Age-Friendly Communities
Good Practice Review, March 2017
Introduction
Queensland’s population is ageing and by 2036 it is estimated that 1.4 million people or 19.8 per cent of Queenslanders will be 65 years or older (Queensland Treasury, 2015). Not only will there be more seniors as baby boomers move into older age; these older people are likely to be healthier, have more money in retirement and have very different expectations from previous generations. The ageing of the population will bring challenges and opportunities for governments and policy makers, for service providers and for the communities in which older people live and thrive.
Age-friendly communities enable people of all ages to actively participate in community life. They ensure older people are free from age-related barriers that prevent their participation in the community in which they live.
In 2002, the World Health Organization (WHO) developed the age-friendly approach. WHO identified eight areas (domains) that directly influence the quality of life and wellbeing of older people.
The eight domains are:
•	Outdoor spaces and buildings – seniors live in an environment that includes open spaces, buildings, shaded areas and walkways that are safe and easy to navigate
•	Transport – seniors can get out and about, using a range of affordable, user friendly transport services
•	Housing – seniors housing options are affordable, accessible and close to transport and community services
•	Social participation – seniors are supported to be active in their community, doing the things they enjoy
•	Respect and social inclusion – seniors from all backgrounds are valued and appreciated, and no one is excluded based on race, geography, culture, language, gender, sexuality, ability or socioeconomic status
•	Civic participation and employment – seniors participate in employment, training, lifelong learning and volunteering opportunities and inform government policies
•	Communication and information – seniors access information they need in a variety of formats to stay informed and connected with their communities, families and friends
•	Community support and health services – seniors are helped to stay healthy, active and independent through community support and health services, including services responding to elder abuse, fraud or exploitation. 
(From Queensland: an age-friendly community, Strategic direction statement, 2016, p3)
Communities in Queensland and around the world are embracing the age-friendly approach and making practical changes to be more inclusive of people of all ages.
The Queensland Government is helping build age-friendly communities by providing appropriate services and information to older people, promoting age-friendly communities more broadly, and working with local government and communities to make Queensland age-friendly. This is a strong foundation on which to build a more age-friendly state.
In 2016 the Queensland Government released the Queensland: an age-friendly community Strategic direction statement to support an inclusive and age-friendly society. The Queensland: an age-friendly community Action plan was developed to outline the Queensland Government’s priorities, initiatives and services they contribute to building age-friendly communities. This Action Plan is based on the eight age-friendly domains established by WHO.
The vision is for Queenslanders to live in age-friendly communities that allow people, regardless of their age, to stay active and connected, and to contribute economically, socially and culturally. From major urban areas to small rural communities, the potential exists for all communities to become more age-friendly, improving the quality of life for older people and the whole community.
Everyone can contribute to an age-friendly Queensland. The Queensland Government is committed to working with other levels of government, with business, industry and academia, with not-for-profit and volunteer organisations, and with community members of all ages to enable all Queenslanders to live in age-friendly communities.
This review provides a brief overview of the WHO age-friendly policy framework and some examples of good practice to explain and what it might mean to be age-friendly in a Queensland context. This review is designed to be a resource for communities and organisations who seek to embrace age-friendly principles and aims to sow the seeds about what could be done to make places and services in Queensland more age-friendly.
Good Practice from Australia and Overseas
Since the WHO released its guide to age-friendly communities in 2007, many countries, cities, towns and communities have embraced the age-friendly framework for improving their community for older people. Ireland and Canada are among those countries which have taken a whole of country perspective and implemented strategies to encourage states/counties to take an age-friendly approach to communities within them.  Elsewhere in Australia, for example Western Australia and South Australia, age-friendly strategies operate within a state-based framework. Alliances have been formed between state governments and local governments to develop age-friendly initiatives, for example the City of Unley partnered with the South Australian Government, as well as the University of South Australia, to develop their Active Ageing Strategy (2015).  In Queensland, Redland City Council has begun its journey to becoming an age-friendly city.
The contemporary age-friendly initiatives outlined in this review are drawn from across Australia and the world and illustrate a diverse range of projects in different settings. This is not a comprehensive collection and should be viewed as a ‘taster’ of the available research and literature about age-friendly strategies and initiatives.  The examples provided reflect those currently available at the time of writing.
Global
World Health Organization (WHO) – Active Ageing Framework
The Active Ageing Framework was developed by the World Health Organization (WHO) in 2002 following two years of workshops and extensive discussions with experts and government and non-government organisations. The Framework created a substantial shift in the ageing paradigm so that the issue of ageing was no longer approached purely from a healthcare perspective.
The Active Ageing Framework championed the process of optimising opportunities for health, participation and security as a means of enhancing the quality of life for people as they age. The Framework flagged participation in social economic, cultural, spiritual and civic affairs not just physical and economic activity for older people. Through these means older people could realise their potential for physical, social and mental well-being throughout their life-course and participate according to their needs, desires and capacity.
This shift in understanding and approach to a life-course perspective enables policy makers to focus on optimising the continuum of quality of life from birth to death and to encourage the engagement of all age groups.  The WHO embedded active ageing in a rights-based approach rather than a needs-based approach, as had been the case previously.
World Health Organization – Global Age-friendly Cities: A Guide
WHO began the shift to age-friendly communities with the publication of Global Age-friendly Cities: a Guide in 2007.
Global Age-friendly Cities: a Guide was developed with the participation of 35 cities from all continents through focus groups involving older people and carers. The focus groups identified the advantages and disadvantages they experienced around eight topics:
•	Outdoor spaces and buildings
•	Transportation
•	Housing
•	Social participation
•	Respect and social inclusion
•	Civic participation and employment
•	Communication and information
•	Community support and health services
These eight topics became the core age-friendly features in the Guide which are key to making a city or community age-friendly. These eight age-friendly features are now in wide use as the eight domains for age-friendly cities and communities. Age-friendly cities encourage active ageing by optimising opportunities for health, participation and security to increase the quality of life of older people.
Global Age-friendly Cities: a Guide is designed to engage cities and encourage them to become more age-friendly and tap into the potential of older people. The Guide is the starting point for the growing age-friendly movement.
WHO operates the Global Network for Age-friendly Cities and Communities to foster the exchange of experience and mutual learning between cities and communities worldwide.
In a review of the WHO Active Ageing Framework, the International Longevity Council published Active Ageing: A Policy Framework in Response to the Longevity Revolution (2015). This report acknowledges that some issues have gained more prominence since the Active Ageing Framework was released in 2002. Issues and trends such as urbanisation, globalisation, migration, technological innovation, environmental and climate changes have impacted on the context in which active ageing strategies operate. This report acknowledges the growing inequities and the growth of the strong international movement toward the human rights of older people.
Australia
The Integrated Age-friendly Toolkit for Local Government in New South Wales
The Integrated Age-Friendly Toolkit for Local Government in New South Wales (2012) was developed by the Local Government Association of New South Wales to assist and encourage all areas of councils to work together to develop age-friendly responses to the needs of an ageing population. The Toolkit emphasises how the built environment can be used to address the issues associated with an ageing population.
A broad range of stakeholders were involved in the development of the Toolkit and the intention was to encourage staff from multiple disciplines to apply an age-friendly lens on council projects in which they are involved. Their local knowledge about ageing would assist them to identify key issues and other matters which impact on draft plans and policies.
The Toolkit provides key information about how the needs of an ageing population can be considered in an integrated cross-council way.
There are four sections to the Toolkit that step readers (councils) through key issues and approaches:
1.	Engaging with an Ageing Population
2.	Ageing within State and Regional Plans
3.	Age-Friendly Actions for Council Community Strategic Plans and Priority Actions
4.	Age-Friendly Land Use Planning and Access
Section One outlines options councils can use to engage with older people to help develop local plans for liveable communities. It is beneficial to guarantee that age-friendly decisions are made. Examples have been included that have been successful in rural, regional and metropolitan New South Wales councils.
Section Two provides information to assist councils to understand the relationship between ageing population issues and broader New South Wales government and regional strategy frameworks.
Section Three was developed through assessing councils’ Community Strategic Plans to see if their broad objectives were congruent with the needs of older people. Examples are included of areas where issues can be addressed within Community Strategic Plans and are based on the quadruple bottom line model of social, economic, environmental and civic leadership.
Section Four focuses on opportunities for councils to respond to an ageing population and the importance of creating liveable communities.
South Australia’s Communities for All: Our Age-friendly Future
South Australia’s Communities for All: Our Age-friendly Future comprises three age-friendly guidelines. Each guideline is targeted to the agency with primary responsibility for delivering age-friendly outcomes, while recognising the roles of other key stakeholders in each case.  Across the three guidelines, the not-for-profit and private sectors and academic institutions are key contributors to achieving age-friendly communities and environments.
Age-friendly Living: Guidelines for Residential Development focuses on the physical environment and communities created in new greenfield and brownfield projects. This guideline build on examples of existing best practice, such as the Housing SA House Design Guide, Design Criteria for Adaptable Housing and Design Guidelines for Site Layouts. The guidelines are aligned to relevant WHO criteria for the provision of age-friendly housing.
Age-friendly Neighbourhoods: Guidelines and Toolkit for Local Governments are designed to contribute to age-friendly communities – urban and suburban areas and rural townships where people live, work and play. The guidelines are targeted to areas where local government has a primary responsibility either as a direct provider, partner or facilitator of the outcomes associated with age-friendly environments and communities. The guidelines and toolkit address a range of social services and programs provided by local government as well as guidelines relating to the physical environment. The Toolkit provides practical tools to assist local governments in taking the next steps to implement the guidelines.
Age-friendly South Australia: Guidelines for State Government are designed to inform age-friendly policies, plans, programs and services. They are designed to integrate the age-friendly principles across various state government departments, to achieve age-friendly cities and regions.
The City of Unley: Active Ageing Strategy
In 2011 and 2012, the South Australian state government sponsored Dr Alexandre Kalache, former Director of the Department of Ageing and Life Course in the World Health Organisation, for a Thinker in Residency program in the City of Unley. During his residency Dr Kalache published The Longevity Revolution, where he urged South Australia to embrace the reality of the longevity revolution and fully realise the opportunities inherent within it (2013, p 3).
“The extra years of life afforded to us in the 21st century are a condition never before experienced by humanity. The 20th century has given us the gift of longevity – but for what? The longevity revolution forces us to abandon existing notions of old age and retirement. These old social constructs are quite simply unsustainable in the face of an additional 30 years of life.” (The Longevity Revolution, p 3)
The City of Unley takes a positive and celebratory approach to its ageing population. The City of Unley wants their residents to experience life-long inclusion, connection, health and wellbeing and to be able to contribute to the community. The City of Unley established an ongoing forum of older people to advise the development of an age-friendly city.
The Active Ageing Strategy guides council in activities to promote active ageing to meet the needs of the population throughout their life course.
The South Australian government is a strategic partner with the City of Unley in implementing actions in areas outside council’s remit including housing affordability, transport and main-road safety. The University of South Australia is also a partner with the City of Unley in pursuing a vision of an age-friendly community.
The Active Ageing Strategy focuses on creating an age-friendly city through positive and active ageing and alignment with the principles for active ageing developed by WHO.
The Strategy’s guiding principles are:
1.	Age is a celebration
2.	A rights-based approach
3.	Whole of life
4.	Ageing in place
5.	Building on our strengths 
6.	Co-design and partnership
The Strategy adds an additional focus area to the eight domains identified by WHO as essential to developing an age-friendly city - Active Ageing Leadership. This focus is intended to highlight the role of the City of Unley in leading the development of age-friendly cities in South Australia and Australia more broadly.
The Active Ageing Strategy is supported by an active ageing action plan outlining the specific actions that will enable the City of Unley to achieve its objectives. Key indicators have been developed to measure performance across the focus areas enabling the City of Unley to report its progress against the indicators to the Active Ageing Alliance, the Service Alliance and the broader community.  The City of Unley has established the ‘Active Ageing Alliance’ – a forum of active citizens who are working in partnership with the City of Unley to oversee implementation of the Strategy.
A council project manager works with the Active Ageing Alliance and internal staff to incorporate actions into council’s annual business plan and budget. Actions are funded through application of an age-friendly lens to existing resources and through grants and working with alliance partners.
In partnership with the City of Unley and the City of Salisbury, the University of South Australia completed a literature review in 2014 on the development of ageing strategies around the world, providing extensive information and resources on age-friendly research and initiatives.
The University of South Australia literature review highlights essential elements for developing an age-friendly city:
•	The involvement of older people
•	A collaborative approach
•	Local leadership
•	An integrated perspective
•	Robust monitoring and evaluation
Overseas
Age-friendly Cleveland
Age-friendly Cleveland (2016) provided the city of Cleveland, Ohio with an opportunity to reassess the needs of the community and respond with an action plan to build on its current programs and develop innovative solutions to the challenges of an ageing population.
Age-friendly Cleveland was prepared as part of the planning phase of the Age-friendly Cleveland initiative. The report includes a baseline assessment of the age-friendliness of the city to be used to develop a three year action plan and to identify indicators to monitor progress.
Primary data to inform the report was gathered from over 1,000 older residents and dozens of community leaders, service providers and stakeholders.
Age-friendly New York City
Using the Global Age-friendly Cities initiative as a framework, the City of New York collaborating with the New York Academy of Medicine, embarked on a comprehensive assessment of the age-friendliness of New York City.
In 2009 the City published the Age-friendly NYC report, after engaging older New Yorkers, City agencies, and leaders from the private, non-profit, and academic sectors to learn how the City could improve the quality of life of seniors. In response to their findings, the City announced 59 initiatives focusing on community and city participation; housing; public spaces and transportation; and health and social services.

59 Initiatives: Age-friendly NYC is a 2013 progress report which highlighted innovative government, private and non-profit initiatives including:
•	Innovative Senior Centres: Ten senior centres were transformed into Innovative Senior Centres, providing enhanced programs including robust wellness programs, additional access to health care services, arts and cultural programs and new technological and volunteer opportunities.
•	Seniors Partnering with Artists Citywide: This initiative places artists in residence at the City’s senior centres, where they provide arts programming to older adults.
•	Support of Naturally Occurring Retirement Communities: A Naturally occurring retirement community (NORC) is a community where older residents comprise a substantial proportion of the local residents as a result of ageing-in-place. The City provides Supportive Services Programs to the 28 naturally occurring retirement communities in New York City. These programs include transportation and shopping services, social activities, connections to community and government resources, health promotion activities, and assistance with health care management.
•	Accessible Dispatch: This initiative compensates drivers for their travel to a pickup location, so passengers pay only the metered taxi fare. All drivers of wheelchair accessible taxicabs are required to participate in the program.
•	Safe Streets for Seniors: This initiative involves safety improvements in areas identified as having an above-average rate of senior pedestrian fatalities and injuries. Typical improvements include: extending pedestrian crossing times at crosswalks, adding countdown clocks, altering curbs and sidewalks, restricting vehicle turns, and narrowing roadways. Since the program began, senior pedestrian fatalities have decreased 21 per cent citywide.
•	Falls Prevention: The NYC Falls Prevention Coalition focuses on advertising solutions to preventing falls among older adults. It includes partners from various sectors, including health care, social services, academia, advocacy, and the government.
•	Silver Alert: A partnership between the City’s Department for the Ageing, the New York City Police Department (NYPD) helped create legislation for Silver Alert, a public notification system that aids police in the search for missing older persons with dementia. When an affected senior goes missing a wide network of media outlets and organisations alert the public to assist the NYPD search for the missing senior.
•	Market Ride: Market Ride uses school buses during off hours to take seniors from senior centres to supermarkets and farmers’ markets that have a greater array of fruits and vegetables than their smaller, neighbourhood stores. School buses are also used to take senior centre members to recreational facilities.
•	Success Mentor Initiative: This initiative connects older people as mentors to school students who are chronically absent, in an effort to improve school attendance.
•	TimeBanksNYC: An online registry where New Yorkers can sign up to assist older adults with errands and other tasks; likewise, older adults can offer their time and talents. For every hour that a participant provides a service for another member, s/he earns a time credit that can be redeemed for services from other members.
Age-friendly Manchester
Manchester was the first UK city to join the WHO global network in 2010. In 2014 Lord Mayor, Sue Cooley, dedicated the year to promoting age-friendly Manchester. The Older People’s Charter was launched in 2015 and the City promotes involvement of older people and age-friendly neighbourhoods.
Manchester aims to improve the quality of life of older people and make the city a better place in which to grow old. Manchester has developed work plans with public, private and voluntary and community sectors aligned with older people and partners.
Age-friendly London, Ontario
London, Ontario was the first Canadian city to join the WHO Global Network.  London published Age-friendly London – a three-year action plan in 2012 with a vision of: a diverse, vibrant, caring and healthy community which empowers all individuals to age well and have opportunities to achieve their full potential.
The action plan followed the eight domains identified by WHO and established the Age-friendly London Network in 2013 with eight working groups to implement the Action Plan.
In the last year of the Action Plan a comprehensive assessment was conducted to determine the impact the Action Plan had on the overall age-friendliness of London. The assessment focused on the process, structure and outcomes and involved members of the Age-friendly London Network and older residents of London.
Areas for particular attention identified during the assessment process include housing affordability, physical activity participation, lifelong learning engagement and volunteer activity.
The assessment found that overall the Action Plan and the age-friendly initiatives are making a difference and the work of the Age-friendly London Network is having an impact.
Age-friendly in rural communities
The good practice examples in this review have focused on cities and urban communities. Of course age-friendly features are just as important for rural communities – but there are challenges.
Local and international research has examined the challenges and success factors in creating age-friendly rural communities. Rural communities are challenged by an increasingly aged rural population and depopulation, as younger people move to urban areas, the availability and structures of rural services and changing family structures (Winterton, 2016). Service provision is challenged by the decline in health and service infrastructure in rural towns, shortages in health and aged care workers and the difficulties of delivering services in a large geographic area. Physical barriers may need to be addressed. Local transport is a significant issue, with a reliance on private transport – the loss of capacity to drive becomes a critical issue for an older person in a rural community.
However rural communities also have important strengths as places for older people – with studies reporting a strong senses of place and social ties between people, commitment to local issues, more accessible local leaders, existing groups and organisations that cater for older people, self-reliance and a healthy lifestyle. (Menec et al, 2015).
The involvement of older people in planning their age-friendly community and collaborations amongst local organisations are key factors in developing age-friendly initiatives. Supportive public organisations such as local government and public health providers are identified as playing an important role in support small organisations in rural communities (Winterton, 2016).
Detailed community research in Canada (Garon et al, 2014) and Australia (Winterton, 2016) have explored the challenges for pursuing age-friendly initiatives in rural communities, and highlight the structures and institutions that contribute to effective local collaboration.
Typical challenges to implementing age-friendly initiatives include limited access to staff, volunteers, building and transport infrastructure, poor quality physical infrastructure and limited funding for social initiatives. Victorian research has raised questions about the necessary community structures to enable diverse older adults to participate and feel included (Winterton, 2016). The research found that local government might have a significant role to place in upskilling groups to manage themselves and better engage with their community.
Research into two rural communities in Canada (Garon et al, 2014) has highlighted the importance of strong municipal leadership in supporting age friendly initiatives identified by older people and implemented with the support of local service providers and local government. One community had difficulty keeping projects going without involvement from local government. The Canadian research emphasises the importance of coordinating collaborative partnership between stakeholders and age friendly processes and described success in a case where good collaboration included the municipal administration.
Conclusion
The examples included here are drawn from the broad resources available on age-friendly projects from around the world. Readers are encouraged to further explore the constantly developing work that is happening to build age-friendly cities and communities around the world. The examples in this review highlight crucial elements that would assist in developing successful age-friendly strategies in Queensland.. 
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