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AGE-FORWARD CITIES for 2030 Caroline Servat and Nora Super Foreword by Paul Irving ABOUT the MILKEN INSTITUTE

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AGE-FORWARD CITIES for 2030 Caroline Servat and Nora Super Foreword by Paul Irving ABOUT the MILKEN INSTITUTE AGE-FORWARD CITIES FOR 2030 Caroline Servat and Nora Super Foreword by Paul Irving ABOUT THE MILKEN INSTITUTE The Milken Institute is a nonprofit, nonpartisan think tank. For the past three decades, the Milken Institute has served as a catalyst for practical, scalable solutions to global challenges by connecting human, financial, and educational resources to those who need them. Guided by a conviction that the best ideas, under-resourced, cannot succeed, we conduct research and analysis and convene top experts, innovators, and influencers from different backgrounds and competing viewpoints. We leverage this expertise and insight to construct programs and policy initiatives. These activities are designed to help people build meaningful lives, in which they can experience health and well-being, pursue effective education and gainful employment, and access the resources required to create ever-expanding opportunities for themselves and their broader communities. ABOUT THE CENTER FOR THE FUTURE OF AGING The Milken Institute Center for the Future of Aging promotes healthy, productive, and purposeful aging. The Center focuses its efforts in three priority areas: Age-Forward 2030, the Business of Aging, and Healthy Longevity. ©2019 Milken Institute This work is made available under the terms of the Creative Commons Attribution-NonCommercial- NoDerivs 3.0 Unported License, available at creativecommons.org/licenses/by-nc-nd/3.0/ TABLE OF CONTENTS FOREWORD ....................................................................................................................................1 INTRODUCTION ............................................................................................................................3 How We Grow, How We Build, How We Care................................................................. 3 Delphi Survey Methodology ............................................................................................... 4 CHAPTER 1. Age-Forward Economic Development: How We Grow ...............................5 Integrating Older Adults into Urban Economies ............................................................ 5 Advancing Economic Opportunities for Successful Aging ............................................. 6 Harnessing Data to Demonstrate Age-Forward Productivity ...................................... 8 Age-Forward Economic Roadmaps .................................................................................10 Promoting Pathways for Public-Private Partnerships ..................................................13 Case Studies: New York, Louisville, and Kansas City ....................................................15 CHAPTER 2. Age-Inclusive 21st Century Design: How We Build ...................................19 Understanding the Socioeconomic Drivers of Longevity Disparities .........................19 Designing For Accessibility ...............................................................................................23 Realizing Age Diversity in Public Spaces, Transit Systems, and Innovation Districts ...................................................................................................25 Age-Forward Cities Making a Difference ......................................................................28 Case Studies: Washington, DC, Los Angeles, and Chicago..........................................29 CHAPTER 3: Resilient Networks for Healthy Aging: How We Care .............................. 35 Strengthening Social Connections for Stronger Communities ....................................35 Age-Friendly Health Systems for Age-Forward Cities .................................................38 Digital Networks, Connectivity, and Resiliency for All .................................................40 Case Studies: Pittsburgh, Denver, and Tampa ...............................................................45 ENDNOTES ................................................................................................................................... 48 ACKNOWLEDGMENTS ............................................................................................................. 57 ABOUT THE AUTHORS ............................................................................................................ 57 FOREWORD A massive shift is taking place in the makeup of the world population, and societies are already struggling to cope. By 2030, more people worldwide will be over the age of 60 than under 10.1 Realizing the benefits of an older population—while addressing the difficulties and realities—will be one of the great human challenges of the 21st century. Cities are ground zero for the demographic shift—eight in 10 US residents 65 and older already live in metropolitan areas,2 underscoring the need to view population aging with the same sense of urgency as climate change, public safety, homelessness, or any major urban priority. Healthy aging means living a long, productive, meaningful life and enjoying a high quality of life.3 Research demonstrates that older adults who adopt healthy behaviors, use preventive health services, and are involved with their family, friends, and communities are healthier and more independent.4 Aging in a healthy way is closely linked to older adults’ physical, social, and economic environments, and where one ages is a key determinant of how long she or he will live.5 Many Americans expect to celebrate birthdays well into their 70s, 80s, and beyond, but not everyone is experiencing longer lifespans. A widening longevity gap across cities and regions poses troubling questions about how health, prosperity, and environment make an uneven impact across the social landscape. In fact, a difference of 20 years separates US counties with the longest and shortest typical life spans based on life expectancy at birth.6 Globally, a similar gulf exists between longer-living countries like Japan and India.7 To narrow the longevity gap and promote purposeful, productive, and healthy aging, cities can take the lead to integrate older adults into policies and planning across multiple domains. Aging is Diversity The shifting age demography is an unavoidable hurdle in nearly every aspect of urban life and demands new ideas—from health system pressures and an increasing need for services and supports, to the disproportionate impact of climate change on older populations and the economic impact of gentrification on neighborhood stability. A one-size-fits-all solution is not the answer. Older adults are as equally diverse as the younger population and are a major—albeit complex—driver of economic expansion. Adults over age 60 are expected to account for about half of urban consumption growth by 20308—but that figure includes those experiencing economic stress. By age 65, approximately 40 percent of middle-class Americans will fall into poverty or near poverty.9 For that reason, older adults are working later in life than earlier generations and seeking employment beyond traditional retirement age, but often face ageist bias and high unemployment rates in the fastest-growing US cities.10 FOREWORD 1 AGE-FORWARD CITIES FOR 2030 Finding solutions to the urban The objective is to spur virtuous jobs longer. Caregiving needs and a challenges of an aging population is a competition among cities to improve shortage of direct care workers will complex issue, particularly because conditions for aging Americans and challenge communities across the older adults can span from healthy, elevate this crucial societal priority. world. Climate change will elevate active, highly-productive members The “Best Cities” publications have the risks of natural disasters that of communities to needing assistance drawn substantial attention in disproportionately threaten older with daily living, being homebound, academic, policy, and media circles populations. or living with life-limiting illnesses and have led to a number of local The United Nations 2030 Agenda like dementia. and regional policy initiatives. for Sustainable Development seeks Slow to Respond In 2014, the Center launched the to define new goals for people, the Mayor’s Pledge, encouraging civic planet, and prosperity, and the World The enormous challenges and leaders to commit to purposeful, Health Organization (WHO) declared opportunities of population aging healthy aging. Two hundred eighteen this the “Decade of Healthy Ageing.” mayors from every US state are require leaders to recognize positive Against this backdrop, Age-Forward pledge signatories.14 aging as an overall community 2030 challenges cities and benefit. Mayors of US cities rarely While the Center for the Future communities to prepare for a new mention older adults in their policy of Aging is proud of its work, era of economic growth, inclusion, pronouncements and priorities. much more can be done. Society and resiliency. It seeks to meet Speaking frequently about economic must push harder to encourage city leaders where they are today growth and development, they action and see faster change. and implores them to focus on the overlook the interconnection Building on “Best Cities,” the World realities of tomorrow. It is a call to between their aging communities Health Organization’s Global action to create a better future for all and their cities’ economic health Network of Age-Friendly Cities residents, investing in solutions that 11 and sustainability. They often fail and Communities, and the AARP deploy the human and social capital to harness compelling opportunities
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