Tag Archives: Featured

Hong Kong plans for a city that’s growing older

Today, about 16 percent of Hong Kong’s population is age 65 or older. By 2064, that is expected to be 36 percent.
HONG KONG — For decades, this city of more than 7 million has been one of Asia’s most dynamic places, filled with a youthful energy that drove rapid growth in both the population and the local economy.

Planners here still see Hong Kong that way. But they also are looking at the long-term trends, and grappling with a force they cannot stop: Hong Kong is getting older. That’s true of both the city’s people and its built environment — a phenomenon planners here call “double ageing”.

Today, about 16 percent of Hong Kong’s population is age 65 and over. By 2064, that’s expected to be 36 percent — and one in ten residents will be over the age of 85.

Meanwhile, housing stock that appears middle-aged today will become outdated tomorrow. By 2047, some 326,000 private housing units will be more than 70 years old. Many of them feature long flights of stairs unfriendly to older people. More than a third of seniors live in public housing, but the two-year wait list is bound to grow longer as citizens age.

The double-ageing problem is just one issue that Hong Kong’s planners are trying to figure out as they write a comprehensive plan called Hong Kong 2030+. The plan aims to take future demographic and economic trends into account while charting a path for improving quality of life in one of the world’s most densely settled cities.

Phyllis Li Chi Miu, deputy director of the city’s territorial planning department, says buildings, roads, parks and public transport all will need rejuvenation to make the city age-friendly. “It’s a challenging task,” she says.

Alignment with New Urban Agenda

Planners are also looking at how they can align the 2030+ plan with the New Urban Agenda. That’s the 20-year plan for sustainable urbanization that nations agreed to last October at the U. N.’s Habitat III conference in Quito, Ecuador.

Alignment was the main topic of conversation at a recent “Urban Thinkers Campus” conference here. At the event, Li noted that the 2030+ plan already stresses key elements of the New Urban Agenda such as social inclusion and environmental protection.

However, there was some debate about the New Urban Agenda’s relevance in the context of a city-state like Hong Kong. Paul Zimmerman, an environmentalist and elected councilor, said that some notable issues mentioned in the New Urban Agenda, such as increasing numbers of cars on the road, growth of slums and poor utility services, are not problems in Hong Kong.

“Hong Kong is a city and also a country,” Zimmerman said. “It’s a city in which hyper-density and wilderness co-exist. Other mega-cities have no space in their periphery, while Hong Kong has a massive open space in its periphery.”

However, Professor NG Mee Kam of the urban studies programme at the Chinese University of Hong Kong, told Citiscope that the 2030+ plan “needs to strongly align with the New Urban Agenda to plug in crucial policy gaps.” For example, she said, Hong Kong’s plan could take a cue from the New Urban Agenda’s focus on the informal sector and the importance of cultural heritage.

Retrofitting and reclaiming

The 2030+ plan proposes three “building blocks” for implementation — planning for a liveable high-density city, embracing new economic challenges, and creating capacity for sustainable growth.

A major focus, particularly when it comes to dealing with the double-ageing problem, is retrofitting districts with the most old buildings. Tall buildings are likely to be renovated, while many smaller buildings will likely be demolished to make way for new construction and open space. Retrofitting public spaces is also a priority. The city intends to add curb-cuts at sidewalks to make it easier for seniors to walk, and aims to increase the amount of public space from 2 square metres per person to 3.5 square metres.

The plan also aims for compact urban growth that is highly integrated with public transport. Homes and offices are to be within 200 to 300 metres of transit; open spaces within 400 metres; and community facilities, railway stations and educational institutes within a range of 500 metres.

“We are looking at optimum land use through retrofitting,” Li said.

The plan also envisions reclaiming a good bit of land from the sea. That’s a strategy that Hong Kong has long relied on to create room for the city to grow — the city’s airport and Hong Kong Disneyland resort are both located on reclaimed land.

Under the 2030+ Plan, Hong Kong would add another 4,800 hectares (nearly 12,000 acres) of land — a little less than the area of Manhattan. The land would be used for housing, industry, transport facilities and open space. These would include a few large urban extensions such as the East Lantau Metropolis, which is to be home to as many as 700,000 people.

Work on the 2030+ plan started in 2015 and is in the fourth of six phases of public consultation. The final plan is expected to be released next year.

What can a simple fruit fly teach us about ageing?

A recent study could lead to interventions that extend human lifespan and improve health in our later years. Based on new evidence regarding a DNA-based theory of ageing, this field aims to attenuate diseases of ageing such as cancer, hypertension and Alzheimer’s disease.

Ageing research dates back many years, but thanks to scientists at the Buck Institute for Research on Aging the field has become more widely recognised. Researchers at Buck coined the term ‘geroscience’ to explain the relationship between ageing and age-related diseases. The notion that people are more susceptible to diseases as they grow older rings true to most of us, although some older adults lead healthy and active lives without medical intervention.

“Every day, 10,000 Americans turn 65, and every day, more and more of them are just as fit as me” – so says Linda Marsa, contributing editor at Discover magazine. Richard Johnson, an economist, says “Today’s seniors are healthier, better educated, and more productive than ever.” Despite these positive trends, many would argue that the goal of geroscience – to explain and intervene in age-related diseases including arthritis – remains highly relevant to today’s societies.

Since life extension studies remain inconclusive, scientists are working to improve ‘healthspan’ – the length of time a person is healthy, especially in the later years. Brown University Professor Dr. Stephen L. Helfand is one of several researchers whose work is advancing the rapidly maturing field of ageing science. He is also senior author of the study mentioned above.

This study showed that many transposable elements (TEs) become activated with age in the fruit fly Drosophila* and that this activation is prevented by dietary restriction – an intervention known to extend lifespan. TEs are sequences of DNA (our genetic material) that move (or jump) from one location in the genome to another. Drosophila is a small fruit fly used extensively in genetic research. Why do scientists use fruit flies? Because fruit flies share 75 percent of the genes that cause disease with humans including having a smaller, fully-sequenced genome for easier genetic manipulations. Ultimately, the study provides evidence that preventing TE activation by dietary restriction may be a useful tool in ameliorating aging-associated diseases. The hope is that such results could be applied to humans as research progresses.

“Our demonstration that dietary [restriction], genetic and pharmacological interventions that reduce the age-related increases in [transposon] activity can also extend lifespan suggests new and novel pathways for the development of interventions designed to extend healthy lifespan.” according to this study. Despite the possibility of a true causal relationship, scientists can (happily!) avoid misleading phrases such as the Fountain of Youth, since geroscience hopes to improve health and longevity – not provide some mythical youth potion. Older people are a rapidly growing demographic – by 2100, the number of people aged 60 and over will reach 3.2 billion. It is, therefore, vital that researchers use terms that do not marginalize an increasingly growing demographic –  or maintain the current narrative of our youth-obsessed culture.

We have seen major breakthroughs in public health and medical research, including a generational leap in longevity, the use of antibiotics, the completion of the Human Genome Project, and more. Society has also reaped the benefits of new medical technologies and advances in nutrition such as sustainable diets, virtual reality, and food scanners. As the field of geroscience continues to evolve, both public and private sectors may increase investments for ageing research, especially if it can reveal treatments for conditions that afflict older people. More data is also needed to understand and support research findings including the current study by Dr. Helfand. This paper comes as scientists from three universities including, Brown University, New York University and the University of Rochester forge a new partnership in DNA-related research. The collaboration is supported by a five-year, $9.67-million grant from the National Institutes of Health. Hence, study outcomes could have a lasting effect on health and society. David Sinclair, a researcher of ageing at Harvard Medical School, has put this attitude into words: “The goal of this research is not to keep people in the nursing home for longer. It’s to keep them out of nursing homes for longer.”

Sophie Okolo is a public health researcher and science writer. After getting degrees in bioinformatics and public health, Sophie started Global Health Aging, a publication that explores the implications of longer, healthier lives. Find Sophie on Twitter and her website.

Population Aging and Urbanization in Europe

Cities are seeing a rise in ageing populations. In the European Union (EU), 75 percent of residents live in urban areas. As urban populations continue to rise, more and more people will grow into old age. For instance, the over age 65 group makes up 20-27 percent of the population in cities inside Portugal, Italy, and Spain. Since population aging will influence health, social exchanges, and well-being of older adults, hundreds of cities are designing urban environments to foster active and healthy aging.


Urbanization affects many areas including the health and well-being of society. As a result, many sectors are collaborating to keep populations engaged and healthy. Adapting cities to demographic trends accommodates residents, allowing for independent living and participation in society. The European Commission estimates that over 75 percent of housing in the EU is not suitable for independent living. Other aspects of physical environments including adequate sidewalks, transportation, and functional green spaces can increase physical activity and improve mobility, which reduces the risk and effects of chronic disease. Social issues, such as employment discrimination, negative stereotypes, and ageism, also play a role in the health of aging populations. It is important to involve older adults’ perspectives on urban planning to identify issues and barriers which prevent participation in society.

To help cities adjust to demographic trends and support healthy ageing, the World Health Organization (WHO) created a Global Network of Age Friendly Cities and Communities and Affiliated Programs, as well as a guide for policy and action in fostering age-friendly urban environments. Over 300 cities in 33 countries are currently involved in the Global Network, including 19 Member States in the European Region. The WHO guide advises on eight areas¹ considered the most influential, which also reflect the UN Principles for Older Persons. Through the work of the European Innovation Partnership on Healthy and Active Ageing (which has a dedicated Action Group on Innovation for age friendly buildings, cities and environments) the European Commission has published a guide on innovation for aging, with examples from 12 countries in Europe.

EuroHealthNet’s Healthy Ageing website also highlights examples of initiatives and key resources on healthy and active aging throughout the European Union. Arup, Help Age International, Intel, and Systematica have produced an overview² of aging in 10 European cities with comparative data on both urbanization and aging. AGE Platform Europe published a guide³ aimed at helping European cities to use the Urban Agenda to become more age-friendly and as a repository of innovative solutions for age-friendly environments. These networks and initiatives encourage cities to be health-promoting environments as they adjust to population aging, and share innovative ideas, experiences, and lessons learned along the way.

unnamed

By 2020, more than 50 percent of the global population over 60 years old will be living in urban areas. Planning now can stimulate active and healthy aging both for current and future generations.

1. The WHO guide addresses: outdoor spaces and buildings; transportation; housing; social participation; respect and social inclusion; civic participation and employment; communication and information; and community support and health services.
2. The ”Shaping Ageing Cities” publication examines: society; mobility; built and digital environments; politics; planning; and aging.
3. The AGE Platform Europe guide addresses the eight areas in the WHO guide as well as eight themes corresponding to the Urban Agenda: inclusion of migrants and refugees; jobs and skills in the local economy; urban poverty; housing; air quality; urban mobility; digital transition; and innovative and responsible public procurement.

Carrie Peterson covers Europe for Global Health Aging. She is a Gerontologist and Consultant in eHealth and Innovation.

Integrating Alternative Medicine with Geriatric Care in Australia

In the last 20 years, aromatherapy in geriatric care has grown extensively especially in the Oceania region. This treatment uses plant-derived, aromatic essential oils to promote physical and psychological well-being. Age-related conditions such as dementia and arthritis as well as respiratory diseases, blood pressure and skin changes can benefit greatly from aromatherapy.

Photo Credit: Pixabay
Photo Credit: Pixabay

A survey from the Australian Longitudinal Study on Women’s Health (ALSWH) identified significant use of self-prescribed complementary and alternative medicine (CAM) for back pain regardless of education, income or urban/rural residency. CAM was among a range of care options but the study found that a large number of women aged 60-65 self-prescribed one or more CAM for back pain in the previous 12 months. The most common self-prescribed CAM was supplements, vitamins/minerals, yoga/meditation, herbal medicines and aromatherapy oils.

It was further noted that women who visited health professionals three or more times in the previous 12 months were more likely to self-prescribe CAM for back pain than those who did not. This study was useful in exploring the prevalence and characteristics of women who self-prescribe CAM for back pain. Medical professionals can integrate alternative medicine with geriatric care to treat ailments and improve quality of life for older adults.

While aromatherapy helps with a number of diseases, studies have mixed results when it comes to treating agitated behaviour in people with dementia. One study found that lavender oil had no discernible effect on affect and behaviour in Australian nursing home residents while another study reported that despite a downward trend in behaviours displayed, no intervention significantly reduced disruptive behaviour. These findings are important because older adults respond differently to alternative medicine. Individual needs must be considered and health professionals can assess the effectiveness of CAM.

Aromatherapy is a great way to manage symptoms of a chronic illness or relieve age-related discomfort. For instance, complementary therapy in palliative care such as Massage/aromatherapy, Reiki, and Therapeutic Touch™ enhances regular symptom management, increases comfort, and more. This can help support the immune system as people get older. Aromatherapy is becoming increasingly popular especially since it improves quality of life during the aging process.

Sophie Okolo is the Founder and Editor-in-Chief of Global Health Aging.

Battling Beauty Stereotypes in Brazil’s Older Women

If you have ever watched a Brazilian telenovela, you might notice that older women look unrealistically younger than the characters they portray, with the help of botox or other “medical miracles”. Older women in Brazil face pressure to look young, not gain weight, and maintain top physical appearance. As women age, their metabolism slows down and wrinkles tend to appear on their faces. This can lead to body image dissatisfaction, which is a distorted perception of appearance that leads an individual to unhealthy lifestyle, weight issues, and/or depression. Such distortion is common among older women in Brazil and having a negative impact on the mental and physical health of this population.

Photo Credit: CarolinaAURO
Photo Credit: CarolinaAURO

Body image dissatisfaction is often discussed in the context of teenage girls. It may cause eating disorders where girls may choose to eat less or vomit after eating, in an effort to maintain a certain physique. Thus, the choices made in adolescence can have a lifelong impact on the health of an individual. Anorexia nervosa and bulimia nervosa are eating disorders that have been linked to low bone mineral density and osteoporosis in teenage years. Both disorders also impact older women. In fact, anorexia nervosa is more likely to cause death in women over 65 than girls or women under 65.

Body image dissatisfaction is a direct result of ageism in society, and the fear of getting older. Older adults may feel less relevant or unwanted if they do not maintain youthful appearances. In a population-based study in southern Brazil, researchers found that women over the age of 50 were most likely to be concerned that they weighed too much. Older men were also more likely to be dissatisfied with their weight than younger men, but the magnitude of the dissatisfaction was smaller than women.

The need to look young in aging women has its roots in an ageist society, where older women are not valued as much as their younger counterparts. Changes in skin and weight are a natural part of aging but in Brazil, many women fear any weight gain. While the solution to this problem is unclear, the media can play a great role by portraying older women who have aged naturally. This population should be able to feel comfortable with their appearance as this may challenge beauty stereotypes and reduce the stigma of growing older. Media, however, is only a small part of the problem and it is clear that older women need to be valued for their contributions to society.

Grace Mandel is pursuing a Master of Public Health in Health Systems and Policy at the Johns Hopkins University Bloomberg School of Public Health.

 

Africa Must Prepare for Aging Population Now

Photo Credit: United Nations Photo

As countries like Japan and Italy prepare for the challenges of an aging population, African countries are focusing on the need for youth empowerment. Youth make up the next generation of workers, parents, and leaders in Africa; hence investing in them is top priority for the continent’s transformation. While empowering youth is important, African nations cannot ignore the outcome of greatly increased birth rates.

Since Africa is the most youthful continent in the world – two-thirds of the continent’s 1.1 billion people are younger than 35 – what will happen when the youth become elderly citizens? And what will happen to elderly citizens if the continent does not plan for increased birth rates now? The rise in the number of elderly citizens may take a strain on families and the incidence of aging-associated diseases like cancer will hit an all time high.

This situation is especially complex because agencies like the World Health Organization and United Nations Population Fund support the use of contraceptives to space out births’ for maternal and child health. The use of contraceptives is a controversial issue in Africa as opponents may argue that contraceptives will prevent women from having children. Proponents for contraceptives may find the concept ludicrous although in countries like Germany, where the use of contraceptives is widely accepted, women have fewer children or no children. Having children or not is one’s personal choice; the concern is the result of choices that a nation made.

West African nations are among the continents most fertile – the average woman in Niger has nearly seven children in her lifetime. With the current youth population, increased birth rates and use of contraceptives, African nations are facing an unforeseen future. Currently, aging Africans are facing new problems including the changing practice of extended families taking care of elderly members. Children are now migrating to other nations for better opportunities, leaving their parents to care for themselves. If African governments do not address current problems as well as prepare for the increased birth rates, it is likely that the future will bring many challenges to the aging population and continent as a whole.

African countries that currently have large youth populations are poised to experience a potential demographic boost to their economies. While such countries will see this population age into the workforce, they will also experience rising proportions of seniors with this group. It is critical for governments to plan now for the future with smart government policies. Training citizens to embrace the aging process and raising awareness of the challenges associated with this stage of life is important. Companies should also be encouraged to work with the elderly so as to improve their health, lifestyle and wellness.

Equipping older adults with coping skills, and encouraging people of all ages – especially the youth – to not smoke, do more physical activity, and practice moderate alcohol consumption and good nutrition will pay good health dividends later in life.

Sophie Okolo is the Founder of Global Health Aging.