Planning for an Ageing Society

By Rose Gilroy

It is well known that we are living in a time of demographic shift to an ageing society, yet our responses to this shift are still uneven and often spring from dated assumptions and images of older people. The significance of place in all our lives, but particularly in the lives of older people, puts responsibility on planners and other place-makers to challenge ideas about later life by developing practices of involvement that put older people's voices at the core of planning responses. This book introduces planners to dominant ideas about ageing and how these have influenced the responses of placemakers, considering how the demographic shift may be a catalyst for new thinking in place-making. It is not so much about planning for old people, but about how an ageing population changes all aspects of our lives. The book introduces useful concepts such as the 20-minute neighbourhood and the everyday-life framework, explains the age-friendly movement, and questions to what extent it helps cities respond to change. Comparing international case studies, it explores the critical role of housing and the possible use of land allocation to encourage developers to think about better and more housing.

• Language: English
• Publisher: Lund Humphries
• Release date: Aug 2, 2021
• ISBN: 9781848223639

Book preview

Chapter 1

Living in an Ageing Society

This book is about you and about me.

Demographic trends suggest that most of us will grow old. However, that later life will be highly diverse as, with all life stages, it is mediated by class, wealth, social capital, marital status, household composition, care roles, gender, ethnicity, sexuality, and disability.

Despite the clear demographic picture, there is no national strategy on ageing for the UK or for any of the devolved administrations. While ageing is often cited as a grand societal challenge and figures in the UK’s industrial strategy, it is not ageing, the lifelong process, but old age that is the political concern (Walker, 2018). A focus on ageing would lead to a strategy that discussed maternal health, the importance of good nutrition throughout life, as well as investment in education from nursery through to lifelong learning and ability to retrain as employment opportunities or personal circumstances alter, would ensure that everyone had lifelong access to decent housing, an income that allowed people to live with dignity, and opportunities for community involvement and new activities, as well as end-of-life care and a discussion of euthanasia.

If the emphasis is the life-course, then do planners need to think specifically about later life? Ageing is not a disease to be cured, nor is the ageing population a problem to be solved. However, age is a factor that changes how people relate to the world around them. The extent to which our environments continue to offer opportunities for living a good quality of life as our needs change is critical to our wellbeing and sense of self. This book argues for creating places that might support people to grow into old age, to care for themselves as well as for their relatives, friends, and neighbours. In a time of demographic change there is a need to develop policies and practices that enable us to adapt to this societal challenge. How can our housing, transport, public realm, and social infrastructure respond?

Given the evidence to support the impact of the environment on later lives, there is no overarching planning strategy. The current National Planning Policy Framework promotes living in healthy communities that demonstrate thoughtful design principles, with sustainable transport options and shopping and social opportunities that work for everyone. Mentions of older people, however, are few and confined to the section on the supply of housing (Ministry of Housing, Communities and Local Government, 2019a). Within the Planning Practice Guidance (PPG), there is more thoughtful discussion, but the focus is narrow.

In striving to make a place more age friendly it remains the case that there is only one city, one town, one village. Every place needs to respond to the child, the young person, families, and older people.

Ageing of the UK regions and the implications

While the UK’s population is ageing in line with most nations in the world, the picture across the regions is very varied. At the extremes are London and the South West of England.

Nine of the ten UK areas with the lowest proportion of those over 65 are London boroughs. Similarly, London also has eight of the nine areas with the lowest proportion of those over 85. Less than one per cent of Tower Hamlets’ residents are 85 or older. Alone among the English regions, London is a place of younger working age adults (Office of National Statistics, 2020a).

The South West has five of the ten areas with the highest number of people aged 65(+). Cornwall is one of the most isolated parts of the UK but one in four people are over 65. This has been sharpened by the out migration of younger people in search of economic opportunities but also the in migration of retirees changing the pace by changing the place of their later life. One in three people in West Somerset are 65 or older and by 2036 this sub area will have the highest population of 85(+). Currently, Christchurch in Dorset – which is a notable retirement destination – has the highest concentration of 65(+) at 36.6 per cent.

London, with its excellent web of train and bus services, offers a very high level of connectivity to its citizens, as well as an exceptional cultural offer. Conversely, rural places suffer from sparse services and poor public transport. Residents in the remote Lizard peninsula face a 30-mile journey to the Royal Cornwall Hospital. Public Health England reports that 55 per cent of rural households compared to 97 per cent of urban households are within eight kilometres of a hospital. While 98 per cent of urban dwellers live within four kilometres of an NHS dentist, this is true for only 57 per cent of rural households (Public Health England and Local Government Association, 2017). This means that older people tend to present to health services at crisis points and may bear down heavily on local authority or third sector resources.

In England and Wales, cities have lower percentages of older people, while small towns, rural and coastal areas have greater proportions. Very typically, in the West Midlands in 2019, Birmingham’s population of 65(+) was 13 per cent and is predicted to rise to 19 per cent by 2036. Around Birmingham, the demographics are very different with those 65(+) making up 20 per cent of the populations of the suburbs and districts of Bromsgrove, Solihull, Dudley, and North Warwickshire. In more rural districts such as the Malvern Hills, the region is under pressure from incoming retirees: 28 per cent are 65 (+), predicted to rise to over one in three, by 2036.

Many scenic places are home to high numbers of older people. In mid-2018, the median age of the population in the national parks ranged from just under 50 in the South Downs to more than 57 in Exmoor, contrasting with a median age in England and Wales of 40 years. For all the national park authorities it is not simply the percentage of older people, but the low density of population that struggles to support an adequate level of everyday amenities or public transport. Northumberland National Park has two people per square kilometre. Sparsely populated places and those thinned out by second homeowners and holiday cottages have a detrimental impact on rural social networks that can lead to a risk of increasing social isolation and loneliness. For older people, the combination of bus subsidy withdrawal, disproportionate closure of local shops and services, and greater provider reliance on web-based information may be particularly damaging (Public Health England and Local Government Association, 2017).

Beyond the national parks, many coastal communities with higher ageing populations are struggling to find a new identity. The North West continues to struggle economically and in 2016, research showed that ten of the UK’s 12 towns and cities in greatest economic decline were in the North, despite the government’s Northern Powerhouse initiative (Pike, MacKinnon, Coombes, et al., 2016). Deprivation is reflected in lower life expectancy. Blackpool unitary authority is ranked as the most deprived lower-tier local authority in England on the Index of Multiple Deprivation rank of average rank measure, plus seven other measures, including income, health, local concentration, and the percentage of people who are without work. It has the most deprived NHS clinical commissioning group, ranked on health deprivation and disability, reflected in low healthy life expectancy. From 2009 to 2013, males born in Bloomfield in Blackpool had a healthy life expectancy of only 47.1 years, a shocking 32 fewer years than those born in wealthy Knightsbridge and Belgravia (Office of National Statistics, 2019).

Currently, the areas of Scotland with the highest populations of over 65s (roughly one in four people) are the rural areas of Argyll & Bute, Dumfries & Galloway, South Ayrshire, and the Scottish Borders. The greatest difference in life expectancy is driven by deprivation which accounts for a gap of 13 years for men and 9.8 for women. In healthy life expectancy the impact is even greater, accounting for 23 years among men and 23.9 years among women. In the cities of Dundee, Edinburgh, and Glasgow there are gaps of 12 years in life expectancy from least deprived to most deprived areas (National Records of Scotland, 2019). Inequality accelerates ageing. The poor die sooner and are more likely to spend a greater proportion of their life with limiting disability or illness. Environmentally, residents of disadvantaged places may suffer from the worst aspects of urban life: air pollution, higher crime levels, and ‘toxic high streets’ with fast food outlets, off licences and betting shops (Townshend, 2017).

In Wales, more than one in four residents of Powys, Conwy, and Anglesey are 65 or over and by 2036 only four authorities (Cardiff, Newport, Swansea, and Rhondda Cynon Taf) will have less. By that time, 38 per cent of the residents of Powys will be over 65 and 8.7 per cent will be over 85. The Welsh cities of Cardiff and Swansea will increase their share of older people but will have some of the lowest numbers in the country. Again, it is the cities that provide the best transport offer and concentration of amenities. Many areas in Mid- and North Wales have poor access to services, seaside towns need investment, many former mining settlements have lost their retail offer, and property values have fallen to practically nothing. In these areas older people find themselves facing multiple disadvantages and potentially few options for making change.

Reversing population trends

Life expectancy has been rising in the UK since 1840 and it has become a mantra to say that life expectancy is increasing at five hours per day. There have always been inequalities in health and life expectancy, but the trajectory was improving. The 2010 report from Sir Michael Marmot set out six priority areas for addressing these inequalities, of which the fifth, ‘creating and developing sustainable places and communities’, lays a clear responsibility on place makers and housing providers to play their role in facilitating better health (Marmot, Allen, Goldblatt, et al., 2010).

Ten years on, the 2020 Marmot review clearly demonstrates that health inequalities are increasing and there is a decrease in life expectancy, particularly apparent, for women in areas of greater deprivation. In short, Britain can no longer take longevity for granted but needs to consider carefully how all policies and practices, including those about the built environment, can be invigorated to increase their contribution to promoting healthy lives (Marmot, 2020).

Talking about later life

Quality of life in later life is determined by an accumulation of positive and negative effects on health and wellbeing throughout life. Discrimination also shapes the quality of our ageing experience. It remains the case that despite the (still) normative expectation of living to our ninth decade or beyond, we live in ageist societies that damage the expectations of older people by perpetuating negative stereotypes and prescribing solutions that stem from these. In planning, the response to older lives is often confined to age-targeted housing such as the patronisingly termed ‘sheltered housing’.

It is not the intention of this book to lecture. However, it is important