education and employment and that the unpaid care they
provide in the family is recognized in pension systems to improve their financial
situation in old age. Access to quality health, care and social services
is important as well as the opportunity to continue to contribute in a
meaningful way and to engage with others.”
Wilmoth of the
UN Population Division agrees that it is important to focus on
antidiscrimination rules against women, who may not have access to pension and
full-time work, including women who never married.
At the
grassroots level, initiatives to generate discussion on these issues have been
underway for years. In 2007, for example, Marianne Kilkenny started Women for Living
in Community, which encourages sharing housing among single women as
they get older.
“Wellbeing is
more than healthcare; it’s emotional care, and that kind of care comes from
being surrounded by people we know, love and trust, not just by nurses and
planned activities,” Kilkenny, who lives in Asheville, N.C., writes on her website.
These and
other gender-specific aging problems will need concerted focus in cities, where
the majority of the aging female population is settling.
Yet cities
generally have far to go in confronting the needs of aging populations, Warth
of Global Network says. Some key necessities include creating barrier-free and
accessible urban environments, combating ageism by raising retirement age or
abolishing compulsory retirement and promoting volunteering through such
organizations as AARP’s
Experience Corps, where people 50 years old and above work with
children on literacy.
The World
Health Organization, for one, has been paying attention to the trends
converging on cities: a report in 2007, “Global Age-Friendly Cities: A Guide,” detailing information
culled by focus groups who met in 33 cities in developed and developing
countries to discuss an array of topics, including housing and infrastructure.
The list of
services and improvements that the groups compiled included more outdoor
seating areas, green spaces, buildings with more escalators and elevators and
nonslip pavements. The groups also suggested some “Do Nots”: like eliminating
cross-walk lights timed for “Olympic runners.”
Some
participating cities have responded to the wish list. Germany
has built multigeneration houses (Mehrgenerationenhauser) in more than 450
cities and communities nationwide. The houses act as hubs for all generations,
with services from child care to elder care as well as offering opportunities
for older people to volunteer, say, as storytellers to children.
In Geneva,
restaurants provide subsidized lunches for older people and volunteers help
those with limited mobility to join a group meal to have company.
The World
Health Organization recently introduced a website, www.agefriendlyworld.org,
with information on other helpful initiatives, like Akita, Japan’s bus-coin
project, in which people age 68 and over ride buses free or are provided free
alternative transportation. The website includes online tools and guides for
cities and communities. (Japan has the world’s largest population over age 60.)
New York,
Portland and Other US Spots
How are
American cities prepping for the converging trends? The country has the
wealthiest population based on gross domestic product, but interviews with
aging experts and demographers reveal that many cities have been slow in making
their environments more amenable.
New York City
is one major exception: it has been making headway on being more responsive to
older people’s needs, recognizing the economic value of attracting this
population to its neighborhoods.
Bethany Brown,
the policy director of HelpAge USA,
a Washington D.C.-based nonprofit group focused on the livelihood and rights of
senior citizens, points out that certain cities on WHO’s list of age-friendly ‘partner cities’ have added traffic
islands and increased the number of seconds to traverse crosswalks. (New York
became the first member of a separate list: WHO’s Global Network of Age-Friendly Cities and Communities in
2010, but it did not participate in the focus groups project.)
In 2009, under Mayor Michael Bloomberg, as many as 59
initiatives to make New York more comfortable emerged from a review by his
office and the New York City Council. These included safer streets and cultural
guides for older people.
On the other
side of the US, in Portland, Ore., which participated in the WHO focus group
project, carried out an action plan in 2013, including engendering “respect and
social inclusion.” (The number of people 65 and older in Portland is forecasted
to jump to 882 million in 2030 from 533 million in 2010.)
Other Portland
initiatives have featured certifications to businesses catering to older people
and promoting less ageist language, like dropping “senior citizens” and “the
elderly,” for “older adults” and “elders.”
While Portland
was the only American city participating in the WHO project, other
organizations like AARP have created age-friendly certifications. AARP’s
Network of Age-Friendly Communities is run under WHO and involves committing to
a five-year program based on “8 Domains of Livability” — like social and civic
participation, employment, communication and information and community support
and health services.
Making the
list of AARP certified cities are Denver, San Francisco and Washington
as well as smaller cities like Des Moines, Ithaca, N.Y., and Lexington, Ky.
Quality of
life is critical as cities undergo makeovers, rehabilitating decades-old
infrastructure and improving other public services to prevent, say, flooding as
climate change problems ensue. The Rockefeller Foundation’s City Resilience
Framework report says that a resilient city “values ecosystem services
and has in place robust environmental policies to protect ecosystems in situ.”
The foundation
and the global consulting firm Arup introduced a 100 Resilient
Cities project in 2013, identifying what makes cities thrive.
Rankings that
examine what cities are doing specifically on aging are surfacing more. The Milken
Institute’s biannual ranking of best cities for successful aging
factors in 84 data indicators. The index included rankings for 352 US
metropolitan areas. Important indicators look at community engagement, for
example.
In 2014, the
top large metropolitan area was Madison, Wis., and the small metropolitan city
was Iowa City.
Smarter cities
that cater to an aging population can generate a domino effect, strengthening
their economy and attracting more tourists. This phenomenon could become a
worldwide trend, experts proclaim, especially in the Asia Pacific region, where
the majority of aging populations are located in Japan and in South Korea.
Struggling
Countries
While
industrialized countries grapple with policies on urbanization and making
cities more adaptable, developing countries — which are also experiencing rapid
urbanization — face a greater challenge in providing such basics necessities as
water and sanitation. A 2015 report from the Save the Children Foundation, “The Urban Disadvantage,” highlighted the large disparities
between the rich and the poor in cities in developing countries, especially
related to children.
Ethiopia provides
a snapshot of a poor nation, often stricken with drought and other natural
calamities, that has a relatively small but growing population of people 60
years old and older. In this case, it’s about 5 percent of the total
population, as life expectancy is now 64 years old, reflecting a steady rise
over decades.
The country,
however, is hardly prepared for an influx of older people moving to its capital
and main city, Addis Ababa. A survey noted in a 2011 report by the United Nations Population Fund
found that most of the older people already living in the city did not have
enough to eat, suffered chronic health problems and lacked proper plumbing and
any family support.
The Importance
of Suburbs
William Frey
of Brookings points out that while most policymaking may be zeroing in on how
cities must prepare to manage fast-increasing aging populations, it is
important not to neglect areas just outside cities. Suburbs traditionally
attract young families, but some couples stay after their children are grown.
“I focus on
the suburbs because I think that’s an area most likely to feel the change as
they aren’t suited to older people,” Frey says. “In a lot of suburbs, you are
dependent on your car; all issues that will affect the suburbs are more
significant than downtowns because the infrastructure [in suburbs] has really
been geared to younger people.”
Aging experts
like Lori
Simon-Rusinowitz, a professor at the University of Maryland’s School
of Public Health, says that the movement to make cities more conducive to an
older population should start in communities. “The age-friendly communities can
be urban, they can be suburban,” Simon-Rusinowitz says.
She noted, for
example, Maryland’s Communities for a Lifetime Act, a “comprehensive,
strategic state plan” to address challenges for aging, like employment.
A separate
initiative, she notes, is the “villages” — community-run, volunteer-led
organizations making neighborhoods more useful, peppered throughout the US. Capitol Hill
Village in Silver Spring, Md., for example, offers programs like
cooking clubs. Beacon Hill
Village in Boston is another “village” shaped by members.
Yet Bethany
Brown of HelpAge USA contends that big cities offer the most perks for an older
population.
“There’s
easier access to services like health services, or even things we take for
granted, like easier access to employment and easier access to stores and to
public transportation,” she says. Moreover, cities can often combat social
isolation.
Raising
Comfort Levels
Government,
city planners, architects and designers have ample room to create better
environments for older people.
Nithin Umapathi,
an economist at the World Bank, says that one important aspect for cities is to
make them more affordable for older residents. Big cities like New York can be
expensive for many folks, especially those living on fixed incomes.
Moreover, a
rich marketplace beckons in design and aesthetics. A Japanese designer, Emi
Kiyota, founded Ibasho,
a charity whose motto is “Creating Socially Integrated and Sustainable
Communities That Value Their Elders.” Kiyota, an environmental gerontologist,
works closely with communities worldwide in designing homes or senior citizen
centers in the pre-design, or brainstorming phase.
The buildings
she helps to develop are inspired by certain realities: It is no longer a
given, for example, that taking care of aging parents will be a generational or
a family affair, in Japan or elsewhere. One such project involved Ibasho
collaborating with Hokkaido University in Japan and a team of architects and
local consultants to renovate a “locally significant building,” Ibasho’s
website says, in Sri Lanka. The building was donated by a retired professor and
turned into homes for elderly people who have no immediate family members; it
also offers a community center for all villagers to congregate in.
Another
project, La Maison du Père, was set up as a community for retired priests in a
village in Ivory Coast that has enabled them to interact with the local
residents through teaching in a variety of ways.
Aging experts,
demographers and designers emphasize that modernizing cities and communities
for a rising older population benefits society overall.
As Brown of HelpAge put it, “The way I would like it to be framed is, how can they [cities] be sure that they are serving all of their citizens?"