Ageing is more than a health issue

A view of George Street Sydney showing pedestrians walking across the mall created by the light rail system. Ageing is not just a health issue.
Picture by Ashleigh Hughes

Guidelines, toolkits and policy frameworks related to population ageing have been around for a while. But are they being used? Ageing is more than a health issue – it’s an urban planning issue as well. COVID-19 has made this very apparent. And so has the 2023 Intergenerational ReportA case study based on Greater Sydney highlights the issues. 

The authors discuss an “ageing city” in the first part of the article where they focus on Australian data on ageing and dementia. The second part of the article provides more information on what is working well and what needs to change. The article uses data, state and city policies to assess how well Greater Sydney is doing as a city for older people. 

Key themes

Sydney has many blue and green spaces that are great for mental and physical health. However, these are inequitably distributed across eastern and western parts of the city. Access to shops and services likewise. 

Active and social places are for the most part good for everyone. Quiet places are important too especially for people with dementia. Feeling safe is related to how active an older person is in their community. The more they get out and about the less worried they are about crime. 

The researchers report on interviews with health and planning professionals, and provide several first hand quotes. 

Key themes from the interviews included: the need for intergenerational spaces, considering mobility and distance between key services, and better access to gardens. Familiar landscapes and architectural landmarks provide a sense of security along with quiet ‘slow spaces’. Ageing and dementia could get lost when nested under policy words such as “liveability” and “universal design”.

Many things are possible and easy to do if planning and health professionals work together. That seems to be the way to go. 

The last part of the article discusses the many toolkits, guidelines and policy frameworks for age-friendly cities. They range from international policies through to the work of the Greater Sydney Commission. The article concludes with recommendations.

The title of the article is, Age-friendly urban design and mental health in Sydney, Australia: a city case study. It is published in the Journal of Urban Design and Mental Health Edition 7: Aging City. There are other articles on the same topic in this edition. 

Authors are, Safia Moore, Associate at Arup, and Georgia Vitale, Practice Leader at Grimshaw. 

 

Size matters in urban design

Aerial view of the city block plan in the city of Barcelona. Size mattes in urban design.
Barcelona architecture: high angle view of the city’s typical urban grid

Walkability is much more than paved walkways. To encourage people to get out and about, places and spaces need to be inviting. We know that urban design impacts our health and wellbeing so it’s important to get it right. Whether people go by foot, e-mobility or mobility device, size matters in urban design. 

Nikola Babic says that the scale and form of buildings has a big impact on walkability. Height and width of places and spaces play their part. For example, the sense of scale is blurred when streets are too wide. Active frontages such as shops and cafes, good lighting and a sense of safety are critical factors in attracting pedestrians. Green infrastructure is another important element to include. 

With the outbreak of COVID19, more people are aware of the importance of walking. However, most footways are too narrow to provide physical distancing. A good case of where size matters. It also matters for accessibility. Having welcoming streets should be part of the accessibility plan. 

Babic discusses the “superblock model” in Barcelona and the 15-Minute City in Paris as examples of what works and what doesn’t. His article is very readable and good for anyone new to this topic. Babic encourages discussion with others to further develop ideas. 

Babic ends with, “This short paper is just a beginning of a more in-depth research of walkable and ‘healthy’ urban forms which will explore the complex relationship between the history of urbanism, urban form, urban design, social processes and well-being.”

The title of the article is, Superblocks – The Future of Walkability in Cities? It can also be downloaded from the Academia website.  

 

Heritage no barrier to accessibility

A street in medieval Chester, UK. Heritage no barrier to accessibility.
A street in Chester, UK

Medieval cities with cobblestones, castles and Roman city walls are not the most disability-friendly places. And they are not easy to make accessible either. However, heritage is no barrier to accessibility in five European cities. They’ve made accessibility a top priority thanks to technology, design and engineering so that heritage is no barrier to accessibility.

The five cities are the Dutch towns of Breda and Rotterdam, Lyon in France, Slovenia’s Ljubljana, and Chester in the UK. The motivation is that these are popular tourist destinations. These examples show that where there is a will there is a way. 

Some of the solutions are:

    • lifting cobblestones, slicing them and re-laying them upside down
    • an app that lets you tell the council about paving issues and follows progress until the remedial work is completed
    • sound beacons that tell blind people when and what bus or tram is pulling into the stop
    • an app for the most accessible restaurants, hotels and hotspots
    • building cascading ramps to the upper walkways of ancient city walls 

Part of the motivation is the tourist trade, both nationally and internationally. However, the EU also takes inclusion seriously and gives access awards to cities that prioritise accessibility in urban planning. The title of the article is Cities without barriers. Heritage is no longer an excuse for exclusion.

Medieval cities need not be “disabled”

A medieval town square with a cobbled pavement.When the user of a place or thing is most likely to be a person with disability, it is often labelled “disabled”. But what about places being disabled? “Disabled” in it’s original meaning is something that doesn’t work. So, if the chain of accessibility for everyone is missing, the place is indeed disabled. This was pointed out in an article in The Guardian: “People aren’t disabled, their city is“. 

The story is about the Dutch medieval city of Breda – now one of the most accessible in Europe. This is because there is “joined up” access throughout – not a bit here and a bit there. They have pulled up cobblestones and re-laid them upside down to create a flatter surface. Hotels are on board too. The key point is that the local authorities have a commitment to inclusion and accessibility and that’s what makes the difference. The next major step will be improving digital communication. See the article for more information.

How will we know when we have achieved inclusion? It will be the day when separate labelling for places and things is no longer required. 

 

Walkability in neighbourhood design

Wide footpath in a shopping strip which has a veranda overhead. There are planter boxes and a seat.Health professionals say the lack of walking is a major factor in poor long term health. But do planners consider the breadth and diversity of the population? Perhaps we need a broader definition of walkability in neighbourhood design.

Lisa Stafford and Claudia Baldwin discuss the issues in their paper. They say few articles on walkable neighbourhoods include people with diverse abilities across the age spectrum. We need to design equitable space – places where everyone is welcome. They recommend that studies on walkable neighbourhoods encapsulate diverse abilities and ages. 

The title of the article is, Planning Walkable Neighborhoods: Are we overlooking diversity in ability and ages? It is available through Sage Journals via your institution. Or you can access for a free read through QUT e-prints

Walkable, rollable, seatable, toiletable

A busy pedestrian street with lots of restaurant tables on both sides.We need a broader term than walkable to explain how everyone can be actively mobile in the community, says Lloyd Alter. In his blog article he adds that unless you are “young and fit and have perfect vision and aren’t pushing a stroller… many streets aren’t walkable at all…” Alter takes his point from a new book where other terms are coined:

    • Rollability. Walkability isn’t enough anymore
    • Strollerability, for people with kids
    • Walkerability, for older people pushing walkers
    • Seeability, for people with vision impairment
    • Seatability – places to sit down and rest
    • Toiletability – comfortable places to go to the bathroom

“All of these contribute to making a city useable for everyone. So we need a broader term for this” says Alter. His suggestions are activemobility, or activeability to cover all the ways different people get around in cities. He says he is open to suggestions for a better word. 

The title of the blog article is, We need a better word than ‘walkable’. The title of the book is Walkable City Rules by Jeff Speck.

Pedestrians First: A Walkability Tool

Front cover of the Pedestrians First resource showing a wide footpath with people of all ages walking across the full width of the path.Cities are expected to hold seventy percent of the the world’s population by 2050. In planning terms that is very soon. Encouraging walking is talked about as if it was just a matter of persuading us to do it. However, planners and urban designers need to focus more on pedestrian needs and find out what the barriers are to getting out and about on foot and with wheels. The Institute for Transportation and Development has a new tool, Pedestrians First: Tools for a Walkable City.

Joe Chestnut, author, says, “but walkability is not just a sidewalk, it’s a whole system of design and infrastructure”. The tool aims to create a better understanding of walkability and ways to measure features. Their interpretation of walkability also includes people with disability. Best practice examples from around the world are provided.  But note – an even footpath or sidewalk is still required!

What about the stairs?

Looking up a long flight of stone steps in a park. No handrails.Walkability is discussed as the solution to keeping people active and engaged in their community. A research study on stairs and older people concludes that the presence of stairs “may deter older persons (and others) from walking outdoors.” The study was a systematic review of the literature. The full article is available online from BMC Public Health. Or you can download the PDF. The title is “Examining the relationships between walkability and physical activity among older persons: what about stairs?” by Nancy Edwards and Joshun Dulai. 

Lack of accessible housing causing most problems

A new home showing the entry with six steps to the front door. It is not accessible.
Newly built home is not accessible

What are the social inclusion obstacles in the built environment, who do they affect, and how? There’s a good amount of research on accessibility in the built environment. There’s also a lot of research on accessible housing design. However, the two are rarely discussed in tandem. While identifying the obstacles in the built environment for people with disability, researchers found that it was a lack of accessible housing causing the most problems.

Researchers at Deakin University were looking for social inclusion obstacles in the built environment. They wanted to know what aspects were key for people with disability. While many were found, most issues could be traced back to a lack of accessible and affordable housing. In short, they found that housing was at the centre of multiple issues creating obstacles for living meaningful lives. 

Several workshops were conducted in the regional city of Geelong. Stakeholders included people with disability.  Access to appropriate and affordable housing was a key factor across all the workshops. It affected employment, connecting with family and friends, transport, services and facilities.

While it is important for people with disability to have an accessible home, all homes must be accessible so they can visit neighbours and feel included in their community. This point is often lost on policy-makers. 

Another factor not often mentioned is the ability to engage with the community to influence attitudes. That is, unless people with disability could get out and about, get a job and get to the shops, they will remain invisible, and nothing changes. Consequently one of the recommendations was to raise awareness of attitudes towards access and inclusion across different professions. 

There is a lot to unpack in this article including a discussion on co-design and whether it has the desired result. Universal design is discussed in the context of built environment courses. Also available from SpringerLink with institutional access.

The title of the article is, “Housing at the fulcrum: a systems approach to uncovering built environment obstacles to city scale accessibility and inclusion”. 

The research was conducted before the Australian Building Codes Board completed their cost benefit analysis on accessible housing

Extracts from abstract

This paper describes a study determining actions to overcome unintended obstacles in the built environment to city-scale accessibility and inclusivity. Prior studies have largely failed to connect social inclusion obstacles in the built environment with factors leading to social exclusion in other domains.

An approach based on systems thinking allowed a wide range of stakeholders, including many with lived-experience of disability, to exchange ideas. One hundred and nineteen actions were identified to overcome these obstacles, with 37 of these prioritised according to impact and feasibility. Nineteen of these 37 are imbedded in the built environment.

Access to appropriate and affordable housing was identified as a key factor across all domains. Access for people with disability to appropriately designed and affordable housing was at the fulcrum of many other issues which created obstacles to meaningful living and fulfilled lives. The process showed how housing is impacted by, and has impacts on, a wide sphere of socio-political and physical contexts.

Comparing the age-friendliness of different countries

A woman is enjoying a cake in an age-friendly outdoor cafe.Older adults spend more time at home compared to other age groups and want to stay in their home as they age. Ageing in place is a broad concept. Attachment to home and place play a key role in the wellbeing of older adults. Consequently, remaining “in place” minimises early entry into supported accommodation. An article by Hing-Wah Chau and Elmira Jamei compares Australia with some of the work on age-friendliness in other countries.

The article covers familiar ground of the WHO Age Friendly Cities program and discusses three aspects related to the built environment. Public spaces, housing and buildings, and public transport. The title of the article is, Age-Friendly Built Environment 

Housing

The UK Lifetime Homes Standard eventually influenced the development of a mandatory code for accessible housing in the UK. The lowest level of the code is now considered too low and will be upgraded. 

So far, the 2010 Australian Livable Housing Design Guidelines have failed to bring about change to the building code. However, in April 2021, state and territory jurisdictions agreed to a basic level of accessibility in all new homes. However, two states have specifically refused to act on this. For more on this check out the posts in the Housing Design Policy section of this website.

The European Homes4Life scheme covers more than building design. It covers physical, outdoor access, economic, social and personal domains for new and existing residential buildings. Affordability, privacy, dignity and connectivity are all considered. Also included is smart technology.

Public spaces and transport

A older woman in a red dress cycles along a path towards the ocean. Outdoor spaces need to be welcoming of older people and encourage social interaction. Mixed use developments, housing diversity, pedestrian safety and natural landscapes all get a mention.

Walkable neighbourhoods and frequent, reliable and safe transport options are key to ageing in place. Affordability is also a consideration for people with minimum incomes. Cycling is also part of the active ageing agenda. However, car ownership is the best mobility option for people living in outer suburbs.

The article compares some of the work in other countries with Australia rather than offering something new. However, the conclusions draw attention to an important point. The design and planning of the built environment needs to hear the voices of those often excluded. Co-design collaboration is worth the time taken, and should be extended to other decision-making processes that affect their neighbourhoods and ability to remain active. 

Dr Hing-Wah Chau presented a paper at the 2021 Universal Design Conference in Melbourne. The topic is about introducing students to universal design through community design studios.

Mapping the inconveniences of urban life

A man in a wheelchair is separated from the crowd by a low concrete barrier Town access audits are not new, but these alone do not gauge accessibility for everyone.  Mapping the inconveniences of urban life for people with disability gives a better understanding of why isolated access features are insufficient to provide access for everyone.

Access features are required in new works and major refurbishments. That means a lot of infrastructure remains inaccessible in our cities. It also means that accessible places aren’t joined up very well, or not at all. 

In a book chapter about the urban circle of life of people with disability, Katarzyna Ujma-Wasowicz explains her mapping project.  The project involved a diverse group of people with disability. The aim was to see how they navigate the built environment. This sounds like a simple and obvious thing to do, but few planners and architects do this. 

The mapping process

The mapping process involves the person with disability specifying a path from home to a destination and back home again. An auditor or researcher follows the person and takes detailed notes along the way. The results of these observations can inform decisions about the most critical rectifications needed. 

Ujma-Wasowicz acknowledges that designers think, “in best faith” about access for each disability group independently. At the end of the chapter she has a section on Post-Pandemic and Universal Design. Ujma-Wasowicsz notes that COVID has changed our behaviours but these changes don’t affect everyone equally. She proposes a universal design approach for design strategies in the summary. 

 “Therefore, a holistic approach to planning is necessary, where one of its elements should be audit of public spaces accessibility. The “urban circle of life” can be a useful tool for such inspection.”

The title of the article is, The Urban Circle of Life of People with Disabilities: Mapping urban inconveniences.  The chapter and the book, Mapping Urban Spaces is available online from Taylor Francis. It is open access

This is a wordy read, but worth the effort if wanting to replicate this process and model. Although some local councils have embarked on similar exercises, there is little written about them in the literature. 

 

Making Mosques Accessible

People at the mosque door taking off their shoes. One person is sitting. Making mosques accessible.
Bolo Hauz Mosque in Uzbekistan.

The classic design of a mosque makes access difficult for people who have difficulty with mobility, removing shoes, hearing the call to prayer, and generally using facilities. The three critical elements for making mosques accessible are the prayer hall, the ablution area and sanitary facilities. 

People cannot enter the mosque with a personal mobility device or shoes. This is to stop dirt from the outside entering the mosque. But it also creates major barriers, especially for older people. The United Arab Emirates, and Dubai in particular, is keen to promote the inclusion of people with disability in all aspects of life. Consequently, the Ministry of Community Development commissioned an access plan and that includes mosques. As a result, Nazem Fawzi Al-Mansoor has come up with a checklist for making mosques accessible. 

The title of the short conference paper with the checklist is, Universal Mosque/Masjid Design. It was presented at the 3rd Universal Design Conference held in UK in 2016.

The checklist includes some basic features found anywhere such as the width of doorways. Seats for shoe removal, space to park mobility devices, and an accessible ablution area feature in the list. 

Photos: Bolo Hauz Mosque, Bukhara, Uzbekistan.

Beyond minimum standards

Urban landscape with shade trees and lots of casual seating with people sitting. Going beyond minimum standards.Why does the design of built environment continue to fail people with disability? Many have asked this question since Selwyn Goldsmith raised it in the 1960s. Many have found answers. But these are not enough to make a difference to the results. New buildings continue to pose barriers in spite of regulations and standards. Going beyond minimum standards is therefore a big ask. 

Imogen Howe, an architect with 10 years experience, wants to find the answer in her PhD study. Her research questions are something we can all think about:

    • Why and how does the Australian built environment continue to marginalise people with disabilities, despite the Disability Discrimination Act (1992)?
    • How does building design reproduce exclusion and segregation? How is this underpinned by design assumptions and approaches both contemporary and historic?
    • Do building and design codes in Australia, NZ, Canada and the UK address dignity?
    • How do we educate becoming architects about the need for inclusive design and then how to enact it in their designs?

References are made to key thinkers and writers on the topic such as Amie Hamraie, C.W. Mills, Joss Boys and Michel Foucault. 

These questions are posed in an article framed as a discussion piece in Academia.edu. The key provocations for the discussion are: eugenics and stigma in design, society structures, and how could this be different. The title of the article is, “The need for inclusive design: going beyond the minimum standards in the built environment”.

Beyond compliance with universal design

Front cover of the guide. A guide book from Ireland on the built environment draws together Irish standards with a practical universal design approach. Many of the standards mirror those in Australia so most of the information is compatible. Parking, siting, pedestrian movement, steps, ramps, lifts, seating and bollards are all covered. 

Building for Everyone, External environment and approach covers each of the features in detail. While the style of tactile indicators varies from the Australian design, the advice on placement is still useful. There is a reference list of related documents including Australian Standards. The guide is undated, but probably published circa 2010. This means some of the technology, such as parking ticket machines is a little outdated.

There is also a section at the end on human abilities and design. It covers walking, balance, handling, strength and endurance, lifting, reaching, speech, hearing, sight, touch and more.

Published by the Centre for Excellence in Universal Design in Ireland it is very detailed. Checklists help guide the reader through the material. This booklet links with others in the series, particularly the one on entrances and circulation spaces. The good aspect of these guides is the perspective of a universal design approach rather than proposing prescriptive design parameters.

Universal design is invisible

The entry to Stortinget metro in Olso showing the uncluttered design with easy access for everyone.
Stortinget Metro Station

Universal design is invisible: that is, until it is not there. Refurbishments and upgrades to buildings can embed universal design without anyone noticing. Using a case study of a train station in Norway, Richard Duncan explains how it was done.

Duncan’s article, Right Under Your Nose: Universal Design in Norway is an easy to read article and is based on Olav Rand Bringa’s work. When done well, universal design minimises the need for separate designs for people with disability. For example, ‘accessible’ exit routes were previously signed with the international symbol. In the new scheme, many of the signs were removed. Yet travellers with disability did not comment on their absence. The design itself indicated where to go. 

And there is more…

There is more in the article about the work of Bringa that traces the history of universal design in Norway. Two surveys from 2018 reveal a gradual change in attitude about universal design. More people understand the concept and agree with the principle of, “Universal design is necessary for some and useful for many”. 

Norway is a global leader in implementing UD strategies. Their landmark document, Norway Universally Designed by 2025, focuses on inclusive policies where everyone is made responsible.

Olav Bringa has written several articles beginning in 1999 when Norway first embraced universal design principles. They are:

Universal Design and Visitability: From accessibility to zoning.  It’s Chapter 6.

Progress on Universal Design in Norway: A review 

Universal Design as a Technical Norm and Juridical Term – A Factor of Development or Recession? Bringa discusses the importance of language in the quest for inclusion. It’s open access.

Richard Duncan has written a similar article on the invisibility of good universal design. This one is about automatic doors. 

Photo by Olav Rand Bringa showing the improved and uncluttered entrance to the station.

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