Growing Older in World Cities: Implications for Healthy Aging
Rodwin, Victor G., Gusmano, Michael K., Aging Today
Growing Older in World Cities, edited by Victor G. Rodwin and Michael K. Gusmano (Nashville, Tenn.: Vanderbilt University Press, 2006) is the first book to emerge from the World Cities Project, which the editors codirect. It is the first research project to examine in depth how major metropolitan areas are confronting the challenges of global aging. The project is a collaborative effort of the International Longevity Center-USA; New York University's Wagner School of Public Service, where Rodwin serves as a professor; and Columbia University's Mailman School of Public Health, where Gusmano is an assistant professor. The following article, printed here with permission of the publisher, is adapted from Growing Older in World Cities.
Declining birthrates, increasing longevity and growing urbanization have created a new challenge for cities: how to respond to an aging population. The World Cities Project was designed to examine whether the four largest cities among the wealthiest nations of the world-New York, London, Paris and Tokyo-offer a model of what other cities will someday resemble as their populations grow older.
Perhaps the four world cities examined here will always be regarded as special cases; however, they share in common a host of important characteristics. Within them live the largest number of older people in their countries, and in some neighborhoods the percent of elders 65 or older far exceeds what the census demographers project for their nations in 2030. Thus, these great cities may serve as laboratories to inquire about the implications of demographic change for health and quality of life, living arrangements and housing, and the provision of long-term care to older adults when they eventually become frail.
New York, London, Paris and Tokyo exercise a powerful influence in the world beyond their national borders. But are these influential centers prepared to meet the challenge posed by what Robert N. Butler has called the revolution of longevity? How will these world cities accommodate this revolutionary demographic change? Are they prepared to implement the innovations in health and social policies that may be required to serve their residents, both old and young? Will they be able to identify the new opportunities that increased longevity may offer? Can they learn from one another as they seek to develop creative solutions to the myriad issues that arise? And, can other cities learn from the experience of these four giants as they confront this challenge?
Most existing studies of health and long-term care systems fail to distinguish rural from urban and dense inner urban from suburban settings. This oversight is problematic not only because most elders live in cities, but also because the institutions serving them in inner urban and suburban areas differ from those serving older people in rural areas. Also, the magnitude of and diversity within world cities suggest that they hold multiple communities of older adults with widely disparate incomes and needs!
The likely causes and consequences of human longevity and population aging have been the subjects of sustained study worldwide, as well as the topics for important expert meetings of the United Nations (Vienna, 1982; Malta, 1986; and Madrid, 2002). But almost no attention has been paid to the impact of these trends on health and quality of life in cities, where most of the world's population will reside in the future.
Among cities in the United States, New York has the highest concentration of people over age 65-close to a million. London, Paris and Tokyo have the highest concentration of elders in their countries. These cities already include neighborhoods in which the percentage of those ages 65 or older is greater than 20%, the level the U.S. Census Bureau projects for the entire country in 2030. As a result, these cities can serve as social laboratories in which to test alternative interventions that address the health and social needs of urban aging populations. …