After health care improvements, the greatest momentum in aging policies and programs is found in developing a robust community social infrastructure (CSI), as societies grasp the economic imperative and enhanced well-being associated with aging in place. Thirty-six percent of experts surveyed cited CSI as the area of most significant progress in the past three to five years. CSI can be understood as the connective tissue of a society, broken down by three key elements: accessibility, engagement, and assistance. Taken together, these elements enable older adults to remain not only independent, but also active and contributing members of their community.

Elements of Community Social Infrastructure

The World Heath Organization’s Age-Friendly Cities initiative has served as a catalyst for municipal action in building holistic, age-friendly communities. Providing a comprehensive framework, this global initiative has been embraced by civic leaders in seven of the 10 2018 ARC countries. Taiwan stands out as having promoted the initiative at a national level. Starting with just one city in 2010, in only three years, all 22 of Taiwan’s cities and counties had committed to the program. In 2017, the country expanded the program to include 99 communities working to build age-friendly neighborhoods supported by government subsidies. There has been a high level of engagement with non-governmental organizations and universities, which have been instrumental in developing programs, assessing their implementation and outcomes, and sharing best practices.

Accessibility of physical infrastructure remains a key impediment in many countries, however. Independent of the level of development or other measures of societal progress, in each of these leading countries, the accessibility of transport and public buildings was directly dependent on not simply the existence of a national mandate but its consistent enforcement. And even where public buildings and transport are broadly accessible, having an adequate supply of housing suitable for an aging population is a challenge across countries. One Norwegian municipality has taken the lead on this issue with a novel program to facilitate economical investments to allow aging in place. In 2013, Lindås municipality launched the Interdepartmental Housing Team, comprising a physiotherapist, a construction expert, and an economist, who together helped older residents assess their needs, develop a plan to meet those needs, and access appropriate financing. Given the cost of long-term care, this interdisciplinary, participant-driven approach is generating savings and providing continued independence.

Local organizations and individuals are the primary drivers of innovative programs that integrate the needs and resources of older adults into those of their broader communities— whether it is recognizing the common value of intergenerational connections, sharing facilities and physical resources, or launching novel social enterprises. However, dispersing these ideas and achieving scale remains a challenge. One social enterprise that has effectively scaled is New Zealand’s Age Concern Accredited Visiting Service, which marries engagement through volunteerism with assistance. The program matches certified volunteers (usually older adults themselves) with an individual who would benefit from regular home visits. Age Concern’s 4,500 volunteers made 72,994 visits in the 2017 fiscal year across New Zealand. The program regularly surveys volunteers and participants to determine how to best evolve to meet their needs.