How Age-Friendly Are Cities?: Measuring Age-Friendliness with a Composite Index

Introduction

In recent decades there has been a “senior friendly boom” (Lui et al., 2009, p. 116): an increase in interest in the strategies, practices, services, products, and processes that reflect the specific needs of ageing people and which should help to increase their quality of life. The environment, a factor mediating the experience of aging and a key component of a positive approach to managing the challenges of population aging at the aggregate level, is also a prominent feature in such a list. Various sources talk about towns and communities friendly to every age (age-friendly cities / communities), liveable communities, elder-friendly communities, a lifetime house or lifetime housing, lifetime neighbourhoods (Lui et al., 2009; Harding 2007; Pynoos, Caraviello, & Cicero, 2009), and even an age-friendly world (see www.agefriendlyworld.org). These concepts serve as umbrella terms for building a favourable environment (especially, but not only) for older people (Lindenberg, & Westendorp, 2015; Moulaert, & Garon, 2015). They are built on a consensus on the need to support aging individuals so that they can remain (age) in their natural communities as long as they want to, or for as long as it is possible (Scharlach, 2009), providing that such support has positive effects, both economic and social, on the individual and societal levels. The idea of “age friendliness” is at the same time an expression of socially inclusive policies which not only provide a place of care and support services, but also guarantee a space in which positive public opinion is constructed and non-discriminatory attitudes affecting the well-being of seniors are strengthened. Its characteristic feature is its multidimensionality, which includes the physical and social environment, ideally integrated with each other by means of appropriate policies, services, and structures. At least within Western (or Global Northern) societies there is a reasonable consensus on what features constitute the age–friendliness of a particular place (Levasseur et al. 2015; Lui, Everingham, Warburton, Cuthill, & Bartlett, 2009; Lindenberg & Westendorp, 2015). The World Health Organisation Guide “Global Age-friendly Cities” (2002) sorts these essential features into eight dimensions: housing, social participation, respect and social inclusion, civic participation, communication, community support and health services, outdoor spaces and buildings, and transportation.

However a more critical perspective on what has been termed ‘age-friendly cities and communities’ has recently been adopted by academia (Buffel, Phillipson, & Scharf, 2012) along with other important bodies and platforms, such as the International Federation on Ageing (2015). They call for increasing awareness of the profound changes in population and the need to increase the quality of life of individuals by shifting the focus from questions such as ‘What is an ideal city/community for older people?’ to the question of ‘How age-friendly are cities and communities?’. Research into the environmental determinants of quality of life in later life is abundant (Menec, & Novicki 2014; Burton, Mitchell, & Stride, 2011; Bowling, & Stafford, 2007; Bramson, Pretty, & Chipuer, 2002; Wight, Ko, & Aneshensel 2011; Beard et. al., 2009; cf. recent overview by Levasseur et al. 2015), but studies assessing the actual physical environment as a subject are much rarer (cf. Moulaert, & Garon, 2015), especially those using a quantitative approach (Wong, Chau, Cheung, Phillips, & Woo, 2015; “Age-friendly Cities”, 2009), and those within the context of environmental gerontology (Wahl, & Weisman, 2003; Kendig, 2003). In this chapter, we propose using a composite index measure to answer the question “How age-friendly are cities?” in a comparative manner, using a nation-wide and representative survey of older residents of the fourteen biggest cities in the Czech Republic.