A research brief

How to target prevention and intervention

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How to target prevention and intervention

services to different groups of older
people (demographics, countries,
As described in the National Institute on
Aging’s (2011)
Global Health and Aging report, “Health systems need better data to understand the health risks faced by older people and to target appropriate prevention and intervention services” (NIA 2011, 16-17).
In these HAPI Research Briefs we aimed to find implications for planning and design at roughly the neighborhood level. These could include quantifiable standards, more qualitative but yet evidence-supported insights, and other good practices. Not every topic has a full complement of these implications.
Many of the implications for healthier aging involve individual behaviors by older people. In these cases environments can mainly support healthier options or at least not provide barriers to such healthier behaviors.
It is important to keep in mind that planning and design are only part of the picture, because a person’s health and exposure to health risks in childhood and adulthood profoundly affects physical and cognitive functioning in later years (Wen and Gu 2011, 153).
Table 4 describes individual behaviors shown to have an effect on disease reduction and prevention in later years. Following this table are policy, planning, and design ideas to promote and support healthy aging (see
Table 5).

Table 4. Individual behaviors to encourage healthy aging for those 65 years or older.

Get regular exercise 30 minutes of moderate-intensity endurance activity on most or all days of the week

Prevent many diseases: type 2 diabetes, certain cancers, obesity, osteoporosis/ osteoarthritis, cardiovascular disease
Eat a healthy diet with lots of fruits and vegetables
2.5 cups of vegetables and fruits per day; foods fortified with vitamin B
(fortified cereals, dietary supplements)
Reduced risk of many chronic diseases: cardiovascular disease, certain types of cancer
Do not smoke or use tobacco products
No smoking or tobacco products
Reduced risk of cardiovascular disease and certain types of cancer
Avoid excessive use of alcohol
No more than 7 drinks a week, no more than 3 drinks per day; Do not drink and drive
Reduce risk of dependency, organ damage, accidents
Keep engaged mentally and socially
Spouse, family, friends, religious affiliation and attendance, employment, other community affiliations
Reduced risk of depression, stress, and cognitive decline; Promotes greater health, longevity and wellbeing, recovery from illness and injury, health behaviors
Get regular medical checkups
For example, annual physical or as recommended by a doctor
Disease prevention and management
Safety habits around the home and car
For example, wear a seat belt, use handrails and assistive equipment if necessary
Prevent falls and fractures, accidents
4. Birren and Schaie 2011, 96-97; Morgan and Kunkel 2001, 6; NIA 2009 (updated 2012), 3; NIA et al. 2011, 24; NIH 2013, 110; Resnick et al 2011, 6; Rowe and
Kahn 1987, 146-147; Taylor and Johnson 2007, x; USDA 2010, 34-35; Whitbourne 2002, 10.

page 8

Social engagement plays an important role in the health and wellbeing of older adults.
Photo by
Ann Forsyth

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While individual behavior is the most important factor for healthy aging, planners and policy makers can support individuals in these activities in several ways. A number of recent studies and reviews have described policy and planning interventions that are supportive of healthy aging, especially the World Health Organization’s (2007)
Checklist of Essential Features of Age-friendly Cities. These topics are also discussed in more detail in the related syntheses of physical activity, healthy eating options, universal design, social capital, healthcare access, and safety.
Table 5 summarizes some age-friendly environmental characteristics with intervention examples and potential health impacts.
Table 5. Environmental features which support healthy aging
Environmental Features
Intervention Examples
Potential Health Impact
Land use promotes walkability (density, mixed use, connectivity)

Smart Growth development patterns

Retrofitting suburbs

Walkways and cycle paths

Age-friendly residences close to shops
Physical activity, walking
Safe and accessible streets and sidewalks

Pedestrian countdown signals (slower walking speeds)

Adequate lighting

Clear signage (wayfinding)


Smooth, level, non-slip surfaces

Sufficient sidewalk width for wheelchairs

Curb cuts

Priority access for pedestrians

Low traffic noise

Public toilets available

Safety (traffic), physical activity

(walking), independence and wellbeing
Affordable, accessible homes (universal design)

Build into new construction (ideally), but also retrofitting, funding, zoning, development incentives, or design requirement

Low-income housing programs

Age-specific housing

Options of designs to accommodate single living, multigenerational, and assisted living housing

Universal design features like single level, ramps, wide doorways, etc.
Safety (accidents), greater independence and wellbeing
Accessible buildings
(universal design)

Elevators, escalators, ramps

Wide doorways and passageways

Suitable stairs with railings

Non-slip flooring

Rest areas and public toilets with handicap access

Adequate signage
Safety (accidents), greater independence and wellbeing
5. Hunter et al. 2011, 357-359, 360, 361, 363; Parra 2010, 1073; WHO 2007, 12-17, 20-27, 30-34, 44, 58-59, 71

Environmental Features
Intervention Examples
Potential Health Impact
Safety from crime (real or perceived), lighting, etc.

Surveillance cameras

Self-organized groups

Grants to improve personal security

Safety (crime), physical activity
(walking), mental health
Adequate transportation
(personal, public, or specialized transport options)

Driving conditions: enhancements to highway design (wayfinding), lower speed routes, connectivity of streets, reduced intersection widths, complete street design

Transportation options: taxis, community transport, para-transit options; available, safe, affordable, and reliable public transportation
(vehicles and stations) with handicapped accessibility and seating, adequate parking
(handicapped accessible)
Independence, wellbeing, social and community life, mental health
Density of parks, greenspace (perceived as safe)

Plenty of available parks and greenspace

Small, quiet areas

Special gardens or areas just for older people

Park maintenance
Physical activity (walking), mental health, “good” reported health status
Pleasant and clean environment

Noise ordinances

Sanitation, street cleaning, and garbage collection

Adequate public toilets
Mental health, physical activity, wellbeing
Public events that are accessible, affordable, and appealing

Located and scheduled conveniently to older people

Open admission, affordable

Diversity of events and activities
Social capital, wellbeing, mental health, supports cognitive, mental and social activity
Volunteering, employment and training options

Volunteer databases

Policy and legislation to prevent discrimination

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