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    Turkey
  • Israel
    Israel
  • South Africa
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    Korea
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Brazil
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Brazil

With a relatively young population and other development priorities, accommodating aging has not yet become a focus of the Brazilian government. Starting in the 1980s, Brazil put in place a set of legal safeguards to protect the rights of older adults as part of its broader effort to pursue social inclusiveness, but in practice policy implementation has fallen short in areas such as transportation and housing accessibility. However, as the Brazilian population begins to age, and independence increases, support for “active aging” is gaining ground, exhibited by efforts of some local governments, like the state of São Paulo, as well as leading NGOs, to promote age-friendly cities.

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Canada
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Canada

Community Social Infrastructure

The majority of older Canadians live independently in their communities, with a higher degree of social connection than their counterparts in most OECD countries. This is partly a result of efforts made by the Canadian government, at both the federal and local levels, to promote age-friendly communities and to fund community-based projects that are tailored to local needs. Accessibility to public transportation and facilities falls short, partly due to the absence of relevant national legislation.

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China
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China

Community Social Infrastructure

The number of older adults living independently in China is expected to double by 2030. To enable aging in place, the Chinese government has intensified efforts to establish a more age-friendly social infrastructure. An extensive network of community/village recreation centers and schools for older adults has been built nationwide to provide various entertainment and cultural activities, although the distribution density of these facilities remains relatively low in rural areas. The government has also encouraged active aging by promoting volunteer activities.

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Germany
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Germany

Community Social Infrastructure

The older population in Germany is highly independent and engaged. Volunteerism is growing, thanks in part to government-sponsored programs that help connect older people with volunteer opportunities that take advantage of their unique experience and skills. Both government and non-government organizations (NGOs) have also used cross-generational interaction as a way to provide community support to older adults. Innovative programs include shared living between older and younger people, and the pairing of nursing homes with elementary schools.

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Israel
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Israel

Community Social Infrastructure

Cultural and historical factors have produced a deep respect for older Israelis by the broader society. The current generation of older people (particularly those age 75 and older) played a central role in building the country after its founding in 1948. These cultural values are reflected in the many long-standing programs operated by the government, often in collaboration with NGOs, to enable active aging and community-based engagement. In recent years, they have grown to include a focus on intergenerational connections and the integration of recent immigrants. A variety of government efforts have also been made to improve the accessibility of public facilities and transportation in order to maintain older adults’ independence, but enforcement of relevant regulations needs to be strengthened at the local level.

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Japan
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Japan

Community Social Infrastructure

Rapid urbanization and demographic shifts over the last decade have laid the groundwork for a lonely and isolated life for many older people in Japan and provided the impetus to design a more age-friendly social infrastructure that supports the needs and wellness of seniors. Innovative solutions have been developed to utilize existing infrastructure to deliver services and to prevent social isolation. Housing and urban planning projects are incorporating new features to accommodate a healthy and independent older population. One area of weakness is in mobility. While Japan has made great strides, public transportation services in suburban areas and barrier-free facilities in older buildings are still lacking.

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Korea
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Korea

Community Social Infrastructure

Korean society has been rapidly shifting away from its traditional extended family structure to nuclear families, resulting in an increase in the share of older people living independently and contributing to their social isolation and risk of suicide. The government has been responding with programs, including older-age volunteering activities and suicide-prevention programs, with positive results.

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Mexico
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Mexico

Community Social Infrastructure

While younger people’s migration to cities has led to changing family dynamics, the traditional multigenerational family structure has remained strong. Mexico still has the largest household size among all OECD countries – an average of nearly four members as of 2015. Outside of families, however, community-support infrastructure is minimal. The Mexican government has established an institution specifically dedicated to the aging population and has given it the responsibility of devising methods for implementing community-based support policies for older adults. While some programs to help older adults access transportation, food, and other basic services exist in urban areas, caregiving and support services for older adults are in short supply, and neither government nor non-governmental organizations (NGOs) have taken significant steps to provide community support for older adults nationwide.

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South Africa
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South Africa

Community Social Infrastructure

South Africa is struggling to provide community support to older people nationwide, particularly in rural areas. Families remain an important system of support for older adults, the majority of whom live in households composed of extended family members, though the share of older people living alone has increased significantly in the past decade. Due to a lack of national resources and other urgent issues, the government has focused on improving physical infrastructure in housing and transportation, and it has operated indirectly through NGOs to improve community support services.

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Turkey
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Turkey

Community Social Infrastructure

A shift toward a nuclear family structure in Turkey is leaving more older adults living independently, but traditional family ties remain strong and continue to enable aging at home. Despite these strong family ties and respect for older adults, negative stereotypes around aging are prevalent in Turkish society. The Turkish government, as well as leading civil societies and non-governmental organizations, have been increasingly focused on cultivating positive perceptions of aging, with the country’s first Active Aging Strategy (2016–2020) expected to come out in 2017.

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United Kingdom
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United Kingdom

Community Social Infrastructure

While the British government recognized the importance of social inclusion with a task force dedicated to this issue, this group was abolished in 2010, and the policy area is no longer an explicit focus. NGOs and the private sector have attempted to fill the gap by developing innovative approaches to enhance social inclusion, transportation access, and suitable housing stock. Funding remains a challenge in areas such as transportation, housing retrofits, and winter heating subsidies, but increasing local governments’ ability to raise needed revenue, collaborations between the public and private sectors to foster innovative design, and utilization of technology and digital inclusion are a few of the areas that are being explored to improve the quality of life for older adults in the UK. Many services targeting older adults have devolved from the central government to local authorities, and successive British governments have provided initial funding for programs to “prime the pump” and help create an enabling environment for local governments and organizations to deliver services independently.

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United States
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United States

Community Social Infrastructure

The relatively independent nature of American culture and the tendency for older adults to live alone or with their spouse and away from their children put older adults in the U.S. particularly at risk of social isolation. Limited transportation options and the lack of affordable housing have been identified as leading issues inhibiting connectedness and social interaction. A network of public, private, and community-based service organizations are striving to provide meal delivery and a range of in-home services in an effort to meet the growing and varied needs of the older U.S. population, which is increasingly aging in place.

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Community Social Infrastructure

Community social infrastructure is the most fundamental and also the most complex component of a society’s support system for the older population, enabling access to necessary resources and providing opportunities for healthy, active aging in place. It can be understood as the connective tissue of a society, broken into three key elements: accessibility, engagement, and assistance. Perhaps unsurprisingly, given the scope and complexity of the challenge, there is tremendous variation in countries’ progress – including within regions and across income levels – in the development of a robust community social infrastructure, with no country leading across the board. However, all are facing fiscal pressures that make government leadership, long-term strategic planning, innovative approaches, and stakeholder partnerships imperative.

Elements of Community Social Infrastructure

photo of a group of individuals exercising outdoors

Aging in Place

Around the world, older people overwhelmingly prefer aging in place – more than 95 percent of older adults in all ARC economies are living at home and in communities, with this rate reaching close to 100 percent in middle-income countries. It is imperative that countries with a rapidly aging population strengthen community social infrastructure to support active, healthy aging in place, particularly middle-income countries as they are undergoing an unprecedented convergence of rapid urbanization, population aging, and changing family structure. Globally, there is growing movement among governments to promote and facilitate aging in place, as demonstrated by efforts to build age-friendly cities and communities. However, fiscal considerations and decision-making that prioritizes short-term savings over long-term benefits are constraining much needed investments.

Loosely defined, an age-friendly community is one in which older people are valued, engaged, and supported by physical and social environments that accommodate their interests and needs. Today, more than 530 cities and communities from 37 countries are participating in the WHO’s Global Network of Age-Friendly Cities and Communities, with the number having doubled in just the past two years.

Distinct Paradigms of Aging and Urbanization, by Income Level
Share of Urban Population vs. Share of Population Age 65 or Older (Baseline = Year 1950)

High-Income Countries

High-Income Countries High-Income Countries

Middle-Income Countries

Middle-Income Countries Middle-Income Countries

Low-Income Countries

Low-Income Countries Low-Income Countries

(Sources: United Nations, Department of Economic and Social Affairs, Population Division; FP Analytics)

Accessibility

Accessibility is fundamental to older adults’ ability to be actively engaged in their communities and to live independently. Limited access to transportation, buildings, and housing has been a stumbling block across countries, independent of level of economic development. The greatest advancements reducing barriers to accessibility are found in countries and communities that have comprehensive regulation and active enforcement, consider the needs of older adults in broader planning processes, and employ innovative solutions to leapfrog the expansion of traditional infrastructure.

According to Gallup surveys of people age 50 or older in 154 countries, an average of just 36 percent of respondents among low-income countries expressed satisfaction with the accessibility and quality of local public transportation systems, and the percentage rose to only 56 percent and 61 percent among middle-income and high-income countries, respectively.

In a 2015-2016 survey of 26 EU countries and including nearly 1,200 individuals (more than one-third age 50 or older), the “lack of access to the built environment” ranked as the third most significant challenge for persons with disabilities, following lack of equal opportunity in the labor market and lack of access to transportation.

Engagement

Social engagement is vital to older adults’ health and happiness, and governments and communities around the world are developing new approaches to meeting this need in a fiscally constrained era. In light of fiscal constraints, efforts to promote engagement are evolving to maximize cost-efficiency; successful models are notable for taking holistic approaches and incorporating older adults into comprehensive societal solutions. These approaches include providing facilities or creating opportunities for intra- and inter-generational interaction, and encouraging and facilitating volunteerism.

According to a meta-analysis of 148 studies of social relationships and mortality, people with strong social connections have a 50 percent increased likelihood of survival after an average follow-up period of 7.5 years, regardless of initial health status.

As social engagement prevents isolation, it helps to lower healthcare expenditure – a lack of social contacts among older adults is associated with an estimated USD 6.7 billion in additional federal healthcare spending each year in the U.S.

Assistance

Whereas social engagement enhances older adults’ well-being, assistance ensures their adequate standard of living. Although engagement and assistance often leverage the same resources, assistance – focused on providing services to support aging in place – is at much greater risk from fiscal pressures. Best practices are emerging from programs aimed at leveraging existing resources, such as postal networks, and mobilizing stakeholders in the community, including residents and front-line service providers. The most significant progress has been observed in middle-income countries that are endeavoring to develop a social infrastructure for a rapidly growing older population.

The Supportive Community Program in Israel

Successful programs enabling older adults to live comfortably in communities integrate assistance and engagement, and Israel’s long-standing Supportive Community program is a particularly effective model. Initiated in 1989 by JDC-Eshel, a leading Israeli NGO, the program provides a comprehensive package of services to older adults based on a monthly membership fee. Services include household repairs, an emergency call system, home-visit medical services, and weekly social activities. The program has achieved high levels of satisfaction – only 4 percent of respondents in a 2010 survey expressed dissatisfaction. To date, the program has grown to some 250 Supportive Communities nationwide and more than 52,000 participants (around 40,000 households), equivalent to roughly 6 percent of older Israelis who live in their community. Building on the existing infrastructure of the Supportive Community, JDC-Eshel is in the process of developing a new program called “Community for Generations,” which will give greater attention to better-matching services for older adults’ needs by engaging them as partners in the process of identifying the services appropriate for them as well as conducting assessments on their personal and families’ needs.

Key Takeaways

Developing a robust community social infrastructure is an immediate and imperative task that must be faced head-on by both industrialized and middle-income countries to enable healthy and active aging. Its broad scope and complexity require both the leadership of governments and multi-disciplinary collaboration across the public and private sectors. In spite of fiscal constraints, proactive, holistic approaches and innovations can maximize cost-efficiency, as observed in best practices emerging out of the ARC study:

 
  • Implementing and enforcing comprehensive accessibility mandates across public and private buildings, transportation, and housing
  • Focusing on older adults as a resource and integrating their capabilities and interests in solutions to address broader societal challenges
  • Empowering and mobilizing local stakeholders, including municipalities, community organizations, businesses, and older adults themselves, to develop programs that leverage existing resources and best suit local situations
  • Engaging older adults to ensure their interests and needs are reflected in urban planning and infrastructure development.

The Full Community Social Infrastructure Report

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Download the full Community Social Infrastructure report