Building great places to grow up and grow old
“There’s no place like home.” Even if it’s not in the same home where they have always lived or raised their children, older adults overwhelmingly express a desire to “age in place,” in a place that is safe, affordable, walkable, healthy, and inclusive. Somewhere they feel a sense of connection and belonging. Somewhere age-friendly.
Older adults can be a vital asset to communities and community development, contributing their experience, leadership, and, often, economic participation. Unfortunately, most live in places that are not well prepared for an aging population, and most communities have a long way to go before they can be called “age-friendly” – that is, great places to grow up and grow old.
Communities need to address this deficit because the population is aging fast, as 10,000 Boomers continue to turn 65 every day for the next 20 years. While many older adults are in good health, staying in the workforce or becoming active volunteers or “re-careerers,” some will need services and supports for at least a few years. The resulting mix of challenges and opportunities facing communities offers a rich array of opportunities for many different types of funders.
GIA has identified age-friendly community development as an issue of great promise and compelling need, with enormous potential for important contributions by funders. In 2012, GIA launched its own age-friendly program called Community AGEnda: Improving American for All Ages, with support from the Pfizer Foundation. Its goal is to accelerate the work of five communities around the country in diverse and creative approaches to becoming more age-friendly. GIA also hopes to provide information and opportunities for more funders about becoming involved in this work and welcomes queries to CEO John Feather about identifying opportunities that align with their existing strengths and interests. Learn more at www.giaging.org/programs-events/community-agenda.
How can communities become more age-friendly? Age-friendly development is multi-faceted and multi-disciplinary. Whether the goal is modest, such as creating curb cuts (of equal benefit to wheelchairs, bicycles, and baby strollers) or more ambitious, such as changing zoning regulations (to create a more walkable downtown area where car ownership is not needed), progress tends to take time, patience, and sustained support on many fronts.
Effective community initiatives of potential interest to grantmakers can include any of the following:
- Municipal and regional planning efforts, including those aimed at infrastructure improvements and smart growth plans, with an emphasis on community and older adult input;
- Transportation projects, including increased public transit, free or reduced-cost taxis and other rides, and promoting walkability and accessibility;
- Housing and other building design, particularly affordable, adaptive/accessible housing and multi-generational options; this can include enhancing a single housing or public site to demonstrate what age-friendly “looks like,” perhaps as a springboard to a more comprehensive effort;
- Health promotion, including community activities to enhance wellness and greater access to health, mental health, and home health care. This can include linking health and social services (which can be quite disjointed) to serve older adults better;
- Improving one aspect of a community, such as transportation, recreation, arts, or healthcare;
- Taking a place-based approach by focusing efforts in a discrete neighborhood with a large population of older people. This can include meeting the needs of a single racial or ethnic population of elders;
- Civic engagement efforts, including intergenerational initiatives and opportunities for meaningful volunteering and paid work that benefit older people and people of all ages; and
- Social services, including meal delivery, adult day programs, and caregiver support, with a focus on meeting the changing needs of the frail, disabled, and homebound elderly. This can include revitalizing aging network services that no longer meet the needs of today’s older adults, or that have been affected by federal and state budget cuts.
The age-friendly movement has been building momentum for about twenty years and today is present in some form in almost every state in the United States. Government funding has played a relatively modest role in that progress; for the most part, efforts have relied on the vision and support of private funders, many of them national.
The "longevity dividend"
Communities that do take steps to become more age-friendly are likely to see benefits; in fact, many thought leaders now believe that these are the communities that will fare best in the 21st century. As Dr. Margaret Chan, Director-General of The World Health Organization (WHO), has said, “the societies that adapt to this changing demographic can reap a sizeable ‘longevity dividend,’ and will have a competitive advantage over those that do not.”
The greatest challenges facing age-friendly advocates include mustering cooperation from many different quarters (including politicians, planners, and community leaders, as well as providers of housing, transportation, health, and aging services), and finding sustainable funding for long-term stability.
Funders can make valuable contribution by helping projects find allies and partners and broaden their base to include political, community, and corporate supporters as well as philanthropic ones. Philanthropies are also uniquely positioned to serve as conveners, helping nonprofits and other advocates identify opportunities, bringing together disparate members of the community and helping them find common ground.
Think Globally, Work Locally
The movement to make communities more age-friendly is global, with the World Health Organization’s Global Network of Age-Friendly Cities and Communities at the forefront. Founded in 2006 with 33 cities in 22 countries, the WHO network requires participating communities to commit to a five-year process of ongoing improvement of age-friendliness through planning, implementation, and evaluation but does not set standards or benchmarks for performance. More specifics are available in its publication Global Age-Friendly Cities: A Guide. Today, any city or community may apply to join the WHO network.
Around the world, WHO-linked programs vary widely. A number of US communities are participating. Probably the best-known example is Age-Friendly New York City; others include Chicago; Philadelphia; Des Moines; Portland, OR; Bowling Green, KY; Los Altos, CA; Roseville, CA; Brookline, MA; Roseville, CA; Macon-Bibb County, GA; Washington, DC; Austin, TX; Wichita, KS; Chemung County, NY, and the list continues to grow.
Start small and build
Often a community, city, or town will tackle one age-friendly challenge at a time, such as a new transportation option, a supportive housing option, or more modest goals like longer crossing times at intersections or an intergenerational community garden. Funders can start small with one project then choose to replicate success or expand the parameters of the project.
A good example is Age-Friendly New York City, which has embraced a “neighborhood by neighborhood” approach and established a series of Aging Improvement Districts, designed and staffed by the New York Academy of Medicine and funded primarily by New York City government with some private funding.
Initiatives include increasing seating for older adults inside and outside, especially in locations where people wait in line; improving access to laundry in public housing; reserving special hours for older adults at the Thomas Jefferson Park swimming pool (so successful that it was expanded to 14 different pools in the following year); enhancing safety and access to the intersection of 125th St. and Lexington Avenue; and helping neighborhood museums, restaurants and libraries improve access and programming for older adult residents.
In 2012, AARP also became a U.S. affiliate of the WHO program and began supporting communities in seven states (Georgia, Iowa, Kansas, Michigan, Pennsylvania, New York, and Oregon) and the District of Columbia in their efforts to join the WHO network and become more age-friendly. While communities can join the WHO network on their own (and New York City and Portland did so before the AARP program formally launched), joining through AARP offers additional support, resources, contacts, and organization. In 2013, AARP anticipates their participation with the WHO will rise to at least 20 communities in 15 states.
Promote livable communities for all ages
The WHO’s Age-Friendly goals closely align with AARP’s broader, state-by-state initiative to promote livable communities for all. Priorities for the AARP Livable Communities include supporting legislative efforts for land use and planning and community-based work on transportation, housing, and transportation. Examples include Complete Streets initiatives that allow pedestrians and bicyclists to travel streets safely and comfortably, adequate sidewalks and benches to encourage walking, and universal design to support aging in place through modifications such as first floor living and step-free showers. Efforts vary by state and are guided and funded in part by individual AARP state offices.
Support people where they live – Naturally Occurring Retirement Communities (NORCs)
Naturally Occurring Retirement Communities can thrive anywhere older people live in clusters and share a need for a way to stay connected to one another and for services that can be provided on-site. The first NORC was started in an apartment complex called Penn South in New York City in 1986. Since 2001, the largest NORC network, the Jewish Federations of North America’s National Aging in Place Initiative, has grown to encompass 45 communities in 26 states, and there are other independent, non-JFNA-affiliated NORCS across the country as well. (For a full listing, please consult GIA’s Age-Friendly America database. Funding has included the early New York State and New York City grants, as well as JFNA support, local funders, and, in some cases, earmarks for federal funds.
The United Hospital Fund’s NORC Blueprint website aims to help planners, managers, funders, and policymakers in developing more effective, high-quality NORC supportive service programs, with funding from the Daniels Fund, the Fan Fox & Leslie R. Samuels Foundation, the Harry and Jeanette Weinberg Foundation, and the United Hospital Fund.
Let data drive your approach
Since much of the work of creating an age-friendly community relies on solid planning that addresses commonly acknowledged needs, it makes sense to collect that data early and deliberately. This also allows for more meaningful evaluation and course correction across the life of a project.
The best-known survey for this purpose is the AdvantAge Initiative, developed in 1999 by the Visiting Nurse Service of New York’s Center for Home Care Policy and Research. The core feature of the AdvantAge Initiative is a comprehensive telephone (and more lately, online) survey of local older adults measuring a community’s elder-friendliness in four domains and 33 related indicators. Since 2002, the program has been used in more than 50 communities, including a nationwide survey, with funding from the Robert Wood Johnson Foundation, the Archstone Foundation, The Atlantic Philanthropies, and the John A. Hartford Foundation, as well as a variety of local funders.
It Takes a Village
Of all the age-friendly models, the Village to Village Network is the fastest-growing. With funding and guidance from NCB Capital Impact as well as many local funders and philanthropies, Villages are membership-driven, designed and run by older adults. Villages offer their members a network of services that support “aging in community,” such as transportation and home repairs delivered by both paid providers and volunteers; social, cultural, and educational programs; health and wellness activities; and member-to-member volunteer support, as well as vetted and discounted service providers for anything and everything its members want and need. While most Villages require individual members to pay a fee to join (anywhere from $50 to $950 per year, but generally around $500), about two-thirds of Villages offer discounts or subsidies to low-income seniors.
Notable Villages around the country include the Capitol Hill Village in Washington. DC, which, as a “volunteer-first” Village, fulfills 80 percent of member requests for help with a volunteer, and offers financial assistance to low-income members. In Newton, Massachusetts, Newton at Home is helping reduce hospital readmissions with a program that assists very frail older people returning home from the hospital.
A group of Villages in California began receiving support in 2011 from the Archstone Foundation’s Creating Aging Friendly Communities through the Expansion of Villages initiative, which seeks to document the variety of Village models being developed, including a Village in San Francisco developing “neighborhood circles” to promote care coordination, a Santa Barbara Village partnering with the local public housing authority, and a Village in Avenidas/Palo Alto working on patient preparedness to help improve medication adherence and lower health care costs.
Think intergenerationally to promote livability for all
An axiom of the age-friendly movement is that what is good for older adults is good for everyone. This means that people of all ages can not only benefit from programming but should take part in it as well, to building capacity and community. Partners for Livable Communities prefers the term “ageless.” Over the past decade, Partners’ Aging in Place Initiative has collaborated with the National Association of Area Agencies on Aging (n4a), the International City and County Management Association (ICMA), the National League of Cities (NLC) and the National Association of Counties (NACo) with major funding support from MetLife Foundation, AARP, and a number of local communities. Their work includes helping communities retrofit their services, infrastructure, and attitudes to help older adults age in their homes and neighborhoods through a series of demonstration programs, forums, surveys, publications, and fee-based consulting.
They have also awarded JumpStart Grants to 12 communities in 10 states and have invited five cities or counties to participate in their MetLife City Leaders Institute on Aging in Place, which helps teams of local leaders identify and tackle a single issue that is, by design, narrow enough to allow progress within eighteen months.
Source: Grantmakers In Aging January 2012
The Maturing of America: Communities Moving Forward for An Aging Population (June 2011), from the National Association of Area Agencies on Aging and the Metlife Foundation
Aging in Place: A State Survey of Livability Policies and Practices: A Research Report, from the National Conference of State Legislatures and the AARP Public Policy Institute
Checklist of Essential Features of Age-Friendly Cities, from the World Health Organization, from WHO Global Age-Friendly Cities project
A Blueprint for Action: Developing Livable Communities for All Ages, from the Partnership for Livable Communities
Creating an Age-Friendly NYC One Neighborhood at a Time: A Toolkit for Establishing an Aging Improvement District in Your Community, from the New York Academy of Medicine and Age-Friendly NYC
Livable Community Indicators for Sustainable Aging in Place, from the Stanford Center on Longevity and the MetLife Mature Market Institute (March 2013)
Growing Smarter, Living Healthier: A Guide to Smart Growth and Active Aging, from the EPA Aging Initiative (August 2009)
Aging Well in Communities: A Toolkit for Planning, Engagement & Action, from the Center for Civic Partnerships (January 2010)
A Tale of Two Older Americas: Community Opportunities and Challenges: AdvantAge Initiative 2003 National Survey of Adults Aged 65 and Older, from the Center for Home Care Policy and Research of the Visiting Nurse Service of New York
The Community Partnerships for Older Adults, funded by the Robert Wood Johnson Foundation developed strategic planning and other resources to guide neighborhoods, towns, and cities as they develop responses to the long-term needs of older people.
AARP’s Livable Communities database boasts a wealth of research on key topic areas, community improvement plans, policies, and model ordinances.
Older Americans 2010: Key Indicators of Well-Being, produced by the Federal Interagency Forum on Aging-Related Statistics
Key organizations and contacts
Age-Friendly New York at the New York Academy of Medicine
Building on its experience developing a series of Aging Improvement Districts throughout New York City, the New York Academy of Medicine has already offered customized tools and consulting to a variety of places around the country and world, from Chicago, Illinois to Nashville, Tennessee, Edmonton, Canada to Manchester, United Kingdom, as well as a network of cities in Taiwan; and Seoul, South Korea.
Contact: Ruth Finkelstein at RFinkelstein@nyam.org
The AdvantAge Initiative
Since 2003, the Visiting Nurse Service of New York has sponsored the AdvantAGE Initiative that has worked with communities across the country to help them become more elder-friendly. The centerpiece of this support is a survey (conducted either by telephone or online) of older people, which enables a city, town, or neighborhood to get a sense of where it stands along four domains and 32 indicators of elder-friendliness.
Contact: Mia Oberlink at Mia.Oberlink@vnsny.org
Communities for All Ages
Developed by the Center for Intergenerational Learning at Temple University, this project works with sites around the country to look at community development through a deliberately multigenerational lens. In addition to a number of tools noted here, CFAA also offers support to communities on a contract or grant basis.
Contact: Nancy Henkin at email@example.com
AARP state offices
While AARP has been actively involved in promoting Livable Communities for several years, recently it also became a U.S. affiliate of the World Health Organization’s Global Network of Age-Friendly Cities and Communities and began supporting communities in seven states (Georgia, Iowa, Kansas, Michigan, Pennsylvania, New York, and Oregon) and the District of Columbia in their efforts to join the WHO network and become more age-friendly. While communities can join the WHO network on their own, and New York City and Portland, Oregon did so before the AARP program formally launched, joining through AARP offers additional support, resources, contacts, and organization. In 2013, AARP anticipates their participation with the WHO will rise to at least 20 communities in 15 states.
Contact: Amy Silverstein-Levner, Manager of Home and Family Education and Outreach at ALevner@aarp.org
Resources from GIA
Age-Friendly Communities: The movement to create great places to grow up and grow old in America: An introduction for private and public funders
Age-Friendly America database has brief descriptions and contact information for more than 200 age-friendly programs across the United States. Search by name, by entering a specific term, or by state (e.g. “community garden,” or “intergenerational”)
Aging Power Tools: A curated selection of resources to promote stronger, age-friendly communities
State of Aging 2013: John Feather's address on age-friendly communities to the 2013 GIA Annual Conference
Grantmakers interested in starting a program area related to age-friendly communities or in expanding their funding in this area are invited to contact Grantmakers in Aging at 703-413-0413 or to email GIA’s Chief Executive Officer, John Feather, for a referral to an expert on staff at a grantmaking foundation who is willing to serve as a mentor to other grantmakers.
For more resources, please visit our Resource Center.