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Housing and Planning Supporting Healthy Aging

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Healthy Aging

Abstract

The homes and communities in which people live are important determinants of health, influencing opportunities for healthy behaviors and social engagement; limiting exposure to physical risks, toxins, and stressors; and determining access to services and healthcare. For older adults, living environments are critical to healthy aging: these are the locations where older people spend the majority of their time, and the characteristics of homes, neighborhoods, and communities can help people manage or avoid functional limitations, disabilities, and chronic disease – or exacerbate them. As the World Health Organization has noted in its report on world aging, “Where the fit between people and their environments is good, [individuals] will enjoy the greatest opportunities to build and maintain both their intrinsic capacity and functional ability.”

Focusing on the United States, but with relevance to many high- and middle-income countries, this chapter describes the ways that homes and communities can influence healthy aging at a time when the population of older adults (those aged 65 and over) is increasing dramatically. Because there are many gaps between existing conditions and the kinds of homes and neighborhoods supportive of older adults, we conclude with strategies and interventions for both individuals and society.

Healthy places are always important to those who live in them, but trends around population aging, longevity, and preferences for “aging in place” mean that more older adults will be living in the community (i.e., not in nursing or other group homes) than in past decades. As a result, the quality and characteristics of homes and neighborhoods will be increasingly important determinants of healthy aging.

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Notes

  1. 1.

    Forsyth et al. [16].

  2. 2.

    World Health Organization [49], p. 30.

  3. 3.

    Keenan [27], Barrett [6], Burbank and Keely [7], Harrell et al. [19], Gfk [17], Joint Center for Housing Studies [26].

  4. 4.

    Shaw [41], Sloane [42], Jacobs et al. [23].

  5. 5.

    Office of the Surgeon General [35].

  6. 6.

    Evans [14], Shaw [41], Gibson et al. [18].

  7. 7.

    Shaw [41], Gibson et al. [18], Jacobs et al. [23].

  8. 8.

    Macey and Schneider [30], Shaw [41], Åström et al. [5].

  9. 9.

    Collins [12].

  10. 10.

    Centers for Disease Control and Prevention [9].

  11. 11.

    Soriano et al. [43].

  12. 12.

    Stevens et al. [44], Joint Center for Housing Studies [26].

  13. 13.

    Centers for Disease Control and Prevention [10], Soriano et al. [43].

  14. 14.

    A 2009 report by the National Coalition for the Homeless notes [34]: “Homeless persons aged 50–65 frequently fall between the cracks of governmental safety nets; while not technically old enough to qualify for Medicare, their physical health, assaulted by poor nutrition and severe living conditions, may resemble that of a 70-year-old.”

  15. 15.

    Iwarsson [22], Oswald (2007).

  16. 16.

    Lawton [29].

  17. 17.

    Joint Center analysis of US Department of Housing and Urban Development, 2011 American Housing Survey accessibility module (the most recent federal survey on housing accessibility), in Joint Center 2014.

  18. 18.

    Walker et al. [48].

  19. 19.

    More information is available at the US Department of Housing and Urban Development Fair Housing Information Resource Center website.

  20. 20.

    Joint Center for Housing Studies analysis of US Bureau of Labor Statistics, 2016 Consumer Expenditure Survey.

  21. 21.

    Pollack et al. [39].

  22. 22.

    Alley et al. [3].

  23. 23.

    Cagney et al. [8], Tsai [46].

  24. 24.

    Pollack and Lynch [38].

  25. 25.

    Evans [14], Tsai [46].

  26. 26.

    Joint Center for Housing Studies analysis of the American Community Survey (2016).

  27. 27.

    Joint Center for Housing Studies analysis of the 2016 American Community Survey.

  28. 28.

    ASPE Issue Brief [4]. The microsimulation model uses data from the Health and Retirement Survey regarding health, disability, use of long-term services and supports, and the presence of insurance for long-term services and support. The model focuses on long-term service and supports needs that result from disabilities meeting the criteria of the Health Insurance Portability and Accountability Act.

  29. 29.

    In 1990, nursing home residents were 10% of the population aged 75 and over; in 2015, the share was 5%. Joint Center for Housing Studies analysis of 1990 US Census Bureau Decennial Census and 2015 American Community Survey 1-year estimates.

  30. 30.

    Johnson [24].

  31. 31.

    Oswald and Wahl [36], Oswald et al. [37], Mackenzie et al. [31].

  32. 32.

    Oswald and Wahl [36].

  33. 33.

    World Health Organization [49].

  34. 34.

    A review of the literature is found in Kerr et al. [28].

  35. 35.

    Van Cauwenberg et al. [47].

  36. 36.

    Clarke and George [11], Forsyth et al. [15], Kerr et al. [28], Moran et al. [32].

  37. 37.

    Joint Center for Housing Studies [26].

  38. 38.

    Health and Places Initiative [20].

  39. 39.

    National Association of Area Agencies on Aging [33], p. 17.

  40. 40.

    Iliffe et al. [21], Shankar et al. [40].

  41. 41.

    Shankar et al. [40].

  42. 42.

    A summary of the literature on loneliness, social isolation, and health is provided in Cornwell and Waite [13], who note that objective and subjective measures of isolation are not strongly correlated and each may have their own impacts on health outcomes. Social disconnectedness is associated with poorer physical health, while loneliness (perceived isolation) appears to affect mental health: the authors posit that to the extent people feel isolated when they are socially disconnected, they are more likely to have poorer mental health.

  43. 43.

    Mackenzie et al. [31].

  44. 44.

    Adams and Rau [1], Joint Center for Housing Studies [26].

  45. 45.

    Joint Center analysis of Federal Reserve Board 2016 Survey of Consumer Finances.

  46. 46.

    See Stucki [45], Joint Center for Housing Studies [25].

  47. 47.

    World Health Organization, http://www.who.int/ageing/projects/age_friendly_cities/en/. Accessed 2.28.18. The US affiliate of the WHO’s Global Network of Age-Friendly Cities and Communities is AARP.

  48. 48.

    Age-Friendly NYC [2].

  49. 49.

    See www.thegreenhouseproject.org

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Author information

Authors and Affiliations

  1. Joint Center for Housing Studies, Harvard University, Cambridge, MA, USA

    Jennifer Molinsky & Christopher Herbert

  2. Department of Urban Planning and Design, Harvard University, Cambridge, MA, USA

    Ann Forsyth

Authors
  1. Jennifer Molinsky
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  2. Christopher Herbert
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  3. Ann Forsyth
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Corresponding authors

Correspondence to Jennifer Molinsky or Christopher Herbert .

Editor information

Editors and Affiliations

  1. Center on Aging and Departments of Family Medicine and Medicine, University of Connecticut School of Medicine, Farmington, CT, USA

    Patrick P. Coll

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Molinsky, J., Herbert, C., Forsyth, A. (2019). Housing and Planning Supporting Healthy Aging. In: Coll, P. (eds) Healthy Aging. Springer, Cham. https://doi.org/10.1007/978-3-030-06200-2_33

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  • DOI: https://doi.org/10.1007/978-3-030-06200-2_33

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