Samantha Biglieri is a PhD Candidate in the School of Planning at the University of Waterloo (UW), a sessional lecturer in the School of Urban and Regional Planning at Ryerson University, and a practicing urban planner. She is a former Canadian Institute of Health Research Program in Aging trainee, and currently serves as a Board Director on the Toronto Council on Aging, organizer for UW’s Symposium on Aging Research, advisory committee member for the UW Network on Aging Research and an academic member of the Evergreen Mid-Sized Cities Research Collaborative + Age-Friendly Cities Working group
Understanding ‘Double Risk’ for Older Adults: An examination of the interactions between social determinants of health and (un)supportive built environments
Context: The confluence of rapid population aging and the overwhelming desire of older adults to age-in-place begs the question: do our cities support the health and wellbeing of older adults? In Ontario, research has shown that cities with the greatest projected demographic share of older adults are the least likely to have started age-friendly planning (Hartt & Biglieri, 2017). Targeted policy intervention is crucial – how can we build AFCs without knowing where the most vulnerable live? Research shows that certain types of neighbourhoods – ones that are walkable/have good public transport with easy access to services/family/friends – increase physical activity and levels of social capital for older adults.
This paper explores the ‘double risk’ that many older adults live with – the potential of being disadvantaged by social determinants of health and by living in a non-supportive built environment (BE). We ask, where are older adults with more health risk factors (poverty, living alone) living? And do those places have supportive or non-supportive BEs? The relationship between vulnerability and neighbourhood typologies have been studied in the past, however these social epidemiological pieces tend to link singular factors to aspects like residential density. Our research instead uses a relational approach to understand the connection between neighbourhoods and the health of older adults.
Research Objectives: Determine (A) where vulnerable older adults live in Canada’s three largest cities; and (B) if these vulnerable older adults are more likely to live in non-supportive BEs.
Method: We adopt a two-part methodology to gauge the vulnerability of older adults at the neighbourhood (census tract) level in Toronto, Vancouver and Montreal. First, we created an index to measure the social determinants of health of older adults using data from the Canadian 2016 Census (65+, living alone but not in congregated living, and living below the LICO). We then gauged the support of each neighbourhood by comparing the spatial distribution of vulnerability with Gordon’s (2013) neighbourhood built form typology and Walkscore™, a widely used tool to understand walkability, cycling and transit access by neighbourhood.
Significance: This research provides insight to policy makers regarding the spatial distribution of the most vulnerable older adults, and if they are being further disadvantaged by living in a non-supportive BE. Our findings complement the WHO’s World Report on Aging and Sustainable Development Goals and together promote more targeted, multi-disciplinary, policy interventions in healthcare, social care, urban planning, transportation planning, housing and community development.