The World Health Organization (WHO) Age Friendly Cities Guide (2007) was originally developed as a policy and practice tool to raise local awareness of various barriers facing older people in urban settings and to stimulate concerted local action to make cities and communities more age-friendly(1). What resulted was a groundswell of enthusiasm not only to act locally, but also to connect and engage with age friendly actors in other communities globally.
In the six years since WHO launched the Guide, more than 1,000 municipalities throughout the world, individually or as part of state or national networks, have joined the WHO Global Network of Age-Friendly Cities and Communities. These communities have seriously committed to becoming more age friendly and want membership in the network to support their efforts. New sub networks have sprung forth as well. WHO has worked closely with engaged partners to channel energies and expectations of enthusiastic members into a sustainable and effective network. At the same time, the “bottom-up” force of networks and networking continues to influence the shape and directions of age friendly initiatives in different parts of the world.
A Global Network Defining Itself
From the very beginning, leaders of municipalities and other levels of government looked to WHO to provide ongoing leadership to guide and vet efforts to develop more age-friendly settings, using the Guide as a starting point. The budding network of engaged communities in various countries provided advice to WHO to create a standard implementation process, based on what was working well in their respective locations. This advice included establishing “top-down,” “bottom-up,” and horizontal networks involving older people within the community. The specific steps are to get the formal commitment of the city council or mayor; create an advisory committee with representatives from the public, nonprofit, and business sector; involve older people as equal partners in all aspects of the project; conduct an assessment of the community´s current level of age friendliness; and develop an action plan with indicators.
A concern from the beginning was to reconcile having standards worthy of recognition for cities in more developed countries with support and encouragement for cities with fewer resources in less developed countries. Again, the pooled experience of the early WHO network provided a viable solution. Becoming part of the global network entails commitment to an ongoing self-development process with action plans and indicators specific to the community.
Another issue raised by early adopters of the Age Friendly Cities initiative AFC was the label “cities.” In fact, many of the first communities that embraced the initiative successfully were towns and villages. In smaller locations, key players from different sectors can be mobilized more readily than in cities with less permeable organizational stovepipes. Towns and villages needed to be able to identify with the global initiative and to be recognized by WHO as part of the movement. The voices of these players influenced WHO to adopt the more inclusive term “age friendly cities and communities.”
International Age Friendly City and Community Conferences
Virtual communication is fine, but face-to-face contact is vital to create real bonds and stimulate ideas and action. Two international conferences, one in Dublin, Ireland (2011), and the second in Quebec City, Canada (2013), have met this goal. Co-hosted by Ageing Well Network Ireland, the Dublin conference drew 400 participants and focused on start-up issues. Two years later, with the collaboration of the government of the province of Quebec, the Quebec City conference attracted about 700 delegates and devoted attention to the innovative projects taking place in communities. At both meetings, WHO and the local hosts sponsored participation from partners in developing countries, including in Africa and Latin America and the Caribbean, in order to support age-friendly community initiatives there.
Linguistic and Cultural Sub Networks
The Francophone Network of Age Friendly Cities was created at the Dublin meeting in 2011. Bringing together officials from French-speaking AFC communities from France, Quebec, Belgium, Switzerland, and Africa, this group builds on linguistic and cultural affinity to strengthen collaboration and to advance the WHO global network in francophone countries. Currently led by the city of Dijon, France, the Francophone Network held its first conference there in 2013. Backed by committed members and supported by strong national networks, the Francophone network is well-positioned to thrive and to assist new members.
The Ibero American Age-Friendly Cities Network was set up at the Quebec City meeting, with Spanish- and Portuguese-speaking delegates from Latin American countries, the United States, and Portugal. National, state, and municipal-level initiatives are developing in Costa Rica, Chile, Argentina, Uruguay and Brazil, as well as in Portugal and Spain. However, at present, only Costa Rica and Chile have the committed leadership of the national government. A statewide Age-Friendly São Paulo was launched in 2012, and in Argentina, initiatives in three cities are coordinated through ISalud University in Buenos Aires. The success of these sub networks will depend on the availability of dedicated leaders, the extent of sharing among members, and availability of mechanisms to support regular exchange.
Healthy and Age-Friendly Cities in Europe
In Europe, an initial impetus and model for the global Age Friendly Cities network was the Healthy Communities movement launched by WHO a few decades ago. About 1,200 European cities belonging to this network undertake a thorough self-assessment on several indicators of health and then regularly report to the WHO European Regional Office on their actions to improve the health of the city’s residents. Public health officials of member cities gather to monitor progress and to periodically steer efforts to new areas of focus or population groups. The WHO “Healthy Cities” Certification is a matter of civic pride in Europe.
Officials of European cities wanting to become more age-friendly expected a similar structured process and formal recognition from WHO. As the number of age-friendly cities has grown, the desire for both these urban development networks to collaborate has led to a project recently supported by a grant from the European Commission to harmonize “Age-Friendly Cities” with “Healthy Cities.”
Age-Friendly Communities in Canada
In Canada, all 10 provinces are now engaged in the initiative, with a combined total of more than 850 communities on the road to becoming age-friendly. Many of these communities are towns and villages with high proportions of older people. This achievement is the result of commitment by provincial governments, working and networking with municipalities, organizations for older people, and other nongovernment organizations (NGOs) within their own jurisdictions. It is also the fruit of successful networking across jurisdictions (federal, provincial, and municipal) and with the public sector.
With provincial partners, the Public Health Agency of Canada (PHAC) established a National Reference Group comprising provincial officials, older people, academics, NGOs, and representatives from municipal governments and from national municipal and planning associations. This national network is a source of expert knowledge and key advice to guide the initiative.
Support and guidance from the reference group was important in deciding to establish a national “milestones” approach to implementation that is consistent with the WHO criteria for the global network. The milestones approach links a network of committed communities within a province to the Pan Canadian Age-Friendly Communities Network coordinated by PHAC, and through PHAC the communities become recognized as members of the WHO global network.
A product of the reference group is the Age-Friendly Communities Canada Hub, which provides a “one stop” access to information, sharing, and exchange. Organized by the Canadian Association on Gerontology and academic centers engaged in age friendly community development and research, the hub features regular webinars on topics of interest, posts of community initiatives and news items, “who’s who” inventories of people and organizations engaged in age-friendly community action and Canadian resources and research studies.
The WHO Global Network of Age- Friendly Cities and Communities has expanded impressively in a short time. Besides providing real and virtual spaces for sharing resources, the network has positioned itself not only as the guide, but also as the reference, for age-friendly action. This has been achieved by using the experience and expertise of members and building on existing alliances and affinities. •
(1) World Health Organization. 2007. Age-Friendly Cities: A Global Guide. Geneva: WHO.
about the authors
Louise Plouffe is a senior policy analyst with 24 years of experience in aging policy research for the government of Canada, the World Health Organization, and currently with the International Longevity Centre (ILC) Brazil in Rio de Janeiro. With Alexandre Kalache, she led the preparation of the World Health Organization´s Age-Friendly Cities: A Global Guide. Louise obtained her PhD in psychology from the University of Ottawa, Canada.
Ina Voelcker is a researcher at the ILC-Brazil. With a BA in Gerontology (Vechta University, Germany) and an MA in Public Policy and Aging (King´s College, United Kingdom), Ina has conducted policy research and analysis at HelpAge International. Following an internship at WHO with Alexandre Kalache and Louise Plouffe, Ina applied the Age-Friendly Communities approach in João Pessoa, Brazil.