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Ageing and the
Environment
GLOBAL
AGEING
Issues & Action
2010 Vol. 6 No 2 International Federation on Ageing
Senior Yorta Yorta woman guiding Bidjira man,
visiting from Queensland, through the flood waters
in the Barmah Forest, Australia, October 2010
cover: © kay briggs
Global Ageing: Issues & Action is the journal of the International Federation on
Ageing (IFA). It is published two times per year.
Guest Editor: Kathy Sykes
Assistant Editor: Susan J. Aziz
Design: Andrew Pullar
Copyright © 2010 by the International Federation on Ageing. All rights reserved.
Articles may be reprinted or quoted in whole or in part only with permission.
ISSN 1729-3472, Vol. 6 No2, 2010
Photos reprinted with permission of Kate Auty, Bradley Boon, Belinda Briggs,
Daniel Briggs, Kay Briggs, Paul Briggs, Alan DeLaTorre, Inger J. Monstad,
Sturle J. Monstad, Margaret B. Neal, Aunty Rochelle Patten, Alan Waddy,
and Melanie Winmar.
Global Ageing welcomes original, unpublished articles. Author’s guidelines are
available from the IFA secretariat. Manuscripts, including graphics (camera-ready
copies of tables, figures or photographs), may be submitted at any time via e-mail,
unless otherwise agreed. Global Ageing may edit articles accepted for publication.
The IFA does not pay authors for articles published. Opinions expressed in
Global Ageing do not necessarily reflect the opinions of the IFA.
IFA SECRETARIAT
Jane Barratt, Secretary General
Greg Shaw, Director, International & Corporate Relations
International Federation on Ageing
351 Christie Street, 1st Floor
Toronto, ON M6G 3C3 Canada
Tel: 1-416-342-1655
[email protected]
Fax: 1-416-392-4157
www.ifa-fiv.org
Table of Contents
2 Editorial Board
Adults and the Environment:
3Older
Making the World a Healthier Place
kathy sykes, guest editor
9The Environment and Ageing in an Australian Context
kate auty, aunty joy wandin murphy, and gordana marin
Service-Learning Program in Nicaragua:
19AAging,
Environment, and Health
margaret b. neal, keren brown wilson,
alan delatorre, and milton lopez
Advocating for a Livable Planet
29Grandparents:
for Today’s and Tomorrow’s Grandchildren
sturle j. monstad
35
marina skinner and dianne rogers
Conservation Volunteering: Sowing Seeds for Long Life
39Urban Aging, Social Isolation, and Emergency Preparedness
michael k. gusmano and victor g. rodwin
ifa global ageing 2010 VOL. 6 N o 2
editorial board
Articles selected for publication in Global Ageing have been reviewed by members of the Editorial
Board; their suggestions and guidance enable the IFA to offer a journal that provides the insights and
analyses of experts on policy and practice issues important to those who promote the well-being of
older adults throughout the world.
Susan J. Aziz, Assistant Editor
consultant on aging
usa
Sharad D. Gokhale
international longevity centre - india
india
W. Andrew Achenbaum
university of houston
usa
Ramón M. Gutmann
advisor for aging policy,
municipality of buenos aires
argentina
Nana Araba Apt
ashesi university
ghana
Robert H. Binstock
case western reserve university
usa
Laurence G. Branch
university of south florida
usa
Yitzhak Brick
jdc-eshel
israel
2
Harry (Rick) Moody
aarp
usa
Charlotte Nusberg
independent consultant
on international aging
usa
James T. Sykes
university of wisconsin
usa
Blossom Wigdor
university of toronto
canada
By Kathy Sykes
guest editor
3
Older Adults and the Environment:
Making the World a Healthier Place
S
cottish-born American conservationist John Muir said: “When we tug at a single
thing in nature, we find it attached to the rest of the world.”
The environment is critical to global ageing, and population ageing is critical to
the environment. The relationship between people and their environment is not new.
However, recently scientists, public health professionals and gerontologists are taking a
closer look at environmental health impacts on older adults and how an ageing society
can affect the environment. The air we breathe and the water we drink are natural
resources upon which we depend for a healthy life. There are two periods during our
lifetime when we are especially susceptible to environmental hazards: when we are very
young and our bodies are developing and then later in life when our body’s systems no
longer function at their peak.
Older adults are particularly susceptible to environmental hazards because as we age,
our bodies are less capable of coping with such toxicants as air pollutants or microbes
in drinking water. Additionally, many older adults live with chronic conditions that
often require medications that may diminish the body’s ability to cope with extreme
temperatures. By virtue of living a long life, persistent chemicals remain in our bodies.
For example, lead is stored in our bones and dioxin or the metabolites of PCBs or
DDT are stored in our body’s tissue. These persistent toxicants may have come to be
stored in the body from exposures early in life, in the workplace, home or community.
They may have been ingested by drinking water containing microbes or metals. We
may have inhaled unhealthy air from living near coal fired plants, highways or from
using wood burning stoves to prepare food. In the United States and many countries all
over the world, laws have been enacted to protect the public health and the health of
our environment. In some countries additional margins of safety have been required to
ensure that the most vulnerable are protected from residues of pesticides (such as the
U.S. and Canada) on our foods.
Climate Change
Climate change is an increasing problem that may well
be the greatest global public health issue of the 21st
century (Costello et al., 2009). Those least well off and
most dependent on others, especially the young and the
old, will be the most affected by climate change and its
consequences, including extreme heat events, drought,
and flooding due to heavy rains. In addition, poorer
nations will suffer the greatest consequences of climate
change, even though they have contributed the least to
the production of greenhouse gas emissions.
President Obama in his opening remarks to the United
Nations General Assembly, said: “The danger posed by
climate change cannot be denied. Our responsibility to
meet it must not be deferred. . . . Future generations
will look back and wonder why we refused to act; why
we failed to pass on an environment that was worthy of
our inheritance.”1
This call to action must be heard and embraced
because the path we are on threatens the survival of our
planet and her inhabitants.
The Intergovernmental Panel on Climate Change has
defined climate change as: “changes in atmospheric
abundance of greenhouse gases, in solar radiation and
in land surface properties altering the energy balance of
the climate system” (IPCC, 2007).
Scientists as well as policymakers worry most about the
fact that global warming is accelerated by human activities that fuel the production of greenhouse gas emissions.
We change the atmosphere’s composition by burning
fossil fuels. We alter the land through deforestation and
urbanization. All too often we have taken our planet’s
natural, pervious surface and converted it into impervious surfaces, such as parking lots and roadways.
Scientists have observed that some consequences of
climate change are already occurring. Observed effects
include sea level rise, shrinking glaciers, changes in
the range and distribution of plants and animals, trees
blooming earlier, lengthening of growing seasons, ice on
rivers and lakes freezing later and breaking up earlier,
and the thawing of permafrost.2
A key issue being studied is how our communities
and the Earth’s environment will adapt to or cope with
climate change. So how does climate change affect
human health? Climate change affects our health both
directly and indirectly. Extreme weather events, floods,
droughts, windstorms, fires and heat waves directly
4
affect human health. Climate change indirectly impacts
health through altered or disrupted location of vectorborne diseases by affecting the incidence of diseases
associated with air pollutants and aeroallergens.
The health status of millions of people, particularly
those with low adaptive capacity, will be affected by
climate change. With climate change we will experience
increases in malnutrition and consequent disorders,
with implications for child growth and development as
well as the health status of vulnerable elders throughout the world. It is expected that climate change will
also cause an increase in deaths, disease and injury
following heat waves, floods, storms, fires and droughts.
Moreover, there will be an increased burden of
diarrheal disease; a greater increase in the frequency
of cardio-respiratory diseases due to higher
concentrations of ground-level ozone; and altered
spatial distribution of some infectious disease vectors,
waterborne and food borne, such as Hantavirus and
West Nile disease.3
We should be concerned about the relationship
between the environment and mankind. However, we
need specific interventions, nation by nation and region
by region, to ensure that today’s elders, and children—
tomorrow’s elders—will have a habitable, healthy
environment in which to grow old.
Those Most at Risk
Health consequences of climate change include death,
disability and suffering. According to the International
Panel on Climate Change (IPCC, 2007, p. 393),
“Populations with high rates of disease and debility
cope less successfully with stresses of all kinds, including those related to climate change.”
Individuals in poor health are more vulnerable to the
effects of climate change and have a reduced capacity to
adapt to these threats. It is ironic that those who have
contributed the least to climate change will suffer the
most. IPCC projects that those at greatest risk, those
who will bear the brunt throughout the world, include
young and old who are counted among the urban poor
living in traditional societies as well as subsistence farmers, and coastal populations.
Those at risk share a common characteristic of having
low adaptive capacity. Climate change is only one of
a number of global changes that affect human wellbeing. Non-climate stressors will increase the severity of
climate changes, such as socio-economic status, technology, infrastructure, human capital, and social context.
Mitigation and adaptations are critical to the survival
of those living at greatest risk.
Smart Growth and the Built Environment
A major step we can take to make the world and our
community a better place to live is to implement the
principles of smart growth and energy efficiencies. Smart
growth can address both environmental concerns, such
as greenhouse gas emissions and human health impacts
from air pollution and water contaminants. The built
environment is critical to climate change. Where and
how we develop the land directly affects not only our
natural resources, such as wildlife habitat, but also the
health of the Earth’s inhabitants.
As we build, we replace natural cover with impervious surfaces such as concrete or asphalt. Joni Mitchell
lamented in her song, Big Yellow Taxi—a song she
wrote 40 years ago—that paradise was being paved. It
was then and it is still happening today.
“The United States, with its 214 million motor
vehicles, has paved 6.3 million kilometers (3.9 million
miles) of roads, enough to circle the Earth at the equator
157 times. In addition to roads, cars require parking
space. Imagine a parking lot for 214 million cars and
trucks. If that is too difficult, try visualizing a parking
lot for 1,000 cars and then imagine what 214,000 of
these would look like. We have paved paradise and we
have put up lots of parking lots.”4
More roads and parking lots increase the problem of
non-point source water pollution and contamination of
water supplies. When it rains, road runoff of oil and
gas, metals, nutrients, organic waste can all end up in
our sewers, streams and lakes and potentially threaten
human health.
Smart Growth Facilitates Healthy Cities
Smart Growth, characterized by development patterns
that create attractive, distinctive, walkable communities,
offers people of all ages, wealth, and physical abilities a
range of safe, affordable, convenient choices of where
to live and how to get around. Communities across the
globe are using creative strategies to develop in ways
that preserve natural lands and critical environmental
areas, protect water and air quality, and reuse previously developed land. Communities conserve resources
by reinvesting in existing infrastructure and reclaiming
historic buildings.
By designing neighborhoods to contain homes, shops,
offices, parks, and other amenities, these communities
are giving their residents and visitors the option of walking, bicycling, taking public transportation, or driving.
A range of different types of homes makes it possible
for persons to stay in their homes as they age and for
young people to purchase a safe, attractive home they
can afford.
Through smart growth approaches that enhance
neighborhoods and involve local citizens in development decisions, these communities are creating vibrant
places to live, work, and play. The high quality of life in
these communities makes them economically competitive, creates business opportunities, and improves the
local tax base.
Five Design Principles that Affect Climate
Change and Build Social Connections
Principles that guide the development and enrichment
of communities are as applicable for elders as they
are for younger people. For example, with welldesigned transportation alternatives, communities can
not only facilitate movement, but also lower greenhouse
gas emissions.
A study by Reid Ewing found that residents of the
most walkable neighborhoods in the United States drive
26% fewer miles per day than those living in the most
sprawling areas (Ewing, Pendall, & Chen, 2002). First,
density can help make communities more walkable and
support public transit. Next, mixed land use ensures
that housing and amenities, such as grocery stores and
pharmacies, are located nearby. Third, parks and green
spaces can reduce the heat island affect and reduce water
run off from streets and parking lots. Fourth, energy
efficient buildings can reduce the need for electricity.
Finally, density and public activity are necessary for vigorous neighborhood social networks. Persons without
secure streets and public places to draw them outside
their dwellings are more likely to suffer from isolation
and social distance.
Powell Lawton, an American pioneer, recognized
the importance of one’s environment; he theorized that
the more dependent one becomes on others to carry
out activities of daily living, the more important one’s
environment is. Mobility can be hampered or facilitated
5
depending on one’s environment, both in the community
as well as one’s home.
In 2007, the United States Environmental Protection
Agency (EPA), the Centers for Disease Control and
Prevention, the President’s Council for Fitness and
Sports, and the National Council on Aging announced
a recognition program entitled Building Healthy
Communities for Active Aging. More than 40 organizations now support this award program that, while
focusing on ageing, demonstrates how changes to the
built environment benefit persons of all ages.
Around the same time, the World Health Organization
announced the Global Network of Age-friendly Cities
initiative by identifying the key elements of the urban
environment that support active and healthy ageing.
More than 30 cities from around the world responded
to questionnaires and confirmed the importance of
access to public transport, outdoor spaces and buildings, and the need for appropriate housing, community
support and health services. They also found the need
to foster the connections that allow older people to be
active participants in society, to overcome ageism and
to provide greater opportunities for civic participation
and employment.5
In this issue of Global Ageing, we have contributions
of some keen observers about the effects of the environment on older people and their role in preserving the
legacy of our natural environment, our land, air and
waters. Kate Auty and her colleagues remind us of the
relationship between indigenous people and the environment, noting we need to ensure that we maintain
an understanding of these cultural connections, that
we respect their diversity, and that we plan for their
inclusion. Those who were present at the International
Federation on Ageing 10th Global Conference in
Melbourne heard Joy Wandin Murphy, an elder of the
people who first occupied the land including Melbourne
itself, inspire the audience not only to be more than
respectful of their forbears, but also to include them in
decisions affecting their people and land.
Neal and her colleagues describe projects that connected
students of the North with a community in the South
that improved the quality of life of older Nicaraguans
and their families while offering students in Oregon, USA
with learning and serving opportunities that changed the
direction of their lives—through intimate understanding
of the dynamics of a very poor nation.
6
Sturle Monstad describes an intergenerational environmental effort, the Grandparents’ Climate Campaign.
Norwegian elders are advocating, not on their own
behalf, but for the next generation who will inherit the
Earth. Their principal motivation for involvement is the
future health and well-being of their grandchildren.
That’s a powerful case for the primary role grandparents have in working with their children and
grandchildren to ensure that their shared environment
is preserved. A subtheme throughout this issue pertains
to how elders are and must be environmental stewards,
teachers and advocates. The writers have shown that
climate change will impact greatest the very young and
very old.
Skinner and Rogers summarize well the benefits to
be gained from engaging elders in being stewards of
the environment. They write: “New Zealand’s Positive
Ageing Strategy promotes the value of older people
and affirms their importance in the community. . . .
and recognises the importance of sharing wisdom and
knowledge and passing this on to younger generations.”
This entire issue provides practical solutions to what is
becoming increasingly an urgent problem—of global
warming and environmental degradation.
The IPCC predicts that extreme weather events will
be more common and more severe due to the fact that
more people are living alone and the world population
is ageing. Gusmano and Rodwin’s article describes how
a planning tool, geographic information systems (GIS),
can map and locate neighborhoods with high concentrations of vulnerable and socially isolated elders in urban
settings and its benefits to emergency preparedness.
Elders as Environmental Stewards
The challenge of this generation of older adults is to
protect and to leave to their children and grandchildren
a healthy and sustainable environment. Sharing their
knowledge of the environment and the need to sustain
the ecology with the younger generation is both a
rewarding experience and a wonderful legacy.
Elders can help get children off the couch, away from
their computer games and into the community where
they will learn to appreciate parks, woods and open
spaces. When many of us were young, we played outside
until we were called in for lunch or dinner. Times have
changed, and obesity has reached epidemic proportions
worldwide. Both young and old can benefit from getting
outdoors and reconnecting with nature. Richard Louv’s
words from the Last Child in the Woods: Saving Our
Children from Nature-Deficit Disorder (Louv, 2008)
resonate with not only ecologically aware elders,
but also public health professionals. Federal legislation entitled “No Child Left Inside” was also inspired
by Louv.
U.S. EPA’s Aging Initiative
The U.S. EPA has supported grants that train elders to
be community environmental stewards. Many of these
projects have been to protect persons of all ages from
environmental hazards. Recipients of these competitive
grants were non-governmental ageing organizations
as well as local health and environment agencies.
For example, the Maryland-based program, Legacy
Institute for the Environment (LIFE), was launched with
EPA funds. Now in its fifth year, the Institute provides
participants with information and insights into the
complex environmental issues and challenges facing
the fragile Chesapeake Bay ecosystem, and strategies
for environmental stewardship. LIFE graduates are
environmental ambassadors and teach children from
preschool through high school about the health of the
local ecosystem and its importance to their well-being.
These graduates also rescued environmental organizations by taking on volunteer leadership roles.
Two recent grants focus on the built environment and
getting elders involved in local planning. The University
of Maine’s Center on Aging has spearheaded the Encore
Leadership Corps (ENCorps). This program focuses
on environmental stewardship, grassroots leadership,
and community development. Its mission is to give
participants the necessary skills, knowledge and guidance to make positive changes in their communities.
Participants also learn about smart growth, a planning
tool that emphasizes making decisions that protect and
improve the quality of life for all community residents.
Portland State University also received a grant to
demonstrate the benefits of green streets for active ageing. The pilot project builds upon their groundbreaking
work in the area of green streets and active living by
demonstrating how green streets or sustainable streets
contribute to the well-being of a community, including
the environment and economy as well as the physical
and mental health of older and younger adults.
EPA also supported Generations United to demonstrate environmental activities in intergenerational
entities. Working with a leader in the intergenerational
field, Generations United prepared a guidebook entitled
Generations United for Environmental Awareness and
Action. Tricycle Gardens started as a community garden and later expanded to numerous neighborhoods in
Richmond, Virginia. The project engaged intergenerational teams to use a non-chemical method of getting rid
of pests, called Integrated Pest Management or IPM.
Rachel Carson Sense of Wonder Contest
Since 2007, the EPA, Generations United, the Rachel
Carson Council, Inc., and this year the Dance Exchange,
have held a poetry, essay, photo and dance contest.
This intergenerational contest solicits entries that best
express the “Sense of Wonder” that you feel for the
sea, the night sky, forests, birds, wildlife, and all that
is beautiful to your eyes. We know that by sharing this
love of nature with a child and others around us, we
celebrate a prescient leader of the environmental movement. We also instill a sense of responsibility to protect
the earth and enjoy nature. When we teach our eyes and
ears and senses to focus on the wonders of nature, we
open ourselves to the wonders around us.
For climate change—we are in this together. Together
we can change the way we build our communities. We
must ensure they are built smart and sustainable.
We must draw from those with wisdom, experience,
perseverance to leave a legacy—an environment—that
is worthy of our inheritance.
And in the words of Chief Seattle, born in the
late 1700s:
Whatever befalls the Earth befalls the people of the
Earth. Man did not weave the web of life; he is merely
a strand in it.
Kathy Sykes
Senior Advisor, Aging Initiative,
Office of Public Engagement,
U.S. Environmental Protection Agency
[email protected]
7
notes
1 Remarks of President Barack Obama - As Prepared for Delivery “Responsibility for our Common
Future” Address to the United Nations General Assembly, New York, NY, September 23, 2009.
Accessed November 6, 2010: www.un.org/en/ga/64/generaldebate/pdf/US_en.pdf
2 Accessed November 1, 2010: www.epa.gov/climatechange/basicinfo.html#effects
3 Accessed November 6, 2010: www.globalaging.org/agingwatch/events/IDOP/climate.htm
4 Accessed September 29, 2010: http://answers.yahoo.com/question/index?qid=20070719230638
AAVVZR0
5 Accessed November 4, 2010: www.who.int/mediacentre/news/releases/2010/age_friendly_cities
_20100628/en/
references
Costello, A., et al. (2009). Managing the health effects of climate change. The Lancet, 373(9676),
693-733.
Ewing, R., Pendall, R., & Chen, D. (2002). Measuring sprawl and its impact. Washington,
DC: Smart Growth America. Available at:
www.smartgrowthamerica.org/sprawlindex/
MeasuringSprawl.PDF
Louv, R. (2008). Last child in the woods: Saving our children from nature-deficit disorder.
Chapel Hill, NC: Algonquin Books of Chapel Hill.
IPCC. (2007). Climate change 2007: Impacts, adaptation and vulnerability. Contribution of
Working Group II to the Fourth Assessment Report of the Intergovernmental Panel on Climate
Change. M. L. Parry, O. F. Canziani, J. P. Palutikof, P. J. van der Linden, & C. E. Hanson (Eds.).
Cambridge, UK: Cambridge University Press.
8
By Kate Auty, Aunty Joy Wandin Murphy, and Gordana Marin
9
The Environment and Ageing
in an Australian Context
T
he very antiquity of the continent of Australia lends itself to the discussion of the
environment and ageing. Such a discussion connects the population, the landscape or
terrain, and it reflects the intersection of the two in what we call ‘the environment.’
Indigenous People and the Environment
The International Federation on Ageing 10th Global Conference, held in Melbourne
in 2010, was opened by one of the authors, Joy Wandin Murphy, a senior representative of the Wurundjeri people whose traditional country forms the basis of the highly
impacted Yarra River watershed.1 The Yarra is an inland water system which joins the
sea at Port Phillip Bay. In the early years of non-Indigenous occupation (1836-1850),
this watershed was re-engineered, virtually redesigned; it is massively exploited as a
fresh water source, of which there were very few at the settlement site, and polluted by
noxious trades and residential outfalls.
For thousands of years, this river system had carved its way to the sea with negligible
human impacts. Within 20 years of colonisation, the mouth and coastal reaches of the
Yarra were virtually unrecognisable. Wetlands were filled in. Ox bows were created and
the river straightened. Waterfalls at the river mouth were re-engineered. An aged river
was ‘enlivened’ to facilitate trade and massive population growth. As the river, and Joy’s
ancestors, adjusted, so too did the colonisers, adapting to a climate as alien to them as
is the one we can expect as a function of climate change today.
Even today, after all this intervention, the Yarra is a river system which reflects centuries of usage by Aboriginal people. All along its course, right into the central business
district of Melbourne, the antiquity of Aboriginal culture is evident in scar trees, stone
scatters, and midden sites celebrated by Victorians. But, they have particular meaning
for Aboriginal people, in this case the Wurundjeri.
Joy’s representations to the conference clearly illustrated the significance of her
people’s ties to the river system and the environmental surrounds, and her opening
remarks provided an insight into the importance of understanding this connection in
contemporary contexts. As things change, they remain the same.
These prefatory observations point up one of the
many challenges we face in any discussion about the
environment and people in Australia. We need to ensure
that we maintain an understanding of these cultural
connections and that we respect their diversity and plan
for their inclusion. The careful work we need to do to
achieve equitable outcomes and to include Indigenous
people gives us many pointers, notwithstanding cultural
and other differences, on how to advance incorporation
of all marginalised groups in any discussion of environment and human interactions.
It is about inclusion and engagement that we write.
Each of us, through our own cultural, professional and
personal lens, regards it as essential that people, the
community, the public be involved in the work we need
to do to deal with climate change and environmental
sustainability.
Our Place in the World:
The Weather and Its Impacts
We, the authors, live in the south eastern corner of
Australia, Joy being of the original, first nations, Kate
being of the first colonisers, and Gordana being of the
wave of migration that made this place home after the
Second World War. Wherever we come from, we feel the
environmental impacts snaking across our country. Each
of us is an environmental practitioner in a particular,
highly personal fashion. Each of us has been involved
in community development at various levels and with
diverse communities, across sectors, cultures, genders
and generations. Each of us regards the involvement of
the public as fundamental to our capacity to deal with
the issues we confront.
The Australian projections on climate change impacts2
suggest that Victoria, in the south east corner of the
continent, will be heavily impacted by increased temperatures and heat effects, coastal inundation, reduced
rainfall, and extreme weather events. It is suggested that
the south west of Western Australia, struggling with significant reductions in rainfall since the 1970s, provides
us with an indication of what to expect. It is the view
of the scientific community that the impacts in Western
Australia are clearly the product of climate change.
The work of the Australian Government Bureau
of Meteorology and Commonwealth Scientific and
Industrial Research Organisation (CSIRO) (2010)
in the 2010 State of the Climate report describes the
10
science simply and elegantly. Since 1960, there has been
an observable increase in Australia’s mean average
temperature of 0.7 degrees. The science is in, and the
long term trend to temperature increase is ‘clear’ notwithstanding some regional variability. We are told that
the Southern Hemisphere’s spring season will be most
affected. Measuring temperatures has generated the fact
that the number of record hots days has increased each
decade over the past 50 years. And, whilst hot days have
increased, record cold days have decreased. We all know
that evidence shows us that the decade between 2000
and 2009 has been the warmest on record.
In Australia, although total rainfall has remained
relatively stable, there have been significant reductions
in rainfall in major population centres and in the south
east and south west (Australian Government Bureau of
Meteorology & CSIRO, 2010).
From 1870 to 2007, the global average sea level rose
by nearly 200 mm. The global rate of sea level rise has
increased from an average of 1.7 mm annually during
the 20th century to about 3.0 mm annually from 1993
to 2009. Since 1993, the rate of annual increase in
northern and western Australia has been between 7 and
10 mm, and in southern and eastern Australia, between
1.5 mm and 3 mm (Australian Government Bureau of
Meteorology & CSIRO, 2010).
As to the impacts on the oceans in the Southern
Hemisphere around Australia, over the last 50 years,
sea surface temperatures have increased by about 0.4
degrees. The southern ocean absorbs around 40% of the
world’s carbon dioxide (CO2), a process which elevates
acidification, adversely impacting marine plants and animals; the implications of this are far reaching (Australian
Government Bureau of Meteorology & CSIRO, 2010).
Atmospheric concentrations of global CO2 and methane have risen rapidly in the last 100 years. The historical rate of CO2 was between 170 and 300 parts per
million (ppm), but in 2009 it was 386 ppm and climbing
(Australian Government Bureau of Meteorology &
CSIRO, 2010). It is understood that these higher levels
of greenhouse gases are likely to explain half the reduction in rainfall in south west Australia.
Australia will be a hotter and drier continent with
more extreme rainfall events. The increase in temperatures is predicted to be from 0.6 to 1.5 degrees C by
2030 (Australian Government Bureau of Meteorology
& CSIRO, 2010).
The United States National Oceanic and Atmospheric
Administration (2010) reports that 2010 will be the
warmest year on record since 1880 and that June was
the 304th consecutive month with a land and ocean
temperature above the 20th century average. We are
extraordinarily vulnerable to this increase.
Additionally, Australia has a poor record of dealing
with biodiversity challenges, even without the compounding impacts of climate change. We have a shocking
record of species extinction. The recently released third
edition of the Global Biodiversity Outlook (Secretariat
of the Convention on Biological Diversity, 2010),
compiled in close cooperation with the United Nations
Environment Programme, calls for swift, radical and
creative action to respond to the threat of rapid degradation of the environment and the continued collapse
of natural systems. The United Nations’ audit is clear:
Australia has failed to meet targets for a significant
reduction in the rate of biodiversity loss.
Adding to these unsettling conclusions, we are told
that potential tipping points, where ecosystems shift to
less productive states from which they may not recover,
are connected to climate change. United Nations’ experts
think it is possible to avert catastrophe by effective and
coordinated effort, but it is clear that the linked challenges of biodiversity loss and climate change need equal
priority; their resolution requires close coordination.
The United Nations optimistically reports that solutions
can be found in better efficiencies in use of land, energy,
water and materials, use of market incentives, strategic
planning and communication, education and by raising
awareness (Secretariat of the Convention on Biological
Diversity, 2010).
Australia’s ClimateWorks3 (2010) suggests these issues
can be addressed by adopting a low carbon growth plan.
If we were to adopt their suggestions, we could reduce
Australia’s greenhouse gas emissions to 25% below
2000 levels: a more ambitious outcome than the target
set in the Victorian Climate Change Act 2010 (addressed
later in the article). And, ClimateWorks argues that we
could meet this target with the technologies available
to us today.
Some of the personal adjustments we could make to
great effect include reducing air travel, reducing short
car trips, improving car occupancy rates, moderating
our heating consumption by two degrees in home and
commercial settings, ceasing all standby appliance use,
and switching from bottled water to tap water. The
ClimateWorks team advises that reducing emissions
can be profitable for business. ClimateWorks argues
that failure to transform low cost opportunities into
accomplishments today will actually ensure greater
costs to society and business over time. To achieve the
reduction outlined by ClimateWorks (2010), we need a
carbon price and targeted action, a position which has
been supported recently by large Australian companies
with national and international reach. They recognise
that we should set a price on carbon.
The public is responsive and active. Travelling around
Victoria and talking to diverse groups, students, their
teachers, individuals, rural women and men, government, local government, health professionals, Indigenous
people, scientists and other academics, Professor
Auty believes the Australian people are seriously concerned about sustainability and climate change impacts
and are ready to act to correct a shocking record of
species extinction.
People who lost family members in the heat wave that
preceded the fires and deaths last year know personally
that the impacts of more hot days will need to be reckoned with. People who drive in Victoria after the recent
flooding episodes observe the damage to road surfaces
and infrastructure, even as they are pleased to have rain.
They know this will translate into rate increases. Whilst
the drought appears to have broken, there is recognition
that heat stress and water scarcity are serious problems
that impact on family and community life. Some people
have adjusted their lives to deal with these changes;
farming along the Campaspe River will never be as
it was. Those who watched the rail lines buckle and
waited in the heat of last summer’s sweltering weather
continue to anticipate such events.
People are acting to adjust, adapt, mitigate climate
change realities and produce better outcomes for
the environment and themselves. Many schools
(primary, secondary and independent), various
groups, departments and agencies, businesses big and
small, non-governmental organisations, and informal
and formal groupings around specific issues are
demonstrating their ability to transform opportunities
into accomplishments.
It is in this context that we suggest the need for a paradigm shift in our focus upon the solutions to the issues.
Crisis can be a stimulus to heightened understanding
11
of the need to act, and it can increase the urgency of
finding means of accomplishing change. If the previous
paradigm was that the problem-solvers were to be found
in government, this, in the face of the looming crisis,
would appear to be only a partial solution.
It is clear that if we have to engender behaviour
change on a wide scale in economies other than command economies, the entire community will be part
of the solution and we will have to rely less on policy
makers and the politicians.
This community includes the capable, the wellresourced, the able and the vulnerable, and the thoughtful. It will include people who understand the past and
who want a future for the generations that will follow.
It will include older people. It is in the light of this
understanding that we reflect upon the science and the
need to engage with people, and explore south eastern
Australia’s recent history.
The Present and Immediate Challenges
In one sense, Victoria has had a trial by fire on the issue
of climate change and environmental protection and
degradation. Recently, Victoria has witnessed wildfires
which resulted in the deaths of 173 people, across
generations and cultures, primarily residents living on
the fringes of the capital city, Melbourne. The smoke
plume from the fires covered most of the south eastern
part of the state and was noted at a spread of up to
200 km from source.4 Many people forced to relocate
as a result of the fires are living in temporary accommodation 18 months later; this dislocation impacts older
people particularly harshly. A Royal Commission into
the Victorian Bushfires has made recommendations that
have been adopted by the Victorian government. There
is a clear recognition that we need to plan for future
climate change challenges with uneven levels of impact.
Some people will be more adversely impacted than
others, and some will have less access to services and
advice. Vulnerable persons will need services more than
others, and they will also require them in a targeted and
timely manner—a challenge of complex dimensions.
Ancillary to these multiple broad ranging fires,
and predating them, a heat wave—many days over
35 degrees C—accelerated the deaths of 374 vulnerable,
mainly older, people, a significant number of Victoria’s
four million people. In Britain in 2003, the deaths of
2000 people from heat wave events was regarded as
12
significant, notwithstanding the much larger population
of that Commonwealth.
Before and after the fires, Australians continued to
strain against the weight of a drought along most of the
eastern seaboard, now in its thirteenth year. This dry
and oppressive weather impacts extraordinarily harshly
on older people, as it is this group that has essentially
remained on the land farming as their children have
moved to the cities. Various reports document the
impact of the drought, including unfunded walk-offs
of farms and an elevated rate of suicides, particularly
amongst middle-aged and older men.
The drought has broken with heavy rains in late
2010, filling dams that store the water for domestic
purposes. But, even as people celebrated, these rains
also brought flooding, events which will increase insurance payouts and raise premiums. Unfortunately, the
floods that ran off the Strathbogie and other ranges in
the north east of Victoria spread across floodplains and
caused widespread damage, some of which will not be
insured. The Victorian government made disaster relief
funds available, but too little to address the unsettling
personal, social, and psychological impact of the floods.
Volunteers, upon whom Australia relies, worked in
response to the floods over days and days; they were the
same people who had given their time to deal with the
fires. Many of the volunteers were not young.
These extreme events compound other slow, grinding,
incremental impacts of climate change for older and vulnerable people along the extensive, densely populated
coastline. About 80% of Australia’s population lives on
the coast. Victoria has particularly vulnerable sites and
communities. The only asset of many older people of
relatively limited means who retired to the coast is their
homes. This is not a Riviera.
For the vulnerable population facing climate-related
problems, it is hard to think about the “opportunities”
that a changing climate might present.
What the Scholarship is Telling Us
Conference presentations in Canberra, Sydney, and
the Gold Cost have drawn increased attention to these
issues. In Canberra, the Australian National University
Fenner Conference collected health scientists and professionals to discuss the co-benefits of acting on climate
change and health issues. As they have formulated their
positions on this, they have been actively exploring
© belinda briggs
Replenishing the red gums after the big rains in October 2010: four generations of a Yorta Yorta family in the Barmah Forest
in Yorta Yorta land in the north east of Victoria
13
the inclusion of the community in solutions. Medical
scientists believe that an informed and highly engaged
public should be involved in finding solutions.
At the Climate Change Adaptation Conference,
convened on the Gold Coast by the National Climate
Change Adaptation Research Facility,5 it was noted
that, whereas once climate change mitigation involved
scientists with their disciplinary rigour, it was now obvious that adapting to the climate change we:
• need a new, broader, more deployable linguistic
form,
• are dealing with different—non-normal scientific—
issues, and
• must engage a broader, differently intelligent public.
an unusual panel to discuss risk adaptation to climate
change, including insurance companies, metropolitan
water management boards, and the national Australian
Attorney General’s department.
Intriguingly, the presentation twinned the critical
infrastructure planning work done to address potential terrorist threats with water board planning to
address the projected threat of climate change-generated
coastal inundation. A sense of urgency and alarm
pervades the discussions. This environment calls for
steady hands and heads. Older people could be said to
bring a quiet and composed wisdom to the thinking that
is needed.
Ways of Responding to Climate Change
Given the extent of national, local and international
interest, and the content and thematic organisation of
the conference, it was obvious that issues of adaptation
were now being treated as a developing disciplinary
concern across a broad range of specialisations. Case
study after case study illustrated the need for adaptation
planning, given:
• the implications for generating an unstoppable tide
of human misery and climate change refugees to our
immediate north;
• the health outcomes in previously unaffected regions
which would become increasingly vulnerable to vector borne disease;
• the demonstrable inadequacy of engineering solutions;
and
• the inequitable spread and impact of climate change
upon Indigenous people, youth and older people
generally and specifically.
The Gold Coast conference illustrated that the intellectual, disciplinary and biotic environment has moved
from a reference point where centralised solutions
involving big, costly projects are the incontrovertible
norm, to recognition that small, localised, intensely
place-based innovations have an important role to play.
With this realisation comes a further recognition that
there is a place for people of various ages, creeds and
cultures to develop solutions and generate opportunities
and achieve results.
Indicating the elevated understanding of the urgency
and confrontational nature of the challenges we face,
a Sydney climate change convocation drew together
14
It is highly unlikely that climate change challenges can
be addressed by single means. There will need to be
multiple solutions. For instance, the simple mechanism
of changing planning systems to work at one level but
not at another would be regarded as forcing or imposing change in a manner resisted in a flexible democratic
society. As an example of the fluidity and complexity of
the situation, the Victorian government has rejected the
suggestion that it is necessary or feasible to engage in
a forced compulsory acquisition of property that may
come under threat from bushfires. There is also no suggestion that coastal inundation will be addressed in this
way. Local government, the third tier of government,
is being encouraged to address this issue proactively.
Decisions being taken in administrative appeals tribunals suggest that, far from adopting a highly regulatory
regime, the Victorian government will let the market
prevail and the courts arbitrate.
However, recently, broad, encouraging legislative and
policy interventions, short of prescriptive solutions,
have been adopted. In Victoria, passage of a Climate
Change Act (2010)6 was married to a government policy
map, the White Paper, in which the former Victorian
government addressed issues with clarity and certainty.
The Act sets a target of a 20% reduction in greenhouse
gas emissions from 2000 levels by 2020. The White
Paper discussed mitigation and adaptation efforts. Both
the Act and White Paper explored ways to generate
community involvement and improve information flow
and funding for projects that involve climate change
innovation. It is envisaged that the community will drive
change at a number of levels, all under the auspices of,
but not formally directed by, government. At a federal
level, the newly installed federal government is forming
a climate change cabinet committee to work through
pressing issues.
It is increasingly important for government to determine the means of conducting formal and informal
discussions important to community development.
There are lessons to be learnt and useful guidelines to
be found from our community development experience.
This involves working with the public, in all its hues and
complexity.
Working with Older People
Working with older people is like working with any
group in the community. It is not dissimilar to working
with Indigenous people. Engagement must be predicated
upon respect and inclusiveness as well as encourage
involvement and be respectfully attentive of long held
informed views. The work should be supported by
organisational structures that are flexible, nimble and
responsive. It is important to note that access to information may be limited. Haq and his colleagues (2010)
estimate that 70% of people over 65 years of age have
not used internet connections, and they report that this
group expresses concern that information is limited or
passes them by. So, one should not assume that older
people will be running to the computer to find a recent
publication from the Bureau of Meteorology; they
almost certainly will not.
Haq and his colleagues (2010) outline the attributes
likely to promote information flows and encourage
engagement of older people. Their methodology for
including older people, exploring the utility of and
celebrating their knowledge bases and drawing them
into the solutions, includes the following attributes: the
abandonment of old stereotypes which have never been
accurate or incisive; knowing something of the target
audience; and using trusted interlocutors and relying
upon peer to peer communication. Their work provides
positive messages and frames issues in interesting and
meaningful ways. They found that communication flows
across divides when it is predicated upon the provision
of real life examples.
Any work with an excluded group, or a group that
perceives the information super-highway to be off limits,
must forge links by developing inclusive dialogues that
will assist in maximising participation.
Haq and his colleagues suggest that it is also helpful to situate the information flow conversation in and
around understandings of the need for whole-of-system
change so that outcomes can be effectively achieved. For
instance, Haq and other scholars suggest that regulatory changes should be linked with financial and infrastructure proposals and policies, as it is only through
interconnected action that change will come. The lesson
for policy makers and legislators is that their failure to
act will not preclude the public from taking steps, even
in isolation and absent clear, supportive messages. The
difficulty here is for government not to get left behind.
The level of immersion proposed by Haq and his
colleagues is supported by recent development aid
scholarship, anthropology, sociology and psychology.
This level of commitment will present challenges to
government instrumentalities unless they regionalise
their operations and encourage field work with reduced
central control and involve considerable training of
administrative staff who are increasingly encouraged to
utilize community consultations.
Communicative exercises that will have the greatest
effect will be those that do not start with a concern about
failure or what we should not do. Good communication
will not commence by worrying people who are already
vulnerable about their efforts being maladaptive.
Good communication practice, across generations,
will arise from relationships of respect and good
humour. Best case communication will, as Moser and
Dilling (2007) and their colleagues show in case after
case, rest upon and reflect the following attributes:
• A mutuality of two-way communication.
• Where possible, choosing a receptive and an able/
capable audience.
• Matching messages to the mental models of the
audience.
• Making the operations local.
• Linking the work or project to issues of immediate
and real interest.
• Being a credible messenger, having rigorously tested
information available, and being solution-oriented
with specific ideas.
• Applying all of these principles to, with and through
small groups.
• Starting with, or working consistently and hard to
develop a common understanding of the issues and
their potential solutions.
15
To facilitate change, effectively and in a timely fashion,
it is always necessary to move beyond a rigid adherence
to forms of discourse and research that do not serve
the needs of the target group. For instance, in dealing
with environmental regulatory issues and the need to
redress pollution and associated matters, science has
served us well since Rachel Carson first challenged us to
deal with these matters in a formal and orderly fashion.
Science must apply interdisciplinary approaches to deal
with the wicked underlying problems of climate change.
Methodologies that counter the prevailing paradigm
make a place for interdisciplinary discourses. Science
for the protection of the environment in the 21st century
will be “post-normal science” (Harding, Hendriks, &
Faruqi, 2009). Adjusting to this need will involve being
bold and, to the extent that all scientific revolutions
require it, taking risks.
The mere identification and description of the issues,
the old formal “State of the Environment Report,” will
prove to be inadequate to the urgent tasks that address
impending climate change. If the object is transformational change, the answer is not “more of the same.”
Transformational change requires action to achieve
accomplishments that must be observable, useful, practice oriented, and at all stages communicated effectively.
The aim of every project or program should be to set
up active networks for change. Leaders need to work to
pass the baton and cultivate their own erasure, training
communicators to expand networks across boundaries
and encourage hybridity with its capacity for innovation
and stimulation.
Conclusion
This article began with a commentary about the place of
the Wurundjeri. Joy, our co-author, is a senior woman
who represents the oldest living culture in the world.
She is concerned about the future for her grandchildren.
As do we, Joy knows there are solutions to be had
that involve the inclusion of diverse people in seeking
solutions. Amongst that group of solution-focussed
community members, there is a special role for older
people. In Victoria, the Council for the Ageing (COTA)
has started the process of establishing “Green Sages,”
a project to actively engage and involve older people
in finding solutions to climate change challenges. The
project will draw upon the knowledge of older people,
their willingness to give back to the community, and
16
their tireless commitment to working with each other to
develop practical outcomes.
Older people are concerned about the environment,
as they see it impacting themselves and their families.
They have an intimate understanding of the issues of
intergenerational equity. They derive this from their
experience, their part in generating the present and the
promise or threat of what the future holds for their
grandchildren.
Kate Auty
Professor
Commissioner for Environmental Sustainability,
The State of Victoria, Australia
[email protected]
Aunty Joy Wandin Murphy, AO
Senior Elder of the Wurundjeri People,
Traditional custodian of the watershed of
Yarra River and associated hinterland,
Victoria, Australia
[email protected]
Gordana Marin
Director, Strategy and Development,
Office of the Commissioner for
Environmental Sustainability,
The State of Victoria, Australia
[email protected]
notes
1 This river is known as Birrarung Marr by Wurundjeri people, but we use its European name for
the reader to situate it in any mapping research he or she may do.
2 The projections for Australia have been undertaken by CSIRO and republished by the Victorian
Department of Sustainability and Environment to heighten understanding of regional possibilities.
3
ClimateWorks Australia is a research venture which operates out of Monash University and
which receives funding from the Myer Foundation in Victoria.
4 See the fire mapping work of the Centre for Environmental Sciences, EPA Victoria.
5 The first international Climate Change Adaptation conference was held in Melbourne in June
2009 under the auspices of the Department of Sustainability and Environment.
6 See www.austlii.edu.au/au/vic/
references
Australian Government Bureau of Meteorology & CSIRO. (2010). State of the climate.
Available at: www.bom.gov.au/announcements/media_releases/ho/20100315a.pdf
ClimateWorks Australia (ClimateWorks). (2010). Low carbon growth plan for Australia
(March 2010). Melbourne, Victoria: ClimateWorks Australia. Available at: www.climateworksaustralia.com/low_carbon_growth_plan.html
Haq, G., Brown, D., & Hards, S. (2010). Older people and climate change: The case for better
engagement. Stockholm Environment Institute, Project Report – 2010. Stockholm: Stockholm
Environment Institute.
Harding, R., Hendriks, C., & Faruqi, M. (2009). Environmental decision-making.
Exploring complexity and context. Sydney: Federation Press.
Moser, S. C., & Dilling, L. (Eds.). (2007). Creating a climate for change. Communicating climate
change and facilitating social change. Cambridge: Cambridge University Press.
Secretariat of the Convention on Biological Diversity. (2010). Foreward by the United Nations
Secretary-General. In Global Biodiversity Outlook 3. Montréal. Available at: http://gbo3.cbd.
int/the-outlook/gbo3/foreword/foreword-by-the-united-nations-secretary-general.aspx
United States National Oceanic and Atmospheric Administration. (2010). State of the Climate
Global Analysis January 2010. Available at: www.ncdc.noaa.gov/sotc/?report=global&year=
2010&month=1
17
18
By Margaret B. Neal, Keren Brown Wilson,
Alan DeLaTorre, and Milton Lopez
19
A Service-Learning Program
in Nicaragua: Aging,
Environment, and Health
I
n 2003, a study-abroad program at Portland State University (PSU) was conceived as
a partnership between the Institute on Aging (IOA) at PSU and the Jessie F. Richardson
Foundation (JFR)—a charitable organization dedicated to helping indigent elders
around the globe by addressing immediate needs, promoting self help and reciprocity,
and fostering intergenerational involvement. The purpose of the program was to help
students learn about global aging, particularly aging in developing countries, by working with local communities in a developing nation to bolster the country’s capacity for
improving the lives of older adults. The IOA was to coordinate the educational component by selecting students for the program, holding classes, and then leading students
on a service-learning trip to Nicaragua. JFR was to serve as the main conduit between
PSU faculty and students and key organizations and stakeholders in Nicaragua. The Pan
American Health Organization (PAHO) provided technical assistance and connections to
individuals and groups in Nicaragua, including officials within the Ministries of Family
and Health. These contacts, in turn, helped in establishing relationships with individuals
and organizations involved in housing and caring for older adults in various locations
throughout Nicaragua. This article describes the development and implementation of
this service-learning program focused on aging, environment, and health.
Connecting Aging, Environment, and Health
Environmental gerontology has described, explored, modified and optimized the environment for older adults for more than 40 years to maintain independence, dignity,
and overall quality of life (Wahl & Weisman, 2003). Early work was based on ecologic
principles that noted the interdependence of people and their environments. Lawton
and Nahemow’s (1973) Ecologic Model of Environment and Aging described this interdependence of various elements in a system and stressed the fact that there is a continual
process of adaptation of older people to their environment.
The field of public health has utilized an ecologic model for building healthy communities. Within the past decade, efforts have focused on aging and environments and
have bridged the fields of gerontology, public health, community development, and
urban planning. According to the ecologic model used
in these efforts, factors that influence healthy behaviors
include biological, behavioral, social, and environmental variables (Satariano & McAuley, 2003). When
considering effective interventions pertaining to healthy
and active aging, an ecologic model is useful in framing
research by taking these factors into account (Sallis,
2003). However, moving beyond basic research and
individual interventions has been identified as an important next step for broadening the effectiveness of the
ecologic model; Cunningham and Michael (2004), for
example, have detailed the need to move toward policy
creation and broader health intervention strategies to
achieve healthier communities for older adults. The
result of this approach would be action-based research
that considers the impact of the factors described by
Satariano and McAuley (2003)—social, biological,
behavioral and environmental—while understanding
the dynamic interplay over time that occurs between
older people and their environments, as detailed by
Lawton and Nahemow (1973). The program described
here incorporates these principles into the learning environment to inform programmatic activities in service to
a community.
Global Aging: Why it Matters
It has been well documented that the world is facing
unprecedented population aging and that certain regions
of the world will age at different rates and with different consequences (Jackson, Strauss, & Howe, 2009;
Kinsella & He, 2009). A call for action from the Pan
American Health Organization and the Merck Institute
of Aging & Health (2004) pointed to a shrinking window of opportunity to prepare for population aging in
developing countries and suggested the need to focus
on the near- and long-term futures in Latin America
and the Caribbean (LAC). In that region, years of
political instability and violence are linked to economic
struggles and stunted development (Solimano, 2004);
additionally, poor health conditions, and demographic
projections point to a more rapid population aging in
LAC as compared to more developed countries in North
America, Europe and parts of Asia (Kinsella & He,
2009). As Jackson et al. (2009, p. 1) note:
The United Nations projects that the share of Latin
America’s population that is aged 65 or over will
triple by mid-century, from 6.3 percent in 2005 to
20
18.5 percent in 2050. Meanwhile, Latin America’s
median age will climb by 14 years, from 26 to 40.
Latin America’s coming age wave is by no means the
largest in the world. By 2050, over 30 percent of the
population will be aged 65 or over in some fast-aging
countries in Europe and East Asia. But incredibly,
several Latin American countries, including Brazil,
Chile, and Mexico, may have older populations than
the United States.
No matter what country is being discussed, however,
whether less or more developed, we are living in a world
with diminished and dwindling resources in which
governments and citizens alike must survive with fewer
formal supports. Organizations, employers, educators,
politicians, and policy makers must answer the question,
“How can we do more with less?” To achieve sustainable growth and development, we need to find a way to
provide for today’s generations without compromising
the opportunities of tomorrow’s generations, whether
older or younger.
Enhancing and sustaining the quality of life for older
adults who are poor, frail or incapacitated, and who
have little support is the central tenet of the work of the
Aging Matters, Locally and Globally Initiative at PSU.
Created through a gift by PSU alumni Drs. Keren Brown
Wilson and Michael DeShane, this initiative is aimed at
expanding knowledge, education, and research pertaining to aging around the world, especially for older people
who are “living at the margins.” The program described
here is a part of that larger initiative that may serve as
a model for improving the quality of life of older adults
here and abroad who have few resources.
Program Background:
A Focus on Nicaragua
The idea for a program focusing on aging in LAC
originated in 2001 from Dr. Martha Peláez, PAHO’s
Regional Director for Latin America and the Caribbean.
Dr. Peláez began a conversation with Dr. Keren Brown
Wilson about global aging and broadening JFR’s work
beyond the U.S. After a visit to various countries in
Latin America, Dr. Wilson contacted PSU faculty Drs.
Nohad Toulan (Dean, College of Urban and Public
Affairs), Margaret B. Neal (Director, IOA) and Marvin
Kaiser (Dean, College of Liberal Arts and Sciences) to
discuss creating a service-learning program. Nicaragua
was chosen as the focus of the program for a number
of reasons: its extreme poverty, its rapidly aging
population, its dearth of expertise in gerontology and
geriatrics, and the existence of few supportive services
for older adults.
According to The World Factbook 2009 (Central
Intelligence Agency, 2009), Nicaragua is the poorest
nation in Central America. It has suffered decades of
natural disasters, political corruption, revolution, war,
and the loss of resources—human, economic, and natural (Plunkett, 2002). Not only have recent generations
lacked access to decent health care and education, but
also the country’s international debt burdens are such
that long-term planning for development and the wellbeing of the population is overshadowed by substantial
debt services (Willman, 2000).
Although Nicaragua is not an old country—an estimated 4.6% of its population is aged 65 years or older,
compared to 13% in the United States—its older adult
population will increase rapidly: to 8.0% in 2030 and to
14.7% in 2050. Comparatively, the projected increase in
the 65-and-over population in developed nations is less
dramatic; Sweden, for example, will grow from 18.3%
in 2010 to 22.6% in 2030 and 24.1% in 2050 (United
Nations, 2009).
Given its rapidly aging population, Nicaragua will
need expertise in social gerontology and geriatrics. As
pointed out by Dr. Peláez, although there are a few
professionals, advocates, politicians, and others who
care for and about the aged in Nicaragua, there also
has been a “brain drain” of qualified experts. Moreover,
despite a large number of non-governmental organizations from outside of Nicaragua that assist the country
(Central Intelligence Agency, 2009), the priority of these
NGOs and the Nicaraguan government has been child
and maternal health. Few organizations target the needs
of older adults other than homes for elders.
The university-community partner relationship
between PSU/IOA and JFR was formed, the servicelearning program developed and classes conducted.
In the spring of 2004, nine students and two faculty
went to Nicaragua. During that initial pilot program,
meetings were held with the Ministry of Family and
the Ministry of Health in Managua and with staff and
elders at comedores (meal sites) and hogares para los
ancianos (homes for elders) in the cities of Granada,
Matagalpa, and Jinotepe. Students and faculty learned
about organizations that cared for, or could care for
older adults in Nicaragua; the process for developing
a long-term plan aimed at identifying and addressing
problems related to long-term care and quality of life
for older, at-risk Nicaraguans was begun.
In 2005, the number of students increased to 14,
and they were split into two groups to serve additional
homes for elders in Juigalpa and Masaya. By 2006, the
city of Boaco was added to the communities in which
students were working. Boaco and Jinotepe became
the two key locations for the PSU-JFR program to provide for program continuity and facilitate relationship
building. To date, after the seventh year of the program,
over 100 students and nine PSU faculty or faculty affiliates have traveled to Nicaraguan communities with a
focus on older adults, natural and built environments,
and health.
Since the program’s beginning, change has been a
constant in serving community needs and increasing
our understanding of the needs as well as community
strengths and assets. As argued by Kretzmann and
McKnight (1993), a community’s assets are an integral
part of a holistic approach to community development.
By using an asset-based approach and actively engaging
community stakeholders, sustainable positive community development can be achieved. This approach leads
to collaboration with various organizations, including
those serving youth (sports teams and schools), business
(microenterprise development), and older persons.
The Role of Service Learning
This program, offered as a six-credit service-learning
course open to undergraduate, post-baccalaureate, and
graduate students, blends service, research, and learning
across international borders. The course, Global Aging
and Health: Enhancing Communities in Nicaragua, fuses
community service projects with academic goals and is an
approved Capstone course (the final community-service
project requirement for an undergraduate degree). In
addition to classroom learning and service projects, the
program emphasizes reflection and continual improvement through program evaluation to foster growth
among students and faculty, and to serve as a model
program for working internationally with students and
community members on social gerontological issues.
This program goes beyond “educational tourism” by
incorporating a service component to address needs,
21
utilize assets and to build capacity. The desire was to
engage in projects that would serve needs of communities in Nicaragua during a two-week program involving
students of any level in any discipline. To date, students
interested in gerontology, public health, community
development, business, engineering, sociology, pre-nursing, pre-medicine, Spanish, social work, international
development, and urban studies have participated. In
the months between students’ two-week experience in
Nicaragua, JFR staff and PSU faculty remain in touch
with key Nicaraguan community contacts. JFR staff
travel two to three times a year to refine the projects
for the next group of students. Another key to the
program’s success has been JFR’s hiring of a staff person
in Nicaragua, a trained geriatrician and public health
practitioner, to serve as the liaison for this and other
JFR programs.
Course Structure and Content
From its beginning, the program was structured to
include coursework in the U.S., along with the development of specific projects to be implemented in Nicaragua,
followed by approximately two weeks of service in
Nicaragua. As reported earlier, Dr. Martha Peláez, the
former regional advisor on aging and health for PAHO
and a current member of the board of directors of the
JFR Foundation, played a key role in the development
of the program, traveling to Portland to lecture. In her
presentations, she described reasons for focusing on
aging in less developed countries and in Latin America
and Nicaragua, in particular. Dr. Peláez presented findings of research that was conducted in Latin America
and the Caribbean that revealed socio-demographic
trends and health patterns affecting health and wellbeing. She noted that the graying of less developed
countries requires several actions: consultation on social
protection policy and program schemes; development of
community resources for supporting caregivers; technical cooperation in policy development; assistance in the
development of sustainable and integrated systems; and
building environments and infrastructure that enhance
the health and well-being of communities. As detailed in
the next section, these suggestions form the basis for the
projects developed in this service-learning program.
The program’s integration of both an ecologic model
and an asset-based approach to community development
for older adults in Nicaragua requires consideration of
22
the biological, behavioral, social, and environmental
factors that affect elders’ quality of life. The content
of Dr. Peláez’s lectures during the first two years of the
program has been incorporated in each subsequent year.
Students learn about global health and aging trends,
theories of aging, “upstream” public health factors
(e.g., income disparities, access to education) and how
they affect quality of life, health promotion strategies
and educational techniques, and issues surrounding the
provision and monitoring of health care. Students also
learn about social-cultural aspects of life in Nicaragua,
including socio-demographic patterns, dietary practices,
religious practices, and community-based systems of
support. Nicaragua’s climate and geography (mountains, lakes, coastline), its history of natural disasters
(volcanic eruptions, hurricanes, earthquakes), and its
political history are described, as these dramatically
affect daily life for Nicaraguans and the students. For
example, climate and weather patterns in Nicaragua
affect the nature of projects that can be completed (tree
planting along the river cannot be accomplished during
the rainy season); the physical infrastructure (roads,
sidewalks, buildings) can act as a barrier or facilitator to
mobility and access to important services; and politics
determines governmental priorities and appointments
to positions.
Use of an ecologic approach helps to identify factors
that contribute to healthy community development for
an aging society. Students may apply their disciplinary
knowledge (for example, of aging, community development, and public health) to their projects in Nicaragua,
along with their understanding of Nicaragua-specific
contextual features. This knowledge, combined with
direct community input into the types of projects needed
and desired, and program experience about previous
successful projects, guides the selection of future projects. The following sections detail such projects as water
projects, home repairs, green and natural projects, public
health education and health fairs, community advocacy,
and a housing construction project.
Water Projects
In the first year of the program, while in the U.S., students developed a project to train elder caregivers on
the use of universal precautions such as hand washing.
Upon arrival in Nicaragua, the students discovered that a
basic resource, water, was unavailable within the homes
for elders. Also, most homes needed physical improvements to support the older residents, including adequate
space; there was also a lack of medical supplies and little
knowledge of aging or training available for staff caring
for frail residents. As a community partner in Jinotepe
explained, due to scarce supply, water was turned on
by City officials only for brief amounts of time. When
water was available, generally at night, staff would fill
the home’s only water tank. The tank’s capacity of 2,500
liters was insufficient for basic daily necessities such
as bathing residents, cleaning and cooking; there was
not consistent access to clean water for the washing of
hands as is required by universal precaution procedures.
It was clear that the student project on hand washing
could not be implemented and, moreover, that the lack
of access to basic utilities was an obvious impediment to
adequate care for residents. Increasing the water supply
to the homes became a top priority.
Between 2004 and 2005, a water project was begun to
fund the acquisition and installation of a water tank for
the Masaya home for elders. To carry out the project,
a partnership with professionals and students from the
Portland chapter of Engineers Without Borders (EWB)
was established. By 2007, PSU students and volunteer
engineers from EWB had added a water tank at the
Jinotepe home and an additional tank in Masaya, which
increased the water capacity to 10,000 liters. Another
PSU/EWB group completed an irrigation project for
an orchard at the home for elders in Matagalpa; this
project was intended to help the orchard provide food
and income for the older adults living in the home.
Engineering students also conducted assessments at
other homes for elders to prepare for future work in
Nicaragua. PSU students affiliated with EWB continue
to work in Nicaragua; although they travel and arrange
projects independently, the two groups continue to share
experiences and assist with each other’s work.
Home Repairs
In Jinotepe, conversations between JFR staff, facility
staff, and program faculty ensued regarding other
physical plant needs of the home and the resources
available in the community for improving the site.
A strong relationship was developed, and a proposal
to improve the facility was developed. After two years
of visits to Jinotepe, the steps required to begin the
physical renovation and expansion of the facility were
accomplished. The home secured NGO status; the local
volunteer board responsible for the operation of the
home grew stronger; title to the land that the home
was on was secured; and money was raised in the U.S.
to fund design and development costs. From 2006 to
2009, approximately $107,500 was spent to relieve
overcrowding by expanding the capacity of the home
from 30 beds to 60.
In addition to the expansion of the facility, the engineering assessment project in Jinotepe revealed other
needs, including retrofitting the roof for increased protection in the event of an earthquake or strong storm,
upgrading the electrical system, and adding storage
space for medical supplies and other items needed to
care for the residents. PSU students designed and tested
upgrades in Portland before traveling to Nicaragua.
This transformation of the physical infrastructure of
the home in Jinotepe over several years has provided a
safer and healthier environment for residents and staff.
Media attention led to increased community support for
the home. Microfinance projects now generate revenue
for the home. The result has been an improvement of
the home’s social, economic, and physical environments
and an increase in the community’s awareness of and
capacity to deal with an aging population. Plans for
remodeling the older section of the home are underway.
Additionally, the possibility of creating a national training center for caregivers that will help Nicaraguans in
supporting their elders is under consideration.
Green and Natural Features
Maintaining the natural environment and facilitating
healthy environments through the use of green spaces
emerged as a need early in the program. As part of the
second year’s activities, students were involved in two
projects in the home for elders in Masaya. While cleaning up the grounds of the home, students used stones
and soil on the site to build a raised-bed garden to grow
vegetables. They noticed that one wall of the home was
fully exposed to direct sun during the hottest part of the
day; on the other side of that wall was the men’s quarters. The team worked with a local nursery to identify
and purchase fast-growing indigenous shade trees. On
the final day of the students’ visit, the students, faculty,
and an older resident from the home planted trees.
During the fourth year of the program, students worked
in Boaco to provide a healthier living environment for
23
persons of all ages. Direct community input and student
and faculty observations of sanitation issues, such as
garbage in the streets, water pollution, lack of potable
water, and deforestation, led to the development of three
projects: a tree-planting project with students from a
school, a river clean-up with community members, and
the installation of trash bins in and around the city’s
center. Students were invited to meet with Boaco provincial government officials interested in environmental
preservation and pollution-related issues to discuss
environmental factors affecting quality of life in Boaco.
Public Health Education and Health Fairs
The expertise and experiences of Dr. Peláez and the PSU
social gerontology faculty led to a concentration in the
program on community health and public health education. As such, several student projects implemented
in this arena have involved training paraprofessional
caregivers, assessing the health of older adults in the
community, educating people of all ages about healthy
practices, and working with trained professionals to
provide health screenings and deliver medical advice
and attention.
During the first three years of the program, guides
and posters were created and distributed in partnership
with JFR as part of its Life Enrichment Activity Program
(LEAP) focused on health issues for older adults, including exercise, foot care, arthritis, diabetes, high blood
pressure, and dementia. These materials, translated
into Spanish and adapted to be understandable to individuals with low literacy levels, have been distributed
widely, including at health fairs and at elementary and
secondary schools.
During the fourth year of the program (2007), the
first health fair in Nicaragua with a focus on older
adults was held in Boaco. As a part of the event, Dr.
Milton Lopez, one of a few Nicaraguan physicians with
training in gerontology and geriatrics and who also has
a Master’s degree in Public Health, saw older patients
in the city center. Many of the older adults had not
received medical attention for months or even years. In
addition to assisting with the clinical attention, students
organized skits and games and distributed educational
materials to inform the community about healthy and
active aging. Local vendors joined the health fair, and a
theater group performed a play on the dangers of using
non-potable water and drinking too much alcohol.
24
Also in 2007, students began working with Dr. Lopez
to organize and offer health clinics outside Boaco,
expanding into the surrounding rural areas; these clinics
have been offered in subsequent years of the program to
provide medical attention to older adults with limited
access to health and medical services. Students have
conducted health education activities, such as leading
exercises, training caregivers on how to lead exercise
activities, distributing health education materials, and
offering community presentations on topics such as
nutrition, especially as it relates to diabetes. Geriatric
expertise and medical supplies and medications are
insufficient to address the health care needs of an aging
population in Nicaragua. Donations of supplies and
medications are solicited by the program and carried to
Nicaragua by students and faculty. While the extent of
need is too great for such donations to make a significant
difference, education is a crucial first step in changing
health behaviors and improving health outcomes in the
long run.
Community Advocacy and Outreach
During the 2005 program, students conducted a community asset mapping project designed to identify
organizations connected with older adults in Juigalpa,
as well as organizations that could be connected. During
the 2006 program, a community development student
team conducted a similar but more extensive community
assessment in Boaco. The inventory of community organizations considered to be assets in both towns included
international non-governmental organizations such as
the Red Cross and Project Hope, the local library and
the police department, lending institutions, and advocacy
groups. Boaco organizations were asked to complete an
electronic survey or were interviewed to catalogue their
objectives, clientele, and connections to other local,
national and international agencies. The responses were
recorded in a resource guide that was distributed to
partners of the PSU program and others in Nicaragua
working with older adults in and around Boaco.
Among the groups vital to the early success of the
program were the local Catholic church, an advocacy
group named “Foundation for a University of the
Third Age” (FUNITE), the U.S. Peace Corps, and the
library. The Catholic church supported the Boaco
home for elders financially and through providing staff.
Monsignor Santa Maria and his church were partners
© alan delatorre
The son of the local contractor working with students to build the bottle house finishes a wall in a rural community outside
of Boaco, Nicaragua; a student and local community member talk about the project.
in the program’s work in Boaco until the Monsignor’s
death in 2010. FUNITE facilitated community contacts
for the program in Boaco and helped to organize the
health fair. During the program’s first year in Boaco, a
Peace Corps volunteer helped in arranging a community
forum on aging near the town square. Seventy community members attended this first community conversation regarding aging in Boaco.
Other educational projects have been intergenerational, providing lessons about aging in elementary and
secondary classrooms, using aging simulation activities
and guiding teachers in the construction and delivery
of training kits. PSU students organized connections
between students in Boaco and elders at the home
through visits and written communication and between
students and elders at the meal site. A documentary
video about the program was produced in 2009, a twominute excerpt of which recently won first prize in the
Gerontological Society of America’s Global65 YouTube
video contest.1
In 2007, Dr. Milton Lopez began working as a program liaison, advocating for elders by raising awareness
of aging in Nicaragua and creating a strong curriculum
in geriatrics and gerontology at Nicaragua universities.
His work included organizing a “coordinating council”
focusing on elders in Boaco composed of individuals
from various stakeholder groups. The Council of Elders
served in an advisory capacity and raised funds for the
home. With the death of Monsignor Santa Maria, the
Council lost a key leader.
Dr. Lopez coordinates an intergenerational servicelearning project connecting youth and older adults in
Boaco, including continuing education on aging. He
is exploring the possibility of connecting youth sports
teams with service projects benefiting older adults.
Housing Construction:
The Bottle House Project
For 2010, Boaco community leaders proposed that
one student project involve finding a use for recyclable
materials such as plastic bottles and tires. The mayor of
Boaco was interested in reusing materials that the city
had been collecting to benefit the community environmentally, socially and economically. An article
published in Portland’s local newspaper about plastic
bottles being used to build houses (Preusch, 2010)
prompted the program team to contact the Peace Corps
volunteer mentioned in the article and a Guatemala
25
26
© alan delatorre
non-profit organization, Pura Vida (2010), that
developed a manual on implementing projects with
eco-ladrillos, “eco-blocks,” or plastic bottles filled with
dry, inorganic garbage.
In the spring, the program team distributed the Pura
Vida document to faculty, students, and professionals
and met with a group that included an engineer, a
contractor, EWB students involved with construction
projects in Nicaragua, and faculty. The feasibility of the
project, including potential adjustments necessary for
completion in a two-week time frame, was discussed.
Based on the advice from that meeting and input from
the community leaders in Boaco, a plan was made to
construct a small home for an older woman living on
the outskirts of Boaco whose home had burned down
and who was living in a makeshift shelter constructed
of tree branches and plastic sheeting.
The replacement home was to use traditional
Nicaraguan building practices, a concrete and reinforced steel foundation, along with a galvanized steel
roof, to create a skeleton that would then have walls
constructed from 1.5 liter plastic bottles filled with
dry, inorganic garbage. Poultry wire would encase the
bottles, and then coats of cement were to be applied
for the walls. The bottles were to be stuffed by local
community groups including children and youth from
schools, sports teams, and churches prior to the students’ arrival. The JFR Foundation contracted with a
Nicaraguan architect and contractor to draw up plans
and complete the foundation and supporting structure.
When the students arrived in Nicaragua in June of
2010, the project was behind schedule: bottles had not
been filled, the foundation had not been started, and
the contractor had identified a budget shortfall. The
two main non-monetary issues were a lack of time
from community members and insufficient garbage to
fill the bottles. The budget shortfall arose because it
had been decided to fill and level the site. An altered
timeline, budget and adjustments to the design were
implemented in an attempt to allow students and the
community adequate time to complete the house before
the students’ departure from Boaco on July 1.
When the project team arrived at the site, little
progress had been made; only 200 of the needed 1,000
bottles had been filled and the foundation had not been
started. Due to a lack of appropriate garbage to fill the
bottles, the team decided to use sand for constructing
An older woman living in a rural community outside of
the city of Boaco, Nicaragua, walks around the site of her
new home that students, faculty and community members
were constructing.
the walls. After two days of filling bottles, the first wall
was completed, with the bottles placed using the poultry
wire, screws, and additional wire to create a taut façade
and flatten the walls. Due to heavy rain and a political
situation that led to the mayor’s removal from office,
the project was delayed further; however, students were
able to work with community members to complete
the majority of the home before leaving Boaco, and the
contractor was paid to finish the project.
On the final day of the students’ work at the site,
the newly appointed Catholic priest visited the nearlycompleted home to give a benediction and to discuss
the importance of community efforts in improving the
lives of older adults. Ultimately, the bottle house was
estimated to have cost more than a home constructed
using traditional building techniques. Nonetheless,
several important outcomes were noted. First, the community was surprised by the use of recycled materials in
the home, providing valuable education regarding environmental stewardship and recycling. Second, the community members’ involvement was viewed as a success,
with people of all ages participating. The effort seemed
to create a new energy in the community, and a desire for
similar future projects has been expressed. Miles away
from the project site, people asked students and faculty
whether they were the “ones working on the bottle
house;” they were excited about possibilities for the
use of recyclables. Finally, an older woman without
adequate shelter had a home that markedly improved
her life.
Future Directions
The world is aging, a trend especially dramatic in less
developed countries such as Nicaragua. According to
Kinsella and He (2009), in 2008, 62% (313 million) of
the world’s people aged 65 and over lived in developing
nations. In 2040, the proportion is expected to exceed
75%, or one billion aged people in the developing world.
As Kinsella and He (2009, p. 14) noted, “Developed
countries grew rich before they grew old, while many
developing nations may grow old before they grow
rich.” The importance of preparing for an aging society,
particularly in places with limited resources and little
gerontological expertise, cannot be overstated.
Population aging in Nicaragua, as well as elsewhere,
must become a priority for nations and their communities. The program described here has not solved the
challenges associated with Nicaragua’s aging population, nor will it. The program does, however, strengthen
communities’ internal capacity for improving the lives of
elders and their surrounding environments in ways that
can be sustained without the presence of U.S. students
and faculty.
The projects have had varying degrees of success.
Myriad obstacles have emerged along the way, including those associated with intercultural and international
communication, political changes and support, and
competing priorities for limited resources. Moreover,
change often comes slowly. Nonetheless, these efforts
have rewards for older Nicaraguans, the students who
serve them, and other stakeholders. Service-learning
principles, asset-based community development, and
application of an ecologic framework have been key
ingredients to success. Implementing these approaches
requires patience, communication, breadth and depth
of knowledge, hard work, learning from mistakes, and
building on successes, no matter how big or small.
Efforts are needed to work with older adults and their
communities to increase awareness and understand the
implications of an aging world. By involving students
in direct service as part of their learning experience—
whether for two weeks, two months, or two years—the
ability to make marked local improvements is evident.
Aging is connected to the environment—the social, the
natural, the built—and many factors impact the health
and well-being of a population. This program offers
an example of how universities and community partners
can work with communities to begin a holistic process
to improve the quality of life and well-being of an
aging population.
Margaret B. Neal
Director, Institute on Aging,
Professor, School of Community Health,
Portland State University
[email protected]
Keren Brown Wilson
President,
Jessie F. Richardson Foundation
[email protected]
Alan DeLaTorre
Research Assistant,
Institute on Aging,
Portland State University
[email protected]
Milton Lopez
Geriatric Physician
Program Liaison,
Jessie F. Richardson Foundation
[email protected]
27
note
1 See www.geron.org/About%20Us/history-celebrating-65-years/global65-youtube-contest and
www.youtube.com/watch?v=AYjQwwJMYg8
references
Central Intelligence Agency. (2009). Nicaragua. The world factbook 2009. Washington, DC:
Central Intelligence Agency. Accessed September 16, 2010: www.cia.gov/library/publications/
the-world-factbook/geos/nu.html
Cunningham, G. O., & Michael, Y. L. (2004). Concepts guiding the study of the impact of the built
environment on physical activity for older adults: A review of the literature. American Journal of
Health Promotion, 18(6), 435-443.
Jackson, R., Strauss, R., & Howe, N. (2009, March 24). Latin America’s aging challenge:
Demographics and retirement policy in Brazil, Chile, and Mexico. Accessed September 16, 2010:
http://csis.org/program/aging-latin-america
Kinsella, K., & He, W. (2009). An aging world: 2008. U.S. Census Bureau, International
Population Reports, P95/09-1. Washington, DC: U.S. Government Printing Office. Available at:
www.census.gov/prod/2009pubs/p95-09-1.pdf
Kretzmann, J. P., & McKnight, J. L. (1993). Building community from the inside out:
A path toward finding and mobilizing a community’s assets. Chicago, IL: ACTA Publications.
Lawton, M. P., & Nahemow, L. (1973). Ecology and the aging process. In C. Eisdorfer & M. P.
Lawton (Eds.), Psychology of adult development and aging (pp. 619–674). Washington, DC:
American Psychological Association.
Pan American Health Organization, & Merck Institute of Aging & Health. (2004). The state of
aging and health in Latin America and the Caribbean. Washington, DC: MIAH.
Plunkett, H. (2002). Nicaragua in focus: A guide to the people, politics and culture. Brooklyn, NY:
Interlink Books.
Preusch, M. (2010, January 7). Portlander uses plastic bottles to build classrooms, community in
Guatemala. The Oregonian. Accessed September 16, 2010: www.oregonlive.com/
Pura Vida. (2010). Para una vida sin contaminación. Accessed September 16, 2010:
http://puravidaatitlan.org
Sallis, J. F. (2003). New thinking on older adults’ physical activity [Supplement 2].
American Journal of Preventive Medicine, 25(3), 110-111.
Satariano, W. A., & McAuley, E. (2003). Promoting physical activity among older adults:
From ecology to the individual [Supplement 2]. American Journal of Preventive Medicine, 25(3),
184-192.
Solimano, A. (2004, October). Political violence and economic development in Latin America:
Issues and evidence. Paper prepared for the conference, Making Peace Work, Helsinki, Finland.
Available at: www.eclac.org/publicaciones/xml/4/20394/lcl2194i.pdf
United Nations. (2009). World population prospects: The 2008 revision [Population database].
Accessed September 16, 2010: http://esa.un.org/unpp
Wahl, H. W., & Weisman, G. D. (2003). Environmental gerontology at the beginning of
the new millennium: Reflections on its historical, empirical, and theoretical development.
The Gerontologist, 43(5), 616-627.
Willman, A. (2000). Bankrupt future: The human cost. Accessed September 16, 2010:
www.witnessforpeace.org/downloads/Bankrupt%20Future.pdf
28
By Sturle J. Monstad
29
Grandparents: Advocating for
a Livable Planet for Today’s and
Tomorrow’s Grandchildren
T
he climate is changing, and people are realizing that some of this change is human
made. Individuals and groups are standing up for more political initiative and action.
Older adults are advocating, not on their own behalf, but for the generation who will
inherit the Earth. Their principal motivation for involvement is the future health and
well-being of their grandchildren.
Climate change and human made heating of the Earth have been thoroughly researched
in the last decades. Carbon monoxide and other heat trapping greenhouse gases released
into the atmosphere are warming the Earth. Global climate change poses risks and will
affect human societies and natural systems in various ways. Some consequences are
predictable, like increased flooding and storms; other effects and scenarios may surprise
future generations (National Research Council, 2010; WHO, 2005).
Attitudes
If figures from the United Kingdom are representative, it may seem that in general, older
adults are not terribly concerned by the climate change and its effects (Spence, Venables,
Pidgeon, Poortinga, & Demski, 2010). Forty-four percent of those over 55 do not feel
they will be affected by climate change, while only 24% of the younger generations
feel the same way. Thirty-two percent over 55 disagree or strongly disagree that they
personally can reduce climate change by altering their behavior. Among the younger age
groups, only 10% feel the same. They also found that many older adults did not know
very much about how to take action in their own lives. A majority believed that government and the commercial sector should take stronger leadership to combat climate
change effects (Spence et al., 2010).
Carbon Footprint
Older adults in the United Kingdom have a high carbon footprint compared to younger
generations. The “carbon footprint” figures are based on expenditures and associated
carbon emissions for the various age groups. Especially the high number of baby boomers, now in the 50 to 64 year age range, will change their consumption habits, replacing
lower carbon footprint generations as they age. This
group is often in a prime economic position, and their
carbon emissions come from a high car dependency,
holiday travel, and eating out. In the older generations,
emissions come mainly from carbon intensive home
heating. Together with demographic population change
in the western world, older adults will also comprise
a larger population segment that contributes more
to climate change than younger cohorts (Haq, Minx,
Whitelegg, & Owen, 2007).
However, more and more individuals and groups are
taking action to reduce climate change. The involvement
of older adults in creating awareness is important, as the
group is both a contributor to and potential casualty of
climate change. Furthermore, they are campaigners who
can have a significant voice on the issue (Haq, Brown,
& Hards, 2010).
Advocacy and Health
The prime goal for taking care of the environment and
limiting global warming is to better the health and
quality of life for the inhabitants of the Earth and the
generation to come. The Lancet and University College
London Institute for Global Health Commission has
called climate change the “biggest global health threat
of the 21st century” and lists challenges that the world
is facing (Costello et al., 2009). Increased flooding, heat
waves, agricultural problems, and more vector borne
diseases are some of the issues that will affect health. A
new movement focusing on advocacy and public health
is needed to put climate change high on health and
political agendas, the commission argues.
According to the Ottawa Charter, health promotion
is often described as “the process of enabling people
to increase control over, and to improve, their health”
(WHO, 1986). Together with peace, education, food
and shelter, the need for a stable eco-system is seen as
fundamental for health. Health promotion involves
advocacy for health, enabling people to pursue better
health and mediating between different social sectors
for the improvement of health.
There are five action means for health promotion:
build healthy public policy, create supportive environments, strengthen community actions, develop personal
skills, and reorient health services (WHO, 1986). While
there are many interests in society and health promoting
short term and long term policies and practices, they
30
frequently appear less important than other priorities.
Shorter term economic issues are often given priority in
the political sphere.
A central concept in health promotion is empowerment. According to Stang (1998), empowerment is
based on autonomous participation, democracy, raising
critical consciousness, cooperation, and mutual respect.
The opposite of being empowered is being in a state of
powerlessness; the reasons for powerlessness may be
that the individual feels alienated and not in control
(Stang, 1998). Therefore, increasing the feeling of
being in control and having power to influence one’s
life becomes paramount for an individual to become
empowered. Older adults who believe they can do
something when it comes to climate change, should feel
more empowered than those who have knowledge, but
have not taken action.
The WHO life course approach to active ageing
recognizes that older adults are part of a diverse and
heterogenic population. Such individual diversity in
needs, resources and capacities becomes more and more
apparent with increased age. Active ageing is a term
defined as “the process of optimizing opportunities for
health, participation and security in order to enhance
quality of life as people age” (WHO, 2002). Older adults
often have better health and resources to influence their
own ageing trajectory than what is the case for earlier
generations. Empowered older adults can take action,
not just for their own well being and quality of life, but
also for generations to come.
Grandparents’ Climate Campaign
In Norway, a movement named the Grandparents’
Climate Campaign1 emerged in 2006, initiated by
Halfdan Wiik, a university college librarian. Newly
turned grandfathers were an accelerator for action, and
a grass roots movement evolved. The group is organized
in collaboration with the established environmental
organization, Future in Our Hands2. Over 4,000 grandparents from the whole country have joined, and the
number is increasing. Those who join the campaign
acknowledge the major development the world has
gone through in their lifetime. After the world wars, the
speed and magnitude of development have changed and
improved life for large numbers of people. The price
for this growth in wealth and consumerism is, however,
likely to be paid for by grandchildren in coming years.
Real change is needed today to secure a livable future
for grandchildren and future generations. The campaign
calls for politicians to be climate warriors and chieftains
and lead the way for policies that support sustainability
and alternative forms of energy. The Commandments
are critical of increased consumerism in the western
world and express the belief that government must
utilize more restriction to harness the business sector.
Their radical message is critical of politicians in general, not just of existing governments. The initiative has
been widely supported by professors, bishops, newspaper editors, and top politicians, among others. To some
surprise, even members of the Conservative party, among
them previous Prime Minister Kåre Willoch, are a part
of the movement. Before the 2009 election, signatures
of 50 of the more famous grandparents appeared in
© sturle j. monstad
The empowered grandparents believe they can have
their say when it comes to future political directions.
The report, Our Common Future, by the World
Commission on Environment and Development (1987)
reflected the Norwegian leader Gro H. Brundtland’s
convictions. It is an important document that introduced
the term, sustainable development. While many people
found hope in the concept defined as “development that
meets the needs of the present without compromising
the ability of future generations to meet their own
needs,” others have been disappointed that enlightened
policies have not followed.
The Ten Commandments for Politicians were formed
and published in a major newspaper, calling for
increased political prioritizing and willpower to address
the climate issue (Wiik & Vetlesen, 2007) (See Box 1).
More and more grandparents realize that one of the most important things they can do is to give their grandchildren a better
world to inherit. Conscious grandparents do not want their grandchildren in coming years to say, “My grandparents knew
what was going to happen, but did not do enough to stop it.”
31
newspaper ads calling for more green politics in the oil
rich country. As a large exporter of oil and gas, Norway
is dependent on fossil fuels, but the grandparents are
calling for alternatives and stricter regulations for the
industry, both nationally and internationally. In Norway,
they are working against drilling for oil off the coast of
the Lofoten Islands, where a dreaded scenario would
be an oil spill in the often harsh climate that potentially
could damage important breeding grounds for fish. In
addition, the scenic natural beauty of the islands is at
risk together with the negative consequences for the
climate as fossil fuels are consumed. Internationally,
oil companies are moving operations from dry wells to
new oil fields. Much of the new fossil fuels areas that
have not yet been used are in developing countries, in
harsh climates and in areas where major ecological
damage is expected with the extraction of oil and gas.
As the Norwegian state owns a large majority of the
stocks in the country’s largest oil company, Statoil, the
Grandparents’ Climate Campaign has also worked on
how the business should operate in other regions of the
world. Statoil is involved in oil sand projects in Canada
that are controversial because of the effect on the local
environment and increased use of fossil fuels. The
Norwegian government has, however, been reluctant to
use their shareholder power to control the company in
this matter.
Scientist Turns Activist
Oil sand is one of the priority issues of the Grandparents’
Climate Campaign which has support from one of the
world’s leading climate change scientists, Dr. James E.
Hansen. Dr. Hansen teamed up with the Campaign and
received Norway’s acclaimed environmental recognition, the Sophie Prize3 from the Norwegian Gaarder
Foundation.
Dr. Hansen, a member of the National Academy of
Sciences and an adjunct professor in the Department
of Earth and Environmental Sciences at Columbia
University and at Columbia’s Earth Institute, is also
the director of the NASA Goddard Institute for Space
Studies4. In 1988, he testified before a U.S. Senate committee on how the Earth was being affected by human
made greenhouse gases and has since been engaged as
an expert on the topic.
Although he is primarily a scientist, Dr. Hansen has
become involved in the public debate. In his recent
32
BOX 1. Ten Commandments for Politicians
1.You shall respect international agreements. Norway has no
chance to meet its Kyoto commitments, except for buying
emissions quotas abroad. Any such trading should be supplemental to domestic action, not a substitute.
2.You shall not engage in the game of symbolic politics. Political
measures must correspond to the seriousness of the threat we
face. The massive gap between required and factual actions
taken must be sealed.
3.You shall consider the totality of your own policy. The traditional goal of an ever-increasing consumption, maximizing
returns and accelerating transportation undermines itself.
With a climate out of control, there will be no business in the
future.
4.You shall admit historical mistakes. Scientists and environmentalists have warned against manmade global warming
since the 1970s, without being heard. A willingness to accept
criticism would today be a promising political gesture.
5.You shall not oversell your good intentions. It’s the results
that count. The Norwegian carbon capture project has a very
uncertain future. The only certain thing about it, is that it will
contribute to rising national emissions.
6.You shall take control and intervene when necessary. That’s
what we have politicians and government for. We’ve had
enough of cowardice and wishful thinking.
7.You shall listen to your unborn grandchild. Not to the prophets
of short-term profits and cost-benefit. Climate change lags
behind its forcings; you will be gone when problems become
insolvable.
8.You shall use words that are honest, plain and simple. The gap
between glossy rhetoric and insufficient action has become
unbearable.
9.You shall be a climate warrior and a chieftain. Continued indecisiveness can only be explained by character flaw, ideological
paralysis and lack of leadership skills.
10.You shall stand up for basic moral values. The gospel of
individualism is false; the community’s needs must take precedence over private interests. We must come together and fight
against consumerism and self-worship, for intergenerational
justice and the wisdom of collective action.
SOURCE: Published in the major newspaper, Aftenposten
(Wiik and Vetlesen, 2006). Revision and translation, 2010.
book, Storms of My Grandchildren: The Truth about
the Coming Climate Catastrophe and Our Last Chance
to Save Humanity, Hansen (2009) uses his knowledge to
create a strong rationale for reducing greenhouse gases
and creating climate-friendly policies. The consequences
© sturle j. monstad
Advocacy, not on their own behalf, but for generations who will live on the Earth in the years to come, is meaningful for
many grandparents.
of climate change led Hansen to coin the term, intergenerational inequity, to emphasize the fact that coming
generations must pay for the actions of previous generations. According to Hansen, many politicians are guilty
of “greenwashing”: “expressing concern about global
warming and the environment while taking no actions
to actually stabilize climate or preserve the environment” (Hansen, 2009, Preface IX).
(Haq, Brown, & Hards, 2010): RSVP West—The
Retired and Senior Volunteer Programme in the West of
England6—and the Evergreen project, run by the charity Global Action Plan7, work to create awareness and
action among seniors and include an intergenerational
component in the projects. Also Kingston University
used a similar focus in their “Sustainable Living and the
Older Community” project8.
Other Groups
Advocating for Future Generations
A number of organizations are pointing at the intergenerational perspective as their motivation for working to
reduce climate change. In the United States, the activism group Gray Panthers5, traditionally working for
increased dignity and rights for older adults, has gone
through a “greening” (Wile, 2010). In the organization’s
40th anniversary year, climate change issues have been put
higher on the agenda. In the UK, several projects have
engaged seniors, according to the report, Older People
and Climate Change: The Case for Better Engagement
In Norway and elsewhere, grandparents are lifting their
voices to express their passion to limit climate change
and advocate for more climate-friendly policies. They
do not want their grandchildren to say, “My grandparents knew what was to happen, but did not do enough
to stop it.”
Sturle J. Monstad
Independent Consultant
[email protected]
33
notes
1 Grandparents’ Climate Campaign: http://besteforeldre.framtiden.no
2 Future in Our Hands: www.framtiden.no
3 The Sophie Prize: www.sofieprisen.no
4 Dr. James Hansen websites: www.columbia.edu/~jeh1/ and www.stormsofmygrandchildren.com
5 Gray Panthers: http://graypanthers.org
6 The Retired and Senior Volunteer Programme in the West of England: www.rsvp-west.org.uk/
climatechange
7 Evergreen Project by Global Action Plan: www.globalactionplan.org.uk/evergreen
8 Sustainable Living & the Older Community: http://sustainablelivingandtheoldercommunity.
co.uk
references
Costello, A., Abbas, M., Allen, A., Ball, S., Bell, S., Bellamy, R., Friel, S., Groce, N., Johnson, A.,
Kett, M., Lee, M., Levy, C., Maslin, M., McCoy, D., McGuire, B., Montgomery, H., Napier, D.,
Pagel, C., Patel, J., Antonio Puppim de Oliveira, J., Redclift, N., Rees, H., Rogger, D., Scott, J.,
Stephenson, J., Twigg, J., Wolff, J., Patterson, C. (2009). Managing the health effects of climate
change. The Lancet, 373(9676), 1693-1733.
Hansen, J. (2009). Storms of my grandchildren: The truth about the coming climate catastrophe
and our last chance to save humanity. New York: Bloomsbury USA.
Haq, G., Brown, D., & Hards, S. (2010). Older people and climate change: The case for better
engagement. Stockholm Environment Institute, Project Report – 2010. Stockholm: SEI. Accessed
October 15, 2010: http://sei-international.org/publications?pid=1581
Haq, G., Minx, J., Whitelegg, J., & Owen, A. (2007). Greening the greys: Climate change and the
over 50s. Accessed October 14, 2010: http://sei-international.org/publications?pid=712
National Research Council. (2010). Advancing the science of climate change. (Prepublication
copy). Washington, DC: The National Academies Press. Accessed October 15, 2010:
www.nap.edu/openbook.php?record_id=12782&page=R1
Spence, A., Venables, D., Pidgeon, N., Poortinga, W., & Demski, C. (2010). Public perceptions of climate change and energy futures in Britain: Summary findings of a survey conducted in January-March 2010. Technical Report. (Understanding Risk Working Paper 10-01).
Cardiff: School of Psychology. Accessed October 16, 2010: www.cf.ac.uk/psych/home2/docs/
UnderstandingRiskFinalReport.pdf
Stang, I. (1998). Makt og bemyndelse: om å ta pasient- og brukermedvirkning på alvor.
Oslo: Universitetsforlaget.
Wile, J. (2010). The greening of the Gray Panthers. Accessed October 12, 2010:
http://graypanthers.org/index.php?option=com_content&task=view&id=142&Itemid=29l
World Commission on Environment and Development. (1987). Report of the World Commission
on Environment and Development: Our Common Future. Published as an Annex to United
Nations General Assembly document A/42/427, Development and International Co-operation:
Environment, August 2, 1987. Accessed October 16, 2010: www.un-documents.net/
wced-ocf.htm
World Health Organization (WHO). (1986). Ottawa Charter for Health Promotion.
Geneva: WHO.
World Health Organization (WHO). (2002). Active ageing: A policy framework. Geneva: WHO.
World Health Organization (WHO). (2005). Health and climate change: The now and how.
A policy action guide. Geneva: WHO.
Wiik, H., & Vetlesen, A. J. (2007, Jan 17). 10 klimabud for politikere. Oslo: Aftenposten.
34
By Marina Skinner and Dianne Rogers
35
Conservation Volunteering:
Sowing Seeds for Long Life
M
entoring, volunteering, looking out for the neighbourhood, and caring for children are some of the many ways New Zealanders aged 65 and older contribute to their
communities. As our population ages, it becomes more apparent that with good health
and active lifestyles, people are certainly not ‘old’ at age 65. It is becoming common for
people when they reach 65 to continue in paid work and to lead businesses.
At the 2006 Census, 15% of older people reported being involved in volunteer work
in the previous four weeks. The age groups 65 to 69 years and 70 to 74 years were
more likely to have volunteered than the 45 to 64 age group (Ministry of Social
Development, 2007).
New Zealand qualitative research illustrates that older people see voluntary work
as part of planning for retirement. For example, in the Health, Work and Retirement
Longitudinal study, many respondents expected to become more involved with voluntary work and were thinking about what and where this might be.
New Zealand has led the way with its Positive Ageing Strategy1, which serves as a
model for other countries. In New Zealand, we encourage older people to share their
knowledge, skills and experience to make New Zealand a better place for everyone.
Stan Butcher is an example of positive ageing. When Stan retired at the age of 58, he
joined a team of Forest & Bird volunteers, getting rid of rats on Matiu/Somes Island
in Wellington harbour. It was physically challenging work, clinging to cliff edges and
battered by the notorious gales of New Zealand’s capital city.
Volunteers are the life force of Forest & Bird—a non-government organisation that
since 1923 has advocated for nature conservation nationally and runs community
restoration projects through its nationwide network of 50 branches.
In an ambitious, visionary project to restore glades of native forest, birds and other
animals to what had become an island of bleached pasture for quarantined farm animals, Stan and other branch members had their work cut out for them 30 years ago.
They set up a native plant nursery on the island and began planting the strappy flax
bushes and low taupata trees that would provide the sheltering support for the larger
totara and rata trees to follow.
Within a decade, Stan and his mates had rid the small
island of rats, so vulnerable native birds and other creatures could be returned to the island. Now, Matiu/Somes
Island is home to rare native birds—the chattering redcrowned parakeet, or kakariki, the inquisitive North
Island robin and many others. It is also a refuge for a
survivor of the dinosaur era, the tuatara—an ancient
order of reptile—and several species of New Zealand’s
large and leggy insect, the weta. Stan and other Forest
& Bird members take pride in their pioneering work.
Stan found Forest & Bird’s conservation projects the
perfect progression after 40 years in government service,
in the army and as a teacher. He missed teaching and
looked for ways to spend his time after working 12-hour
days. “Emptiness comes with retirement,” he reflects.
He believes people should begin planning activities for
their retirement many years ahead.
He has been a member of Forest & Bird since 1940,
but it was not until he retired in 1981 that he became
active in the community conservation organisation.
“Any involvement in an organisation is a recipe for a
longer life. It keeps you mentally alert and engaged,”
he says.
Until recently, Stan’s Forest & Bird work has kept him
physically fit, too. In his early 60s, he became heavily
involved in a reserve project a three-hour drive from his
home. He would stay three days a month at Bushy Park
in Whanganui, cutting tracks through dense forest to lay
rat traps and maintaining the historic homestead in the
park grounds. He painted the exterior of the sprawling
homestead, planted native plants and raised them.
The sense of purpose that retired people derive from
their Forest & Bird involvement is justified. General
manager Mike Britton says members close to retirement
and in retirement devote thousands of hours to Forest
& Bird work every year.
“Conservation in the future will hinge on the efforts
of people in local communities, and retired people have
the time, energy and local knowledge to make enormous
contributions. Without our more mature members,
Forest & Bird would not have been able to make the
progress we have made. Older people also pass on their
knowledge about native plants and animals, and they
are wonderful mentors for our younger members.”
New Zealand’s Positive Ageing Strategy promotes the
value of older people and affirms their importance in
the community. With its ten aspirational goals—relating
36
to income, health, housing, transport, ageing in the
community, cultural diversity, rural services, positive
attitudes, employment opportunities, and opportunities
for personal growth and participation—the Strategy
recognises the importance of sharing wisdom and
knowledge and passing this on to younger generations.
The best way to change attitudes to ageing, so that it
is viewed as a positive experience, is for younger and
older people to work together on projects like Isobel
Morgan’s work with the Napier Forest & Bird.
Napier Forest & Bird member Isabel Morgan spent 40
years leading children on nature trips. In 1967, she set
up a junior Forest & Bird group, which paved the way
for Forest & Bird’s national Kiwi Conservation Club for
children launched in 1988. The former primary school
teacher, retired for many years, enjoys sharing her love
of nature with others. “I have been able to pass on my
knowledge about plants to adults and children,” she
says. “Children see me as a grandmother figure. I feel
loved and respected and the children hang on my words.
A lot of children don’t have grandmothers. I hope
I’m passing on the ethos of Forest & Bird and care for
the environment.”
Once Isobel retired, she had more time and flexibility
to work on other Forest & Bird projects, including
planting and writing letters and submissions to councils
about developments that affect the natural environment. “Volunteer work makes me feel more involved
with the community. It also keeps you more alert. Your
brain keeps on going; you’ve got to think about the consequences of submissions, you’ve got to go to hearings
and make your case.”
Older people today have more choices about how
they want to live their lives. They have the freedom
to continue working, to take up volunteering, and to
demand that they are not taken for granted. The success
of the Positive Ageing Strategy has been largely due to
older volunteers who have been at the forefront of the
work from the beginning; they continue to work with
their local councils, encouraging councils to plan for an
ageing population. Similarly, volunteers play a crucial
role in the success of the projects undertaken by Forest
& Bird and the smooth running of the organisation.
Forest & Bird volunteers are called on to do a wide
range of tasks: planting, weeding, pest control, bird
surveying, raising seedlings, building bird nesting boxes,
cutting tracks, writing submissions, meeting politicians,
running meetings, fundraising, teaching children about
nature, and writing newsletters and newspaper articles.
There is something to interest people of all ages and
degrees of commitment and fitness. “Forest & Bird
is a good organisation to connect with because of the
number of projects,” Stan says.
Des Dunbar has done voluntary administrative work
at Forest & Bird’s head office since 2001, and he has
become involved in his local branch’s planting projects.
Forest & Bird has given the English-born retired industrial chemist a greater understanding of conservation in
his adopted country. “It’s assisted me in my knowledge
of New Zealand plants and birds,” he says.
Forest & Bird has also contributed to Des’s social
life. He has enjoyed working with staff and attends
branch social events with his wife. Stan Butcher has
made friends and met many people with shared interests
through Forest & Bird. When Stan’s wife Gloria died in
1993, he dedicated more time to Forest & Bird projects.
Forest & Bird offered him companionship and a sense
of purpose during a difficult time.
In recent years, Stan has handed over the more strenuous work to younger Forest & Bird members, but he
continues as secretary for his branch. Stan is typing the
agenda for his branch meeting that night when I interrupt
him for an interview. “Forest & Bird has contributed to
my long life and has provided quality of life,” he says.
“Forest & Bird can extend your life.”
New Zealand’s Positive Ageing Strategy is designed to
produce policies that support people as they grow older
to lead productive lives. The benefits of positive ageing
for individuals are obvious: good health, independence,
intellectual stimulation, self-fulfillment and friendship
are just some of the good outcomes. Society as a whole
has a lot to gain from these: a healthy and confident
ageing population that contributes a wealth of expertise
and skills to the community and the workforce. They
also place less demand on social services and provide
positive role models for younger generations.
Marina Skinner
Communications Manager,
Forest & Bird
[email protected]
Dianne Rogers
General Manager,
Older People’s and International Policy,
Ministry of Social Development
[email protected]
37
note
1 See www.osc.govt.nz/positive-ageing-strategy
reference
Ministry of Social Development. (2007). Positive ageing indicators 2007. Wellington. Available at:
www.msd.govt.nz/about-msd-and-our-work/publications-resources/monitoring/positive-ageingindicators/
38
By Michael K. Gusmano and Victor G. Rodwin
39
Urban Aging, Social Isolation,
and Emergency Preparedness
S
ocially isolated older persons are difficult to find. Like other vulnerable populations, they tend to be invisible. Unfortunately, it takes a crisis to bring the issues of social
isolation and vulnerability among older persons to the policy agenda. For example,
thousands of older New Yorkers were left dangerously isolated immediately after the
September 11th terrorist attacks in 2001 (O’Brien, 2003). Similarly, during the 2003
summer heat wave, there were 2,000 “excess deaths,” in Paris, mostly among persons
age 75+ (ORS, 2003). In 1995, Chicago suffered a heat wave. Klinenberg’s “autopsy” of
this disaster highlighted the importance of neighborhood characteristics since he found
that socially isolated older persons had higher mortality rates in poor neighborhoods
with abandoned lots than in equally poor, but more socially-connected neighborhoods
(Klinenberg, 2002). Hurricane Katrina reminded us of how visible otherwise invisible
problems can become.
In 2003, the International City/County Management Association (ICMA) recognized
that social policy innovations will be required to meet this challenge (ICMA, 2003).
They urged local governments to “begin with an analysis of the distribution of population and amenities as these pertain to older adults and active living.” In 2007, the
World Health Organization launched the Global Age-Friendly Cities Project, designed
to encourage cities to assess how well they are responding to the needs of their aging
populations1.
Despite these calls for action, not enough has been done by cities around the world
on this agenda, and too little is known about the spatial distribution of older vulnerable
persons, including isolated persons across city neighborhoods (Glass & Balfour, 2003).
This paper provides a critique of an individual approach to emergency preparedness for
older persons and discusses the value of incorporating geographic needs analysis into
the planning process.
Emergency Supply Kits and ‘Go Bags’:
An Individual Approach to Emergency
Preparedness
The Centers for Disease Control and Prevention (CDC),
in partnership with the American Red Cross, developed
and publicized an effort to address the challenge of
emergency preparedness for older persons2. These organizations provide individuals with information regarding what they should do to prepare for an emergency.
They encourage individuals to prepare an emergency
supply kit and develop a family disaster plan, as well
as to be informed about how to shelter in place, understand quarantine and isolation, and be informed about
how to maintain a healthy state of mind. The website
provides a detailed list of items that should be included
in emergency supply kits and links to other sites with
useful information.
Similarly, the New York City Office of Emergency
Management (and sister agencies in other cities around
the country) encourages residents to prepare an emergency supply kit and to pack a ‘Go Bag’ that contains
a host of items one may need in the event of an evacuation, including copies of important documents, at least
$50 to $100 in cash, bottled water and non-perishable
food, extra medications that are updated regularly, a
flashlight, and numerous other items that are listed3.
Although following the suggestions included on these
websites would almost certainly be helpful for many
people in the event of an emergency, the approach they
represent is limited, particularly for individuals who are
at greatest risk in an emergency. Indeed, many of the suggestions are simply unrealistic for individuals on a fixed
income. In New York City, for example, the poverty
rate among older persons is over 20%. In the poorest
neighborhoods of the city, more than half of the older
residents are living within 125% of the federal poverty
limit (FPL) (Gusmano, Rodwin, & Cantor, 2007). Extra
cash, medicines, food and water are not luxuries that
older persons living within 125% of the FPL in New
York City are likely to set aside for an emergency that
may never occur.
Although efforts to provide information about emergency kits, go-bags and family disaster plans should
not be abandoned, it is crucial for national and local
governments to create systems that are capable of directing resources to individuals and neighborhoods that
are most likely to require assistance in the event of an
40
emergency. Many of these are the same individuals least
likely to have the resources necessary to take advantage
of the well-intended advice currently available on the
world wide web.
In this article, the challenge of emergency preparedness for older residents of cities is discussed with a focus
on cities because: 1) most older persons live in urban
areas and 2) there are reasons to believe that, ironically,
there is a great deal of social isolation among older
persons living in cities. Moreover, a number of recent
events, including the 2003 heat wave in Europe, remind
us that in an emergency, social isolation among older
people living in cities can contribute to tragic results.
After a review of the challenge of social isolation
among older persons in cities, our vulnerability index—a
tool designed to help public officials identify neighborhoods in which there is a concentration of vulnerable
older persons—is presented. This tool builds on lessons
from the literature, including our analysis of the Paris
heat wave, to select individual and neighborhood
characteristics associated with vulnerability. These characteristics are measured using publicly available data,
compiled into a single index, and mapped. An analysis
of data from New York City, including a sample map,
illustrates how the vulnerability index works. We argue
that governments should use tools of this sort, not only
to raise awareness of the problem of vulnerable older
persons in cities, but also to plan for emergencies by
deploying resources in neighborhoods with a concentration of vulnerable persons.
The Growing Importance of Urban Aging
Over the twentieth century, life expectancy in developed
countries increased by roughly 30 years. By the year
2020, the Census Bureau estimates that one fifth of the
U.S. population will be 65 years and over and about
5% will be 85 years and over. While these projections
are well known, the fact that the “longevity revolution”
(Butler, 1987) is taking place in the context of growing
urbanization has only recently received attention. United
Nations’ estimates indicate that 60% of the population
will live in cities in 2030 (UN, 2001). Although older
people are less likely than younger people to live in urban
areas, more than 75% of older Americans live in urban
areas (Kinsella & Velkoff, 2001). As population aging
and urbanization increase, cities will have to respond to
the needs of the most rapidly growing cohort of older
people—the old old, vulnerable persons 85 years of age
and over. In particular, cities must find ways to identify
and respond to the needs of isolated older people.
in the rural areas. These concerns limited mobility and
interaction and feelings of “connectedness” with the
neighborhood (Joël & Haas, 2006).
Cities and Social Isolation
Investigating Social Isolation:
The World Cities Project
Many studies in sociology and anthropology conclude
that urbanization does not lead to social isolation
(Durkheim, 1893; Mookherjee, 1998; Sokolovsky &
Cohen, 1981). However, social networks in urban areas
appear to be different in nature than those in rural areas
(Putnam, 2000), and it is clear that the extent and nature
of social networks vary within cities. In addition to the
individual characteristics that influence the scope and
nature of social networks among older people in cities
(Fischer, 1982), neighborhoods in which older people
live influence their social networks and the quality of
their lives. Studies of “productive aging,” for example,
highlight the importance of local institutions on decisions to engage in paid and unpaid labor (MorrowHowell, 2000).
Older people who live in neighborhoods with lower
crime rates, more parks, fewer vacant lots, and greater
recreational and social opportunities are more likely to
have social networks, more likely to exercise, and more
likely to have a positive outlook on life than those who
live in neighborhoods with high crime, little green space,
and few recreational and social opportunities (Kuo,
Sullivan, Coley, & Brunson, 1998). Fear of crime can
provide a strong deterrent to social interaction.
Features of city life can limit the mobility among older
people, discourage social interaction, and increase the
probability of isolation. As Phillipson argues, the idea
that cities threaten to “imprison” older residents has
been around for centuries.
The image of confinement is still present in the city,
notably with the fear of entering particular neighbourhoods, or the danger of moving around areas at
certain times of the day or night, or the threats posed
by natural disasters (Phillipson, 2004: 964).
In their study of aging in Paris, for example, Joël and
colleagues found that older persons in Paris were more
concerned, than those who live in rural areas in France,
about the lack of security in their neighborhoods.
Among persons 60 years and over, 15% of those living
in provincial cities and 22% in the Paris region were
concerned about security, compared with less than 5%
One reason for the increased focus among gerontologists on urban aging and its consequences for social isolation is that “cities are themselves undergoing radical
change, notably through the process of globalization”
(Phillipson, 2004: 964), which is thought to produce
greater isolation, particularly among those who do not
benefit from these economic forces.
Not surprisingly, the effects of globalization, both
positive and negative, on life in cities are seen most
acutely in world cities. The terms world cities and
global cities have been used interchangeably to mean
cities at the center of the global economy, or hubs in
the international world of transnational corporations,
financial services, and information exchange (Hall,
1984; Sassen, 1981). For thousands of years, cities have
been regarded, simultaneously, as “the natural center of
everything that mattered” and “the source of corruption and evil” (Zwingle, 2002). When examining the
characteristics of world cities and their implications for
older persons, it is easy to understand why. High levels
of congestion, pollution, crime rates, the high cost of
housing, as well as economic and social polarization
may undermine quality of life for older people. Yet
these cities offer greater access to public transportation,
pharmacies and stores, world-class medical centers,
museums, parks, concert halls, colleges and universities,
libraries, theaters and other venues for entertainment.
We do not know enough about the impact of this
environment on older people, yet there are reasons to
believe that the environment may pose serious challenges. World cities offer tremendous cultural and entertainment opportunities, but they are expensive places to
live. Only a small percentage of older persons have the
resources to take advantage of the opportunities that
world cities provide. In New York, for example, Tobier
estimates that only one of every 20 older households
have enough money to take full advantage of New
York’s unique opportunities for a higher quality of
life. With the growth of a large population working in
low pay service industries, the next generation of older
persons in these cities may have even greater need for
41
assistance due to the physical demands of these jobs.
The substantial costs associated with long-term care,
particularly assisted living, home care, and other alternatives to institutionalization, make them out of reach
for many of the oldest old.
To explore the consequences of growing older in such
an environment for emergency preparedness, we draw
on findings from our World Cities Project (WCP)4. The
WCP is a comprehensive study of health and aging in
four of the world’s most dynamic cities: New York, Paris,
London and Tokyo. The project pulls together data and
analysis that can help nations and municipalities meet
the needs of a citizenry that is older and vastly changed
from the traditional post-war model of the twentieth
century (Rodwin & Gusmano, 2006).
Though these four cities share similar demographic
trends, their means of providing services to elderly citizens and recognizing the impact of an aging population
differ considerably. The World Cities Project compares
health status and quality of life, informal support, social
networks, health and social services, and long-term care
within and among these cities. By comparing cities with
common key characteristics, useful lessons are able to
be identified for improving the health and quality of life
of older persons, including lessons about how to plan
for emergencies, in large cities around the world.
Aging in place in cities, “especially deprived inner city
areas, creates significant risks for older people and those
concerned with the delivery of services” (Phillipson,
2004). Given the expense of living in a world city, the
extraordinary inequality of wealth and cultural diversity
within them, there is reason to believe that these risks
may be more pronounced in these cities. As Warnes
(2006) puts it:
World cities are different from the generality of urban
settlements. . . . These distinctive attributes are bound
to be expressed in the activities and quality-of-life
of older people. There will be positive and negative
effects. Among the negative attributes may be an
exceptional level of dispersion and separation of
families, which in turn may generate above-average
levels of social isolation and anonymity.
Recent findings from the English Longitudinal Study
of Ageing (ELSA) appear to support these concerns, at
least with regard to Greater London. Based on their
analysis of ELSA, Barnes and colleagues found that
42
“older people who live in London are most likely to
suffer from neighbourhood exclusion.” It is not possible to examine neighborhoods within London using
the ELSA survey, but the study noted that the greater
degree of social exclusion among older persons in
Greater London compared with the rest of the United
Kingdom (UK) may be due to the fact that London has
the most deprived areas in the country (Barnes, Blom,
Cox, Lessof, & Walker, 2006).
Even in Tokyo, which has much lower rates of older
persons living alone than in the other three cities examined, there are growing concerns about the number of
isolated older people. In recent years, Japanese media
have reported a growth in the number of criminals who
prey on isolated older persons and attempt to swindle
them out of their life savings. As one report concluded,
“big cities are becoming hostile places in many ways for
elderly people living alone. . . . These con artists know
all too well that elderly people who live in isolation and
suffer from a weakening sense of judgment are easy
targets” (Japan Times, 2005).
Some have argued that New York, London, Paris and
Tokyo are the only cities that meet the definition of a
world city (Hall, 1966). Indeed, some question whether
Paris and Tokyo are world cities to the same degree as
New York and London (White, 1998). Without adopting a strict definition of the term, our study is based on
the premise that these four cities are useful laboratories
for exploring the issues raised by growing older in cities.
To begin, these cities share a similar scale and concentration of older residents. Second, there exist many studies
about them. Despite this, comparative information
about the well being of older persons in these cities is
limited, particularly the extent to which they are living
in isolation. In the sections below, we draw on our
analysis of social isolation in these four cities to develop
and present a tool that can be used by governments and
social service agencies for emergency planning.
Living Alone in World Cities
Living alone is not the same thing as being lonely or
isolated (Victor, Scambler, Bond, & Bowling, 2000).
One might argue that the rise of people living alone,
like the growth of population aging, is an extraordinary human achievement worthy of celebration.
Nevertheless, it is a risk factor for social isolation. In
1988, the Commonwealth Fund Commission on the
Elderly Living Alone indicated, based on a national
telephone survey, that one third of older Americans live
alone and one quarter of these persons, typically older
women, live in poverty and report poor health: “The
elderly person living alone is often a widowed woman
in her eighties who struggles alone to make ends meet
on a meager income. Being older, she is more likely to be
in fair or poor health. She is frequently either childless
or does not have a son or daughter nearby to provide
assistance when needed. Lacking social support, she is
a high risk for institutionalization and for losing her
independent life style” (Commonwealth Fund, 1988).
Rates of living alone among all age groups are
typically higher in urban areas, particularly dense urban
areas, which makes world cities a prime location for
the risks associated with such household arrangements.
Indeed, there are millions of people who live alone in
these world cities, and the oldest old living alone is the
fastest-growing segment of these populations.
When compared across the four cities, however, Tokyo
stands out. For example, Inner Tokyo has the lowest
rate of persons 85 years and older living alone (18%) in
comparison to London (54%), Manhattan (55%), and
Paris (59%). The contrast is striking when broken down
by gender. Yet, it is important to note that the rate of
living alone is more than twice as high in Tokyo as it is
in Japan as a whole (Kudo, 2006).
In addition to gender, data on characteristics of
older persons in New York and London indicate that
ethnicity and race are important factors in distinguishing among older persons who live alone. In New York,
rates of living alone are significantly lower among
Hispanics and Asians aged 65 and older, and slightly
lower among African Americans in this cohort than
among Caucasians. Likewise, in Greater London, rates
of living alone are higher among the white population
than among black Caribbean, Indian, and Bangladeshi
populations.
There are also important differences between the
characteristics of older persons living alone in world
cities and those who are institutionalized. In Manhattan
and Paris, the two cities for which data are available,
men and women over 65 who live alone have higher
levels of educational attainment than those who live in
institutions. Although the sample of persons over 85 is
small, this pattern holds for Manhattanites.
Our finding with regard to educational attainment of
older persons who live alone suggests that the rise of
older people living alone, like the growth of population
aging, is an achievement. The challenge is to distinguish,
among older persons who live alone, (and not exclude
those who do not), how many are vulnerable due to
social isolation, poverty, disabilities, lack of access to
primary care, linguistic isolation, or inadequate housing, e.g., living in walk-up apartments without elevators.
The consequences of failing to do so are illustrated by
recent events in these cities.
Lessons from Tragedy: The Paris Heat
Wave of 2003 and Social Isolation
It takes a catastrophe to mobilize public attention on
the health risks of vulnerable older people. In the UK,
for example, Age Concern has helped to push the issue
of social isolation among older people onto the policy
agenda by arguing that loneliness and isolation among
older people contribute to the large number of annual
winter deaths due to hypothermia (Peterborough Evening
Telegraph, 2006). In New York City, the International
Longevity Center-USA emphasized the issue of isolation
of older people in the wake of the September 11th terrorist attacks, finding that “within 24 hours following
the 9/11 terrorist attacks, animal advocates were on the
scene rescuing pets, yet abandoned older and disabled
people waited for up to seven days for an ad hoc medical
team to rescue them,” and concluded that “currently,
there is no effective way to identify vulnerable people
who are not connected to a community service agency”
(O’Brien, 2003).
The 2003 heat wave in France provides a window
on the extent of social isolation in Paris and its consequences (Cadot, Rodwin, & Spira, 2007). This heat
wave, which occurred between August 1st and 20th,
had devastating effects on older people, particularly in
Paris where sustained and precipitous elevations in temperature reached an average of 38°C (100°F). In France,
excess mortality—the number of deaths recorded above
the preceding three-year average—reached 14,802,
an increase of 60%. In Paris, there were 1,254 excess
deaths, an increase of 190%. In contrast to the rest
of France where 65% of excess mortality were of
institutionalized older people, in Paris 74% of excess
deaths occurred among those who lived at home. It is
difficult to determine the characteristics of the deceased
because their death certificates do not provide individual
43
characteristics such as their income, occupation, level
of education, and living arrangements. Moreover, for
those who arrived at emergency rooms in ambulances,
there is no record of their previous residence.
Paris has the highest share of people 85 years and
over among the four world cities and, as in Manhattan
and Inner London, in Paris rates of living alone among
women exceed 60%. But age and gender density are not
sufficient to explain the concentration of excess deaths
in Paris, nor are temperature levels in Paris compared
to the rest of France. Does Paris have a higher density
of vulnerable, socially isolated older people than in
France? Do the excess death rates reflect such individual
characteristics of Parisians or are they related to the
character of the health care system and the neighborhoods in which they lived? The Paris health system
seems an implausible suspect, particularly in light of its
high performance along many dimensions (Gusmano,
Rodwin, & Weisz, 2006). Since this catastrophe took
the French medical profession and public health establishment by surprise, it is important to review at least
partial answers to these questions.
The principal epidemiological study on individual
factors associated with excess deaths reveals that
Parisians 75 years and over were at highest risk of death
(Canouï-Poitrine, Cadot, & Spira, 2006). Higher risk
was also associated with older people who were unmarried (and more frequently live alone) than with those
who were in couples, and with women (but not men)
who were foreign nationals. This later association may
reflect differences in family structure and social support.
For example, foreign-nationals, particularly those from
Africa and Asia—in contrast to French women—live,
more often, in multi-generational families with stronger
mutual support and social networks; hence, there is a
lower risk of social isolation. Finally, excess mortality
was higher among women than men, after adjusting for
age. This probably reflects a pattern of greater attention
devoted to the most vulnerable institutionalized population. Paradoxical as this may seem, older women who
lived alone more often than men, and who were generally in better health, were also at higher risk of death.
An unpublished study (Paris Public Health Agency)
analyzed the characteristics of the deceased who were
receiving a personal autonomy allowance based on their
disability levels. Among these community-dwelling
beneficiaries, the risk of heat-related mortality was
44
twice as high for those living alone than for those living as a couple. Among community-dwelling as well as
institutionalized beneficiaries, those with lower levels of
disability had a four-fold lower risk of mortality. But
community-dwelling beneficiaries—despite their lower
levels of disability and the home-care services that they
received—appeared more vulnerable, perhaps because
nursing home residents benefited from a medicalized environment where assistance was more rapidly
mobilized.
The spatial distribution of mortality across Paris
arrondissements (municipal administrative districts, or
neighborhoods) typically reveals higher rates, adjusted
for age and gender, in the northeastern parts of the city.
However, during the heat wave, these rates were highest in southeastern Paris, indicating a shift in mortality
from poorer to more well-to-do neighborhoods, in
comparison to the three years preceding the heat wave.
This finding is confirmed by the concentration of the
highest rate of excess mortality in the south of Paris.
Minimal temperature levels were positively correlated
with mortality rates but not with excess mortality rates.
Likewise, higher average household incomes were associated with a lower risk of mortality, but there was no
association with excess mortality rates.
Key risk factors during the heat wave included being
a woman 75 years and over, and living alone at home.
Excess mortality rates were highest among dependent
older people with lower levels of disability. This was the
group least well cared for by nurses, social workers or
home helpers. We should therefore be concerned about
such individuals in the event of another heat wave where
a lapse of attention, even for a few hours, can lead to
acute dehydration and hyperthermia.
Perhaps the most important lesson of the Paris heat
wave is to reinforce the notion that disaster preparedness and promotion of urban health must focus not
only on individual, but also on neighborhood risk
factors. As Klinenberg demonstrates in his study of
the 1995 Chicago heat wave, social isolation and
lack of neighborhood cohesion were powerful factors
explaining disparities in excess mortality among equally
poor neighborhoods (Klinenberg, 2002). Indeed such
neighborhood characteristics may explain the disparities in excess deaths among southern and northwestern
arrondissements of Paris. One might speculate that in
the southern arrondissements, families can more easily
MAP 1. Vulnerability Index for Population 75 and Over, New York City Census Tracts
N
Vulnerability Index (75+)
1.0 - 3.0
Parks
3.1 - 4.6
Cemetaries
4.7 - 5.8
Airports
5.9 - 6.9
0
2
4
6
8 Miles
7.0 - 9.4
SOURCE: U.S Census 2000, NYC Department of Finance, NYSPARCS
45
afford vacations while in the northeast, such options are
more limited, and there are probably stronger family
ties, more social interaction and neighborhood cohesion
among foreign nationals than among the French.
The relative importance of such neighborhood
characteristics in relation to individual risk factors for
excess mortality in heat waves or other disasters must
be investigated. Findings on these characteristics can be
used to identify neighborhoods with a concentration of
vulnerable older persons and to design interventions that
improve housing conditions and promote neighborhood
cohesion and social interaction.
Using Existing Data to Identify
Vulnerable Older Persons
The 2003 August heat wave in France served as a dramatic example of how a city with a high concentration
of older persons can be unprepared to cope with its aging
population. In Paris, the result was thousands of deaths.
Throughout the world, major cities are unprepared to
cope with their aging populations.
Fortunately, there is a new awareness about the vulnerability of the oldest old and recognition that municipal
governments have a responsibility to identify and reach
out to the vulnerable oldest old who live in isolation.
The challenge for these cities is to find methods for identifying and tracking vulnerable older persons without
violating their civil liberties.
In their report on social isolation among seniors (65+)
in New York City, the United Neighborhood Houses
(UNH) of New York identified several risk factors that
are more pronounced in New York City than they are
nationwide: living alone, disability, poverty, linguistic
isolation, never having married, and being divorced,
separated or widowed (United Neighborhood Houses
of New York, 2005). Based on unpublished work of
the New York City Department of Health and Mental
Hygiene, this report also identifies 12 Community
Districts (out of 59) in New York City that are “likely
the most at risk for senior isolation based on the amount
of seniors living alone and the level of need among the
elderly residents” (United Neighborhood Houses of
New York, 2005).
Building on this work, and the lessons from the tragedies described above, we developed a “vulnerability
index” for each of the 2,217 census tracts of New York
City. The index is based on indicators for which data
46
could be obtained at the census tract level. These include
several measures of population characteristics, including: the number of people age 75 years and over; the
percentage of people (75+) living below poverty level;
the percentage of people (75+) living alone; the percentage of people (75+) reporting at least one disability; and
the percentage of people (75+) who are linguistically
isolated. We also examine the rate of avoidable hospitalizations as an indicator of access to primary care and
two measures of the quality of the built environment:
the number of vacant lots in the census tract and the
number of buildings classified as walk-ups (two or more
floors without an elevator).
For each of the variables above, census tracts were
ranked by deciles. Then the mean decile ranking for each
census tract was calculated to produce a vulnerability
score from 1 to 10. Map 1 presents the distribution of
vulnerability in New York City, among those age 75+
(grouped in quintiles for presentation purposes).
Not surprisingly, the poorest census tracts in New
York City are among the most vulnerable according
to this index. Nonetheless, it is important to note
several exceptions to this general pattern. A number of
above median income neighborhoods have very high
vulnerability scores. For example, census tract 110 in
Manhattan—located between 59th and 65th streets on the
east side—has a vulnerability score of 5.6, but only 2%
of its residents age 75 years and over are living below
the poverty line. It has a higher than average vulnerability score, however, because more than half (53%) of
its 474 residents age 75 years and over live alone.
This highlights both the value and the limit of our
definition of vulnerability. On the one hand, older
residents of census tract 110 in Manhattan are, in many
respects, doing quite well. Few of the 75+ residents of
this neighborhood report being in poverty or having a
disability, and based on the neighborhood avoidable
hospital condition (AHC) rate, residents appear to
enjoy good access to medical care services. On the other
hand, a neighborhood with such a large number of
older residents who live alone may deserve special attention during an emergency. Alone, our census tract-level
vulnerability index cannot determine which neighborhoods require special attention during an emergency.
For example, census tract 52.01 in Brooklyn has a
vulnerability measure of 7, which is quite high. A large
number of neighborhood residents are 75 years or over,
most live alone, and a large percentage are in poverty.
Despite these indicators of vulnerability, as we discuss
in the section that follows, many of the residents of this
neighborhood live in Shore Hills Housing, a Section 202
senior housing facility operated by Lutheran Medical
Center. As a result, the residents of this facility, and to a
lesser extent, the residents of the entire neighborhood,
already enjoy a great deal of support.
Despite its limitations, we believe the vulnerability
index is a useful tool if used in conjunction with other
indicators to start a conversation among policy makers,
community groups, and non-profit organizations that
serve older persons. While our vulnerability index is
insufficient to make decisions about which neighborhoods require special attention, it can help policy
makers and emergency response teams to target their
planning efforts.
Concluding Thoughts
The unprecedented convergence of population aging
and urbanization presents great challenges and opportunities for cities and their older residents. Our project
explores how the four largest cities in the wealthiest
nations of the world—New York, London, Paris and
Tokyo—are confronting these changes. In the wake of the
September 11th terrorist attacks and the canicule (heat
wave) of 2003, the need to address the needs of vulnerable older persons living in cities is apparent. Isolated
older persons are an invisible population that does not
receive attention from policy makers, the media or the
general public. Greater appreciation of the needs of
this vulnerable population is probably the only positive
outcome from these catastrophic events.
Although policy makers are starting to take note of
this issue, there is still a dearth of systematic evidence
about the needs of older persons living in cities and the
degree to which these needs are being met by public programs. For example, the last large scale survey of older
New Yorkers was conducted in 1990, and even this
substantial effort was insufficient to provide an assessment of need at the neighborhood level. We believe that
a useful strategy would be to make maximum use of
existing, publicly available information to target areas
of concern and then to employ more limited surveys to
evaluate the health and quality of life of older people in
neighborhoods, where there appears to be a large gap
between needs and service use.
Beyond the need to gather better information about
the needs of older persons in cities, it is important to
distribute such information to health and social service
agencies to help them manage and target their resources
more effectively. Disseminating such information could
also help agencies develop a population-based approach
to case management. Instead of the traditional reactive approach of the existing aging services network,
which consists of coming to the rescue and assisting
their clients to obtain services for which their agencies
are hired, population-based case management seeks
to identify and assist clients who have not entered
the system and to refer clients to appropriate services.
This would require training social workers and other
case managers to conduct community assessments and
develop outreach strategies for finding, and subsequently
assisting, vulnerable older persons. The indicators (e.g.,
community assessments and asset mapping) can be used
to understand neighborhood specificities and design
interventions that improve access to aging and health
services for vulnerable older persons.
To promote this approach, governments should produce manuals, available online, to allow social workers
and other case managers to assess the socio-demographic
characteristics, health indicators, and community assets
of their clients’ neighborhoods and to identify services,
beyond the aging services network, for which their
clients are eligible. In addition, these manuals should
include information on websites where one may obtain
neighborhood level socio-demographic data, health
data, as well as data from the city planning department on characteristics of the built environment. These
websites would allow social workers to compare the
neighborhoods in which they work to others in the city
and, when necessary, to make a stronger case for obtaining additional resources for deprived neighborhoods.
By incorporating spatial analysis, based on geographic
information systems and maps, to identify neighborhoods with concentrations of vulnerable older persons,
governments could help to raise awareness of the
problem of vulnerable older persons in cities. Sharing
these data with agencies in the field may help aging
service professionals to solve immediate problems and
allow them to develop population-based approaches
for outreach (Vladeck, 2004). The result would be to
identify vulnerable older persons and enable them to
receive assistance both within and beyond the aging
47
services network. This type of analysis would also allow
governments to plan more effectively for emergencies by
directing resources to neighborhoods in which there is a
concentration of vulnerable people.
Michael K. Gusmano
Research Scholar, The Hastings Center
Co-Director, World Cities Project,
International Longevity Center-USA
[email protected]
Victor G. Rodwin
Professor of Health Policy and Management,
Wagner School of Public Service,
New York University
Co-Director, World Cities Project,
International Longevity Center-USA
[email protected]
48
notes
1 See www.hc-sc.gc.ca/seniors-aines/pubs/age_friendly/index.htm
2 See www.bt.cdc.gov/preparedness
3 See www.nyc.gov/html/oem/html/get_prepared/supplies.shtml#go_bag
4 See www.ilcusa.org/pages/projects/world-cities-project.php
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ifa board of directors
Officers
Directors
President
Australia
Korea
Argentina
Irene Hoskins
David Deans
Myong Juch
Ramón M. Gutmann
United States
Consultant, International
Affairs and Aging
International
Vice President
Gordon Lishman
United Kingdom
Regional
Vice President, Europe
Bjarne Hastrup
Denmark
DaneAge Association
Regional
Vice President, Oceania
Robert Reid
Australia
Strategic and Crisis
Management Consultant
Regional
Vice President, Asia
K. R. Gangadharan
India
Heritage Hospital
Past President
Yitzhak Brick
Israel
JDC-ESHEL
Association for the Planning and
Development of Services for the
Aged in Israel
Treasurer
Alan How
United Kingdom
Australian Seniors Finance Ltd.
Kaye Fallick
Honourary Directors
Korean Association
of Retired Persons
Canada
Blossom Wigdor
About Seniors website
YOURLifeChoices magazine
Mauritius
Belgium
Ministry of
Social Security,
National Solidarity & Senior
Citizens Welfare
The Honourable
Y. F. Hui
Netherlands
Sharad D. Gokhale
Elizabeth Mestheneos
AGE – The European Older
People’s Platform
Canada
Robert Chagnon
Quebec Association
of Gerontology
Pat Spadafora
Sheridan Elder
Research Centre
China
Chen Chuanshu
China National Committee on
Ageing
Czech Republic
Jan Lorman
Zivot-90
Hong Kong SAR
Christine Fang
Hong Kong Council
of Social Service
Israel
Ariela Lowenstein
University of Haifa
Japan
Hisashi Hozumi
Medical Corporation
Junkei-kai
R. C. Gopee
Marja Pijl
ANBO–Dutch Union
of Older People
Pakistan
Grace Clark
Pakistan National Centre on
Ageing
Singapore
Mary Ann Tsao
Tsao Foundation
United States
Helen R. Hamlin
IFA Main Representative at the
United Nations
Wales
Ruth Marks
Older People’s Commissioner for
Wales
Hong Kong SAR
India
Netherlands
Denys Correll
United Kingdom
Baroness Sally Greengross
United States
James T. Sykes
IFA 11TH GLOBAL CONFERENCE ON AGEING
28 May – 1 June 2012 | Prague, Czech Republic | www.ifa2012.com
Ageing Connects is an urgent call for repositioning, bridging and connecting issues and action to improve the lives of older
people globally.
In celebration of the 10th Anniversary of the Madrid International Plan of Action on Ageing (MIPAA) and the European Year
of Active Ageing the IFA and Život 90 are proud to focus attention on the MIPAA priorities and objectives as a basis for our
conference.
Be part of this historical event by registering your interest at www.ifa2012.com and submitting an abstract for the conference
program in early 2011.
�emes and Sub-themes
1. Older Persons and Development
1a. Work and the ageing labour force
1b. Access to knowledge, education and training
1c. Income security, social protection/social security
and poverty prevention
2.
2a.
2b.
2c.
Advancing Health and Well-being into Old Age
Health promotion and well-being throughout life
Universal and equal access to health-care services
Mental health needs of older persons
3.
3a.
3b.
3c.
Ensuring Enabling and Supportive Environments
Housing and the living environment
Care and support for caregivers
Neglect, abuse and violence
4. Connected Technologies
4a. Connecting services and providers – e-health, telehealth,
telepresence and ﬂips
4b. Engaging generations – tweets, blogs, social networks
and the digital divide
4c. Enabling older people – assistive technology, devices
and products
Call for Abstracts
In early 2011 the call for abstracts will be announced and include for the ﬁrst time short videos
and photographs as well as paper presentations, symposia and workshops.
Conference Hub
GUARANT International spol. s.r.o.
Opletalova 22, 110 00 Prague, Czech Republic
Tel: +420 284 001 444, Fax: +420 284 001 448
E-mail: [email protected]

Link - International Federation on Ageing

Transcription

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