Academic journal article Public Health Reviews; Rennes

Ageing and Urbanization: Can Cities Be Designed to Foster Active Ageing?

Academic journal article Public Health Reviews; Rennes

Ageing and Urbanization: Can Cities Be Designed to Foster Active Ageing?

Article excerpt


Populations around the world are rapidly ageing. By 2050, the global population of people aged 60 years and over is expected to reach almost two billion, with the proportion of older people doubling between 2006 and 2050.1 Less developed countries will experience the most dramatic change, and by mid-century approximately 80 percent of older people will live in what are now low or middle income countries.

Some analysts and commentators have suggested that these demographic shifts will place a major burden on health and social systems.2 One way of quantifying this is the "old age dependency ratio" which measures the proportion of people aged 65 and over per 100 persons of working age. In Japan, currently the country with the highest life expectancy, this ratio will have increased almost tenfold by 2050 compared to 1950.3 While it is tempting to think Japan has already completed the transition to an older population, more than half of this increase has yet to occur.

However, this negative perspective on ageing populations is based on an assumption that older people are inevitably dependent and a burden on society. If older people can maintain their health until the last years of life, and if they live in an environment that allows their ongoing productive engagement in society, ageing populations might instead be considered an overlooked societal resource.

In recent years, there has been mounting interest in the role the urban environment may play in achieving these more positive goals. In part, this reflects new theoretical models, the availability of new analytical methods4,5 and awareness that older adults may be more sensitive to urban characteristics such as safety and urban form.6 But it has also arisen in response to another major demographic trend that is occurring alongside population ageing: urbanization. In 2008, for the first time, the majority of the world's population lived in cities, and this transition from rural to urban living is expected to continue.7

These two demographic trends are not unrelated. By 2050, it is expected that a quarter of urban populations in less developed countries will be over the age of 60 years. In developed countries, 80 percent of older people already live in urban areas.7

This paper briefly summarizes current theories on how the urban environment may influence ageing, reviews major population based epidemiologic studies that have investigated this relationship, and provides examples of urban initiatives that have been put in place to make cities more supportive of older people.


Many different urban characteristics have been proposed as possible determinants of an equally wide array of health outcomes at all ages. The specific mechanism behind each of these associations is likely to vary, but a number of basic theories have been proposed.

Most attention has been given to the influence of neighbourhood socioeconomic disadvantage (as distinct from household or individual socioeconomic disadvantage). Whether this has been entirely theory driven, or whether it simply reflects the ready availability of neighbourhood socioeconomic data from secondary sources such as census data, is not clear. However, a number of related theoretical models have been developed to explain the frequently observed association between an older person's health and the socioeconomic status of their neighbourhood of residence.

Both the "differential vulnerability" hypothesis and social stress theory posit that disadvantaged neighbourhoods can influence health by directly increasing the likelihood of experiencing personal stress events such as trauma or unemployment.8 Physical conditions such as urban decay, physical disorder, and high levels of crime may generate more chronic levels of stress and fear.9,10

Neighbourhood disadvantage might also be associated with higher levels of social disorder,11,12 lower social cohesion and less informal social control over problem behaviours. …

Search by... Author
Show... All Results Primary Sources Peer-reviewed


An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.