DFH

Design For Health

When planning for health, elderly or senior populations often need additional attention. The following information gives planners some tools to understand this population’s specific health issues and how planning can influence them.

Health Issues

  • Older people, due to chronic illness, physical restrictions, and limited vision, face a number of mobility limitations since they may have fewer transportation options. As a result, they may have less access to healthcare services, jobs, grocery stores, financial institutions, social contacts, etc.1, 2
  • They, along with other special populations, face greater negative health outcomes related to air pollution.3. 4
  • As people get older, they often have different housing needs that range from traditional apartment living and accessory units (i.e., granny flats or mother-in-law apartments) to assisted-living facilities or full-care retirement communities. The diversity of these living decisions are linked to other health issues in terms of whether or not a person’s needs are met within his or her home and within the larger community, which links to land-use decisions, design strategies, and accessibility considerations.1

Most of these disadvantages are not related to the built environment at the scale of the neighborhood, city or metropolis, but rather reflect individual and family characteristics or features of buildings. The domain of planning, however, can influence some health issues most related to accessibility and land-use decisions.

  • Accessibility—the ability to reach a variety of destinations—is critical to many dimensions of a healthy community. Particularly for the elderly, the young, people with disabilities, or the financially disadvantaged, transit is the mode of transportation that provides such access where walking or cycling is too burdensome.5
    • Low-density urban development has limitations for older people. Features, such as rapid suburbanization, dispersed development patterns, lack of pedestrian paths, separation of land uses, and automobile dependency, all present significant challenges for independence.6
    • The elderly have different accessibility needs for transportation, which planners need to consider when thinking about the design of streets and trails.7 This involves issues of universal design, but also access to transit if people need to give up driver’s licenses and access to age-appropriate physical activity options.
  • The design of the built environment influences whether or not the elderly have access to food sources.
    • Those without driver’s licenses may be more reliant on local food-distribution centers than those with easy access to automobiles.8, 9
    • Communities often separate land-use categories, which may create significant distances between residential areas and commercial services, such as supermarkets and restaurants. For those without access to transportation, it makes it difficult to make healthy-food choices.10, 11
  • Air-quality concerns for the elderly are of a particular concern since they are at great risk for certain respiratory diseases.12, 13 Concentrations of susceptible populations in locations, such as long-term healthcare facilities, rehabilitation centers, hospitals, and retirement homes, are of concern.12, 14 Planners may be able to influence air quality through the consideration of buffers, landscaping, and site planning.

DFH Resources

Many of these topics are dealt with in the Key Questions Research Summaries and Planning Information Sheets. This includes:

  • The City of Boulder, Colorado, has prioritized maintaining and improving its multimodal transportation system within the transportation section of the Boulder Valley Comprehensive Plan to provide transportation choices, services, and facilities for older adults as outlined in the Accessibility Information Sheet (867 KB) on page 6.
  • The City of San Diego, California’s Land Use and Community Planning element promotes transit accessibility for specialized populations by supporting policies, such as working to implement small neighborhood shuttles and increasing the supply of housing units that are in close physical proximity to transit and to everyday goods and services as outlined in the Accessibility Information Sheet (867 KB) on page 13.
  • The City of Riverside, California, addresses older populations in the air-quality element of the Riverside General Plan 2025 by supporting objectives that keeping polluting sites away from sensitive receptors and by ensuring equitable land-use decisions as outlined in the Air Quality Information Sheet on page 13.

DFH offers a number of measurement tools and checklists that cover specialized populations like the elderly.

Other Resources

  • Healthy Aging & The Built Environment
    This web page provided links to a number of resources and policies by various groups including the American Association of Retired Persons and World Health Organization.
  • America’s Aging: The Social and Built Environment in an Older Society
    by the National Academy Press in 1988, this text includes a number of very relevant chapters, such as “Social and Physical Environments for the Vulnerable Aged” and “Design Problems in Enhancing Productivity and Independence in Housing for the Elderly.”
  • Institute on Aging and Environment
    The institute of the University of Wisconsin-Milwaukee, School of Architecture and Urban Planning, promotes research, scholarship, and service concerning environments for older persons.
  • Planning for an Ageing Community
    This is a relevant report of the Australian Local Government Association. It covers topics from pedestrian safety to housing choices.

*Special thanks to Amanda Johnson and Ashley Miller for their work creating this resource.

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