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UCSF UC San Francisco Electronic Theses and Dissertations UCSF UC San Francisco Electronic Theses and Dissertations Title A Critical Analysis of Age-friendly Community Initiatives Permalink https://escholarship.org/uc/item/9z8944d4 Author Yeh, Jarmin Christine Publication Date 2020 Peer reviewed|Thesis/dissertation eScholarship.org Powered by the California Digital Library University of California A critical analysis of age-friendly community initiatives by Jarmin Yeh DISSERTATION Submitted in partial satisfaction of the requirements for degree of DOCTOR OF PHILOSOPHY in Sociology in the GRADUATE DIVISION of the UNIVERSITY OF CALIFORNIA, SAN FRANCISCO Approved: ______________________________________________________________________________Pat Fox Chair ______________________________________________________________________________Howard Pinderhughes ______________________________________________________________________________David Vlahov ______________________________________________________________________________ ______________________________________________________________________________ Committee Members Copyright 2020 by Jarmin Christine Yeh ii Dedication and Acknowledgements This dissertation is dedicated to the informants who shared their lives with me and taught me more than I could convey in writing. I would like to acknowledge my dissertation committee for guiding me through this process and giving me encouragement and feedback along the way. I thank Dr. David Vlahov for fueling my interest to study urban health and Dr. Howard Pinderhughes for fueling my interest to study social justice. I especially thank my dissertation committee chair, Dr. Pat Fox, for fueling my interest to study aging; who was generous with mentorship and patience; provided levity during rough times; and offered unwavering support to help me complete this project over several years. I would like to express gratitude to my friends, colleagues, and family for both being there for me and giving me space so this could be accomplished. Finally, I thank my parents for always cheering: 加油! iii A Critical Analysis of Age-friendly Community Initiatives by Jarmin Christine Yeh Abstract Problem: As aging and urbanization trends converge, developing “age-friendly community initiatives” (AFCIs) has become a global movement and important policy area, aspiring to support people’s desires to age in place regardless of age, income, or ability level. This project interrogated how AFCIs have been operationalized in practice and in the lived experiences of older people. Methods: Situational analysis was a theory-methods package used to compare the conceptual frames undergirding AFCIs with expert knowledges and lay perspectives. Historical and literature reviews, participant observations, and semi-structured in-depth interviews were conducted with thirteen AFCI experts and seventeen older adults asked to chronicle their everyday lives using disposable cameras. Findings: The rational dreams of AFCIs and material realities of aging in place are misaligned. Older adults elucidated a moving tension between the daily interiority of identity and contingencies of a changing environment that produces a sensation characterized as the uncanny. The vicissitudes of life and precariousness of their positionalities exposed tactics for “passing” as creative forms of resistance to their expulsion from society. This revealed how there are normative structures around which formal systems or institutions involved with AFCIs could impinge upon older adults; highlighting society’s interest in ensuring they remain healthy and safe, lest they be a threat to themselves or burden on others. This project illuminated how aging in place finds meaning through the quotidian; the mundanity of this work is the crux of its poignancy. AFCIs form a biopolitical paradigm because they not only seek to rework boundaries between bodies and environments, they operate as modes of individual and population governance for the sake of health; yet, struggle to find ways to preserve the inclusion of older people in the ongoing social system. This project contributes to gerontological discourse and has theoretical and policy implications for aging in place inequities. iv TABLE OF CONTENTS PART 1: Background ...................................................................................................................... 1 PART 1. Chapter 1: Introduction ................................................................................................ 1 PART 1. Chapter 2: Theoretical Frameworks ............................................................................. 9 PART 1. Chapter 3: Methods and Materials ............................................................................. 27 PART 2: Historicizing Gerontology ............................................................................................. 48 PART 2. Chapter 4: Emergence of the Gerontological Gaze.................................................... 49 PART 2. Chapter 5: Expanding the Gerontological Gaze......................................................... 61 PART 3: Age-Friendly Community Initiatives............................................................................. 80 PART 3. Chapter 6: Aging in Place .......................................................................................... 81 PART 3. Chapter 7: Aging in Community ................................................................................ 87 PART 4: Experts’ Perspectives on Age-Friendly Community Initiatives .................................. 103 PART 4. Chapter 8: Experts’ Understanding of Aging .......................................................... 104 PART 4. Chapter 9: Experts’ Understanding of the Environment .......................................... 123 PART 5: Aging in Place Finds Meaning Through the Quotidian ............................................... 142 PART 5. Chapter 10: Uncanny Aging .................................................................................... 147 PART 5. Chapter 11: Doing Aging in Place in an Age-Friendly City .................................... 204 PART 5. Chapter 12: Surviving Aging in Place ..................................................................... 291 PART 6: Conclusion: Age-friendly Community Initiatives Form a Biopolitical Paradigm ...... 318 Appendix 1: Select list of conceptual definitions and their references ....................................... 331 Appendix 2: In-depth interview guide for experts ...................................................................... 337 Appendix 3: In-depth interview guide for informants ................................................................ 340 v Appendix 4: How to use your disposable camera instruction sheet ........................................... 342 Appendix 5: Photography instructions........................................................................................ 344 References ................................................................................................................................... 345 vi LIST OF FIGURES FIGURE 1.1 SAN FRANCISCO MAP ................................................................................................. 33 FIGURE 3.1 WHO EIGHT INTERCONNECTED DOMAINS OF URBAN LIFE ........................................ 96 FIGURE 3.2 SMART AGE-FRIENDLY ECO-SYSTEM FRAMEWORK ................................................... 98 FIGURE 3.3 SOCIAL DETERMINANTS FOR AN AGING- AND DISABILITY-FRIENDLY CITY ............. 100 FIGURE 5.1 DENISE'S SHIRT ........................................................................................................ 155 FIGURE 5.2 GEORGE'S CABINET .................................................................................................. 161 FIGURE 5.3 JOAN AT LAFAYETTE PLAYGROUND ......................................................................... 164 FIGURE 5.4 JOAN ON BUS ............................................................................................................ 165 FIGURE 5.5 JOAN AT BURLINGAME MERCY CENTER LABYRINTH ............................................... 165 FIGURE 5.6 JOAN'S BEDROOM NIGHTSTAND ............................................................................... 165 FIGURE 5.7 JOAN AT BURLINGAME MERCY CENTER GARDEN .................................................... 166 FIGURE 5.8 JOAN'S IPOD .............................................................................................................. 166 FIGURE 5.9 JOAN AT A BUS STOP ................................................................................................ 166 FIGURE 5.10 JOAN'S LAPTOP COMPUTER ..................................................................................... 167 FIGURE 5.11 JOAN AT THE JEWISH COMMUNITY CENTER ........................................................... 167 FIGURE 5.12 PHYLLIS' KITCHEN .................................................................................................. 169 FIGURE 5.13 CHINA DOLL AT HOWARD GRAYSON ELDER LIFE CONFERENCE ............................ 173 FIGURE 5.14 CHINA DOLL TABLING FOR “SCREAMING QUEENS” ANNIVERSARY ........................ 173 FIGURE 5.15 CHINA DOLL AT MARTIN DE PORRES HOSPITALITY HOUSE.................................... 174 FIGURE 5.16 PRESTON AT GOLDEN GATE PARK SENIOR CENTER ............................................... 177 FIGURE 5.17 MARIE'S WORK ROOM ............................................................................................ 181 FIGURE 5.18 MARIE'S WORK ROOM WALLS
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