The age-friendly community movement has done a tremendous job raising awareness about the need to prepare for a changing population. A decade ago it was hard to find a planner, a local official, or social service provider who knew how to plan and build for an aging society. Today major institutions and associations have incorporated livable communities for older adults into their work plans and organizational goals. Workshops on the aging of the population fill rooms at the annual meetings of organizations like the National League of Cities and the American Planning Association. Foundations and the federal, state, and local governments have invested resources into projects that have initiated changes in housing and zoning policies, transportation services, health and wellness, and community engagement programs. In many places across the country, a variety of professionals including those in the aging network are using the growing older adult population to drive service and infrastructure improvements. The connection between the quality of the physical environment and successful aging has grown stronger and clearer within a wide range of professional disciplines.
This is great and laudable progress but as the work is currently positioned, it is not likely to sufficiently engage the gears that will transform American neighborhoods and communities into places where people of all ages and abilities can live. The age-friendly community movement is both incredibly broad in its scope yet entirely too unambitious in its strategy and execution to address the demographic imperative at the scale it demands. If communities in the United States are going to become places where people of all ages and all abilities can live in time for either of the largest and most analyzed populations—the Boomers and the Millennials—then the pace of change has to accelerate. Rather than creating more pilots, the work must now take on specific, critical issues. While we may not have a complete picture of all the policy and financing levers that can reposition major systems currently working against older adults toward the investments and services they need, it is well past time to act boldly on the ones we know well. Now the work must fully integrate into the daily, weekly, and yearly decisions about what gets built, where and with what money, what services are available and how they are funded, and the options available to move people from point A to point B and how they get paid for.
As a next stage in its development and in an effort to get to scale, the age-friendly community movement should narrow its scope, quantify its results and expand its ambitions beyond pilot programs to the larger policy and finance levers that could put communities across the United States firmly on the path to becoming places for people of all ages.
Defining the Problem
The age-friendly community movement is necessary because communities were and continue to be built without integrating the needs of people of all ages and abilities into decision making. If longevity and increasing longevity were anywhere in the planning and financing of American communities after World War II, transportation investments could not have been so heavily biased toward the single occupancy vehicle, single use zoning with uniform and exclusionary housing types would have been rejected, and a health care system in which long-term care is largely unavailable to anyone, but those who are the poorest, sickest, and willing to live institutions would have been overturned. But longevity was nowhere on the agenda when decisions about these fundamental elements of communities were designed, funded, and built. Science, medicine, and public health were busy throughout the twentieth century making it possible for people to live much longer than ever before, yet cities and counties developed without the choices needed to support an aging population and certainly not the aging of the largest cohort to be born on the planet.
Given that this is the context in which any age-friendly community effort operates, age-friendly must be defined not as a new program or a new trend in service delivery but as a fundamental rethinking of how we live together. It must be the force behind a before and after—things used to be done one way, but now millions are likely to live well into their 80s, their 90s, and beyond. Housing, transportation, health care, and supportive service delivery must now be done differently.
Age-friendly community is also not a new way to get more funds to older adult services and programs. Instead, it must drive significant and fundamental change in the way infrastructure is financed. Advocates have consistently articulated the case for additional financial resources to meet the growing needs of the aging population with more success some years than others. While this resource gap continues to grow wider as more and more people turn 60, a lack of resources is no longer the only issue. The problem is that we age in a world financed for the young.
The definition of the problem matters. It sets the stage for the scope and scale of the work. If the problem age-friendly community work is designed to solve is redefined as a transformation in the way communities are designed, built, and paid for, then there is a considerable argument to be made in favor of narrowing the scope and more ambitiously addressing the larger systems that make it so hard to age in America today.
Narrowing Scope and Strategy to Get to Scale
Current work under the age-friendly umbrella ranges from local community gardens to new zoning policies, walking clubs to accessibility ordinances, volunteer driver programs to home repair services to cross walks, curb cuts and bike lanes, health education, socialization, and exercise programs. The World Health Organization (WHO, 2007) has built a comprehensive framework that includes outdoor spaces and buildings, transportation, housing, social participation, respect and inclusion, civic participation and employment, communication and information, and community and health services. Other frameworks and toolkits offer similar and just as comprehensive approaches to taking action in local communities. While it is clear that it takes a considerable amount of both services and infrastructure to make a community work for changing bodies and changing minds, there is so much on the age-friendly “to-do” list, it is often easier to describe what does not need to be done than what does.
With so many issues to tackle, local age-friendly work must span many different sectors and reach out to many different professionals. This complex and multifaceted framework can be difficult to message effectively. Whether inside a local government or an aging program, the work is often positioned as an initiative on its own. Yet to be successful, it must interface with just about every system that supports community life. Considering just the WHO framework, age-friendly staff or volunteers must learn the transportation system, community design and public works, public health, aging and supportive services, housing finance, supportive and affordable housing policies, employer policies and trends, hospitals, and health care. It is the rare place and the rare partnership that fully execute an agenda with all these parts, priorities, and objectives. It is happening but not at the scale it needs to or could. In many places, the extraordinary breadth of the age-friendly agenda stalls out at small programs or projects; it paralyzes staff and partners into short-term activities rather than large-scale systems change.
With such a diverse agenda and limited resources spread across a wide subject and often geographic area, impact is hard to measure. If age-friendly work is going to attract the long-term investment of the time, attention and resources it will take to make communities places older adults can live, it must create measurable impact. Older adults need transportation options, they need more walkable environments, they need affordable housing choices, exercise classes, and places to gather and socialize, but there is not enough evidence to prove that when these things are available, older adults access them, receive measurable benefit, and/or that any of the changes achieve cost savings. Without the ability to measure impact, it is not likely that this work will receive consistent funding and support.
It is easy to understand why the agenda is broad and it will be difficult to take things off the age-friendly to-do list, but narrowing the scope is essential if the goals and objectives are going to be achieved. Recognizing what the work can and cannot accomplish and tackling the systems that are making communities unfriendly to older adults could catapult the work to scale.
Pulling Levers to Go Big
Instead of or perhaps in addition to the multidimensional frameworks that currently organize age-friendly work, it is time to narrow the focus of the work and concentrate not on all things needed to become age-friendly but the strategic opportunities currently available. It is time to pull “big levers” that if successful could greatly facilitate age-friendly work. Consider just a few of the following.
Largely the same since the federal government started investing in roads, the transportation finance system in the United States is being rethought. The gasoline tax can no longer support the maintenance and infrastructure needed to support a twenty-first-century population or a twenty-first-century economy. The National Highway Trust Fund requires regular infusions from the general fund to avoid bankruptcy. While Congress has been reluctant to tackle the comprehensive reform most experts agree is needed, they have introduced performance measures and are actively considering new funding opportunities. They have extended the current transportation bill, kicking reauthorization down the road to a more politically expedient time but ensuring that the dialogue will continue. How transportation is funded and what types of projects and programs get funded will continue to be one of the more significant policy debates of the coming years at both the state and federal levels. Right now there is very little to prevent those decisions from being made once again ignoring the realities of longevity. In many of these debates and as new reforms or financing structures are banded about, human service transportation struggles to even get to the table. No matter what transportation innovation an age-friendly program is able to launch at the local level, it will not be the long-term, sustainable systems change that can address transportation needs at the scale the coming older adult population demands.
Age-friendly communities, specifically the transportation options older adults need to move around their communities, could be dramatically impacted either positively or negatively by the future directions of transportation finance policy. There are many organizations and partnerships aligned to advocate for options to the car. Age-friendly work has a great opportunity to engage, lend data, support, and expertise to ensure that as this lever is pulled, the needs of all will be addressed throughout the coming decades.
This country is rapidly rethinking its housing system including the roles that government and the private sectors play. The Federal Housing Administration was created in 1934 in the National Housing Act and quickly made a relatively new idea—the 30-year mortgage—accessible to a large number of Americans pulling out of the Great Depression. As we slowly recover from the Great Recession, housing finance, housing subsidy, and the roles and practices of just about every actor in the market are being rethought, retooled, and reregulated. Housing and more specifically affordable housing with appropriate supports is one of the most critical issues facing older adults attempting to age in the community. It is not an issue that can be solved at the local level. To create enough affordable housing with supportive services, much bigger federal and state levers need to be pulled.
The recent Bipartisan Housing Commission (2013) led by Secretary Henry Cisneros, former Senators George Mitchell, Mel Martinez, and Christopher “Kit” Bond published a report summarizing the research they completed on the future of the nation’s housing system. They shared a range of ideas organized into five central recommendations. The fifth focused exclusively on the impact of the growing older adult population on the housing market. They considered ways to support an aging population that wants to remain in the community including reinvigorating markets for financial products that allow older adults to safely access the equity in their homes while they remain in place, increasing the availability of affordable rental housing, better coordination between health services and housing supports, and the integration of aging-in-place concerns across a range of federal programs.
The age-friendly community movement should be actively engaged with these recommendations and other efforts to rethink housing policy and finance at this critical time. Older adults need good quality places, and good places are inherently local. But they are the products of larger fiscal regulations and federal and state subsidies. As the U.S. housing market is re-created postrecession, the new policies and regulations are likely to set the stage for the next 30, 40, or even 50 years. They could cover not only the remainder of the baby boomer’s life span but also the millennials entry into old age. Age-friendly communities could either be facilitated by the decisions made regarding housing policy in the coming months and years or thwarted. This is one of the “big levers” that must be engaged and quickly.
Communities across the country want to ensure that they and those who come after them can thrive. The ability to attract jobs, maintain good schools, and provide a high quality of life is central to the well-being of a community and the health of their economy. While there are clearly very specific local economic development strategies that are highly dependent on the state and region in which a community resides, strategies have historically hinged on attracting and retaining the young. If the age-friendly community movement is going to successfully advocate for the creation of communities that accommodate people of all ages and abilities, it must find a way to integrate older adults into the economic development strategy of cities, counties, and states. These strategies far more than the efforts of one initiative or one program govern the short- and long-term investments of both governments and the private sector. These strategies inform what gets built where, who is served, what businesses are attracted, and sometimes what philanthropic dollars are invested.
Aging is not something that can be avoided. The tremendous demographic shift that is upon the United States and much of the globe involves not only the growth of the older adult population but also a profound change in the ratio of the young to the old. Communities across the country will have to change and adapt their economic development strategies to reflect these demographics, and age-friendly community advocates with the right analysis, messages, and strategies could be very effective in steering these plans toward healthy, walkable, livable communities that can accommodate all. But like the previous suggestions, it will require a more strategic and focused approach than is currently the practice.
Go Big or Go Home?
“Do not let the perfect be the enemy of the good.” While true in many other contexts, the threat to the age-friendly movement is more accurately described as “do not let the perfect, the idealized vision of an aging community become the enemy of the necessary and the now.” There are too many large, significant policy issues in play as the country emerges from the Great Recession that will fundamentally alter the core elements of community life. How these issues are addressed, who is included, and who is left out will form the basis for how we live together throughout the twenty-first century. The movement has enough experience and has generated enough awareness to now narrow its focus if only temporarily and ambitiously tackle these much larger issues. If it does not, if it leaves the necessary and core levers that have the potential to swing development, infrastructure, and service investment unaddressed, then we will have refined our ideas about the perfect, all inclusive and ideal age-friendly community through pilots and programs. But once again longevity will not be at the table as twenty-first-century communities emerge.
It is probably not accurate to phrase the choice as “Go Big or Go Home.” But it might be accurate to say it is time the movement “Go Big,” so current and future older adults can “Stay Home.”