A] Prelude
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B] The Issue
We will now cite the essence of a very interesting recent survey on the impact of location on aging in Spain.
As the population ages and grows in our cities, the question arises of whether this environment is truly a suitable space for older people to live fully, with health, comfort, and quality of life. Although cities offer access to medical services, social activities, and amenities that are often lacking in rural areas, they also present barriers that limit the quality of life.
Are our streets and services really adapted to their needs? Are we making enough progress? Are rural areas more welcoming to them? Access to efficient public transportation, safe green spaces, walkable streets, and nearby health services are elements that influence the quality of life of those who have lived and contributed to building our cities.
And it is the environment, whether urban or rural, that significantly influences intrinsic capabilities in old age. This is explained by Vânia de la Fuente, a doctor and anthropologist, an international expert in healthy aging, and a participant in the III Aging Forum of the Age & Life Foundation.
C] Research
“Although genetic factors explain approximately 25% of longevity, the rest depends on the interaction with the environment we inhabit.” That’s why initiatives like the Network of Age-Friendly Cities and Communities, promoted by the World Health Organization, seek to transform urban spaces and improve the quality of life for this population group.
In this context, Irene Lebrusán, Ph.D. in Sociology, professor at the Autonomous University of Madrid (UAM), and researcher at the International Center on Aging (CENIE), introduces the concept of urban health as one of the key factors in longevity.
Warn, for example, about the risks of emitting microparticles, especially PM 2.5 (particles suspended in the air with a diameter of less than 2.5 microns), whose impact reduces life expectancy and quality of life, with effects on the brain similar to Alzheimer’s. Furthermore, it cautions against the impact of noise pollution or issues like dampness in buildings that can exacerbate respiratory illnesses, directly affecting longevity.
D] Everyday barriers in an aging society
Population aging demands a profound reflection on how we adapt our cities and towns to the needs of the elderly. Paz Martín, an architect specializing in longevity, has spent the last few years researching how architecture and urban planning can respond to these challenges.
Her personal experience, marked by her father’s degenerative illness, drove her to explore the impact of spaces on the quality of life in old age. In 2015, a Leonardo scholarship from the BBVA Foundation allowed her to delve deeper into this topic, culminating in the traveling exhibition Envejez Ando. Design for All: Architecture and Seniors in Spain.
Today, Envejez Ando is an innovation platform that seeks to showcase and improve urban and rural spaces by addressing inclusive housing, leisure, and design. “The great challenge is a paradigm shift that places people at the center of architecture and urban planning, anticipating the real needs of an aging society and offering innovative solutions,” says Martín.
For Vânia de la Fuente, the environment—“everything outside of the individual, from physical infrastructure and accessibility to broader aspects”—should support the functional capacity of the elderly, allowing them to maintain their lifestyle even in the face of physical limitations. “Without well-maintained sidewalks, efficient public transport, or accessible buildings, the risks of falls increase and mobility is hindered, preventing an active life in old age,” the architect points out. Furthermore, the lack of safe paths or parks restricts regular exercise, increasing the risk of cardiovascular diseases; whereas green and recreational spaces help improve air quality and reduce stress.
Housing is another determining factor, explains de la Fuente, and its lack of adaptation or accessibility also raises the risk of accidents and isolation. “A person on a fourth floor without an elevator can become trapped in their home, reducing not only their mobility but also their social relationships, which impacts their emotional state and contributes to reducing life expectancy,” says Irene Lebrusán.
E] Redesigning the environment to improve longevity
The city, or the town, is the space where interaction between different social groups takes place. It is the public space, as an extension of the domestic space, where the socialization of adults occurs, explains Paz. Therefore, she considers it urgent to reevaluate the design of these spaces as “the achievement of a more intelligent, sustainable, and socially inclusive urban development”.
While measures such as pedestrianizing or removing physical barriers are a step in the right direction, she warns that this is not enough: “Other factors such as work and social and citizen participation, social respect and inclusion, communication and information, transportation, or social and health services must be taken into account.”
Urbanism truly friendly to the elderly, noted Martín, should include elements such as benches or resting areas every 300 meters for sitting in the shade without the need to consume, accessible public restrooms, wide and obstacle-free sidewalks, as well as safe and well-lit green spaces.
“These measures, although simple, can have a significant impact on the mobility and autonomy of the elderly,” says Martín. He also emphasizes the importance of allowing them to age in their own homes. “An accessible home, with spacious bathrooms, good natural lighting, and windows that connect to the outside, is essential for healthy aging.” He also advocates for building adapted housing, but “in the places where the elderly already live, so they can stay in their immediate environment.”
F] Moving in the right direction
Against stereotypes, Paz Martín points out that older people are not passive subjects; “they are active, they know what they want, and they demand environments that respect their autonomy and quality of life. It is a change that benefits society as a whole, not just them.” In her opinion, this empowerment, increasingly visible, has and will have very concrete consequences at the social, urban, and architectural levels.
In this field, Vânia de la Fuente highlights the work of initiatives such as the mentioned Network of Age-Friendly Cities and Communities, which works to identify and prioritize barriers in local environments. In Spain, the Imserso program, affiliated with this WHO network, helps municipalities implement these ideas in a phased model. The first, and fundamental, phase is citizen participation: “older people living in the environment must identify the barriers they face in their day-to-day lives.” Then, priority actions are planned, improvements are implemented, and finally, their impact is evaluated.
In Spain, the highest concentrations of people over 65 are found in urban municipalities with more than 10,000 inhabitants. In fact, Madrid and Barcelona together host more people in this age group than all rural municipalities in the country. However, Vânia de la Fuente points out that the rural population is more aged compared to the urban population, as the majority of people living in those areas are elderly.
That being said, Lebrusán argues for integrating an age perspective into urban design to make it more inclusive. “Public spaces are too focused on cars, with narrow sidewalks and few options for pedestrians,” she explains. She also criticizes the privatization of public spaces, which hinders their shared use and affects both the elderly and children. For her, the arrival of tourists should be an additional benefit, not the main objective: “The important thing is for a city to function well for its residents, for them to feel comfortable and not be pushed to the outskirts or outside of it.”
Despite urban obstacles, Irene Lebrusán observes that older people maintain a strong connection to cities. Although the idea of returning to the village is idealized, in practice it is uncommon. “After a lifetime in a particular environment, people develop attachments, customs, and social connections that make it difficult to return to the village,” she comments. Additionally, factors such as proximity to children and the comfort of the urban environment make this decision even more complex. “Returning to a place where they no longer recognize themselves, and where they are not recognized either, can be very difficult for them,” she states.
Sometimes, what happens is that some older people, upon retiring, choose to spend more or less extended periods in rural areas (their hometowns or adopted villages), becoming temporary rural residents seeking a quieter lifestyle.
G] Rural areas and new opportunities
For Paz Martín, the rural environment offers an ideal scale to experiment with innovative solutions. Despite the challenges of young people leaving and the lack of services, she points out that the creation of innovative housing projects for the elderly is gaining ground in this favored setting due to the price of land and the quality of life in these places (absence of pollution, close human and social relationships, a sense of rootedness…). However, she adds, it is important to adapt it to the real needs of the elderly without imposing urban solutions that do not fit their reality.
Despite the advantages of the rural environment, experts also warn about its drawbacks, such as the terrain in mountainous areas, geographic dispersion, and the lack of public transportation connecting different municipalities and basic services. “While it’s not necessary to have a hospital in every village, it’s essential to ensure that distances are overcome with appropriate mechanisms,” Lebrusán points out.
On the other hand, Vânia de la Fuente emphasizes the challenge of the digital divide in rural areas. This issue, she says, is not only about technological skills but also about the lack of infrastructure, such as internet access. To bridge this gap, it is necessary to implement digital training programs, ensure that services and procedures are not solely dependent on digital means, and improve connectivity in areas where it is still unavailable.
H] Finally: Looking to the future
Paz Martín alerts about the need for a serious and collective debate on how cities and towns will face the impending ‘gray tsunami’: “If the statistical projections come true, by 2050, 34% of the Spanish population will be over 65 years old”.
While progress is already being seen, such as the exponential growth of cities affiliated with the WHO program, this demographic shift poses new challenges. “Mayors cannot escape the reflection on how to govern their localities when more than half of their voters are over 65 years old,” the architect comments. She states that there are solutions that do not require large investments but rather coordinated planning among different municipal areas and professionals.
Coordination is also key for Lebrusán. The fragmented approach to urban design, housing, and community activities is a mistake. “As long as we continue to work in isolation, we will continue to make mistakes,” he concludes, calling for a more holistic vision of the cities and spaces where we live.
On the other hand, the sociologist rejects establishing a dichotomy between rural and urban areas regarding life expectancy, as longevity rates depend on multiple factors that are more related to the quality of services and economic issues. An example of this is Madrid, where life expectancy varies from 7 to 11 years between neighborhoods such as Puente de Vallecas and Salamanca; these disparities, she says, should receive priority attention from authorities.
The conception of spaces is, for Irene Lebrusán, another key aspect: “a small motor difficulty can become a disability if the space is not accessible.” However, in an appropriate environment, those limitations do not have the same impact. “In many cases, it’s not a matter of economic resources, but of will and design to ensure that public services work and allow access to well-being,” she concludes, emphasizing the importance of people having the possibility to choose where to live.
“Ensuring that choice is something that, unfortunately, seems to be slipping away from us little by little,” she asserts.