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Problems without Borders: The World's Aging Peoples and Their Home Environments

Peter R. Walker, Ph.D.

A paper prepared for presentation at the American Psychological Association Convention in Toronto, 2003

The author is the Main United Nations Representative for the Society for the Psychological Study of Social Issues (SPSSI), Division 9 of the American Psychological Association. For more information please contact the author at 5 Bayside Terrace, Riverside, CT 06878, nucprw@attglobal.net

Draft Page Problems without Borders: The World's Aging Peoples and Their Home Environments Introduction

In April, 2002, the United Nations held the Second World Assembly on Ageing in Madrid,1 20 years after the first World Assembly was held in Vienna.2 In the week leading up to the Madrid Ageing Assembly, two additional conferences were held. The first, The Valencia Forum,3 was a meeting of gerontological researchers, educators and providers who focused on a research agenda for the Second World Assembly. The second was the World NGO Forum on Ageing,4 which brought together several thousand Non-Governmental Organization Representatives (NGOs). At all three events, the significance of home and providing enabling environments for older persons were central themes. This is quite in keeping with the United Nations Principals of Older Persons, which grew out of the Vienna Conference. The Principles emphasize five key elements for older persons: independence, participation, care, self-fulfillment and dignity.5 Although there were notable differences between developed and developing countries in the discussion at these three meetings, there were also a number of common concerns. These concerns -- problems without borders -- included issues of aging in place, when appropriate; the rights of older persons to adequate housing; independent living; barrier-free access -- in the home and to work, health, and recreational facilities; safe and affordable transportation; and the opportunity for continued participation and recognition in the community. Older Persons An older person, in UN terms, is one over the age of 60.6 Secretary General Kofi Annan, in his remarks to the International Day of Older Persons, 2001, pointed out that, The average life expectancy at birth has increased from 46 to 66 since 1950,7 adding 20 years to life. There are several additional statistics regarding the growth in the older populace that are worth noting. Worldwide, the fastest growing age group is the oldestold, those aged 80 years and over. They are growing at a rate of 3.8 per cent per year, compared to the age group 60 years and over which is growing at only 2 per cent per year. Globally, the total population is growing at a rate of 1.2 per cent annually.8 It is probably not a surprise that, in most countries, women live longer than men. What is not

Draft Page so evident, particularly in developing countries, is that women can expect to spend a smaller proportion of their lives in good health than men9.

Worldwide, there is an increasing trend for older people to live alone especially unattached older women who are mainly widows and are often poor, even in developed countries.10 For these individuals access to adequate housing is particularly important. In many developing countries, the proportion of older people living in urban slums and shanty towns is rising quickly. Many, who moved to the cities long ago, have become long-term slum-dwellers. Older people living in these settlements are at high risk for social isolation and poor health. A Survey of Low-Income Older Persons In 1999, a survey was conducted of older persons in urban areas of developing countries outlining the difficulties they are experiencing in continuing to lead fruitful lives (United Nations Centre for Human Settlements, 2000). The survey, composed of 11 small case studies was undertake in 11 major cities around the world, including Beijing, Budapest, Cairo, Manila and New Delhi. There were 200 interviews with older persons. Although the sample was small and each city surveyed differed in terms of its culture, climate, economic and social problems, there were many common conditions and problems. For example, many older persons in squatter settlements complained about the inadequate size, poor construction and unhealthy surroundings of their homes. Those individuals in good health said that they would improve their homes if provided with legal tenure of their sites at affordable costs. A few additional responses included complaints about the need for protection from crime, discrimination, and traffic, as well as the need for reduction air and water pollution. The respondents were roughly two-thirds women, one-third men. Just over half were in their 60s, one-third were in there 70s, and the remainder were over 80, over half said they had lived in the community for 30 years or more. Adequate Housing as a Right, and the UN Housing Rights Program The right to adequate housing11 is established under article 25(1) of the Universal Declaration of Human Rights. The central human rights treaty concerning the right to housing is the International Covenant on Economic, Social and Cultural Rights

Draft Page (ICESCR). In 1991, the UN Committee on Economic, Social and Cultural Rights adopted General Comment No. 4 on the Right to Adequate Housing.12 This right is not restricted to emergency shelter. In Comment No. 4, the Committee explained that the right to housing should not be interpreted in a narrow or restrictive sense which equates it with, for example, the shelter provided by merely

having a roof over one's head. Rather, it should be seen as the right to live somewhere in security, peace and dignity. The term adequate means housing that offers security of tenure, availability of services, affordability, habitability, accessibility, location, and cultural adequacy. General Comment No. 4 explains that housing rights involve more than the bricks and mortar that go into the physical structure referred to as a home. They cannot be viewed in isolation from the full enjoyment of other rights - such as the right to freedom of expression, the right to freedom of association, and the right to participate in public decision-making. In April 2002, and in response to Commission on Human Rights resolution 2001/28 and the Commission on Human Settlements resolution 16/7, the office of the High Commissioner on Human Rights (OHCHR) and UN-Habitat jointly launched the United Nations Housing Rights Programme (UNHRP)13. It aims to support the efforts by Governments and civil society towards the realization of the right to adequate housing, for all persons, as provided for in international human rights instruments and reaffirmed in the Habitat Agenda. 14 The Habitat Agenda devotes article 17 of the preamble to older persons, saying in part, Special attention should be given to meeting the evolving housing and mobility needs [of older persons] in order to enable them to continue to lead rewarding lives in the their communities. Specifically, the UN Housing Rights Program has five main areas of focus: (a) advocacy; (b) support of United Nations human rights mechanisms; (c) monitoring and evaluation; (d) research and analysis; (e) and capacitybuilding and technical cooperation in the field of housing rights. Aging in Place Aging in place was an important theme in all three of the ageing conferences held in Spain in April 2002. The Valencia Report15 makes perhaps the strongest statement in its paragraph 3.1.2 (Key Messages from the Valencia Forum) Home is critically

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important to older people; ageing in place is the overwhelming preference of most elders throughout the world . . . . This theme is echoed in the Final Declaration of the World NGO Forum,16 which states that, Governments must foster the development of social services and health networks so as to allow individuals to grow old with dignity at home . . . . Paragraph 98 of the Madrid International Plan of Action on Ageing, 2002,17 calls for the Promotion of ageing in place in the community with due regard to individual preferences . . . . Aging in place refers broadly to the experience of a bounded geographic setting in which the activities of daily life occur (Buttimer, 1980; Proshansky, 1978; Relph, 1976; Rowles, 1983). Lavin and Agastein offer a particularly comprehensive definition. The experience of a place is linked with not only the physical setting, but also the activities that take place there. Setting and activity are intertwined in place making. It may also be that, in order for the setting to be a place for a particular individual, the activities occurring there, as well as the physical setting, must be valued by the individual (Lavin & Agastein, 1984, pp. 51-52). One of the most succinct descriptions of the dwelling place is Hayward's (Hayward, 1975) description of home. He suggests a home may have one or all of the following characteristics for the inhabitant: o "a physical structure;" o "a territory" over which some control is exerted by the tenant; o "a locus of space," a central point of reference in daily life;
o

"self-identity . . . people think of home as an integral part of themselves;" and "a social cultural unit" in community with family or larger local populations.

What are the some of the environmental conditions supporting ageing in place? The World Health Organization (WHO) recently released the Active Ageing Framework.18 First on the WHO list of enabling conditions is barrier free environments, including well lighted streets for safe walking with accessible traffic lights that allow more time to cross streets. Safe, adequate housing and neighborhoods are

Draft Page essential to well-being. For older people, location, including proximity to family members, services and transportation can mean the difference between positive social

interaction and isolation. Building codes need to take the health and safety needs of older persons into account. Household hazards that increase the risk of falling need to be remedied or removed. With this emphasis on ageing in place, what are the elements that work against this possibility? Perhaps not the first to come to mind, however, many examples can be found in the past ten years of war, civil unrest, internal displacement, rural/urban migration, and forced and involuntary relocation which have impacted millions of older persons globally. In times of crisis and conflict, displaced older people are particularly vulnerable. Often they are unable to walk to refugee camps. Even if they make it to camps, it may be hard to obtain shelter and food, especially for older women and older persons with disabilities who experience low social status and multiple other barriers. In 2002, responding to portions of the Secretary-Generals report on Abuse of Older Persons19 the Madrid International Plan of Action on Ageing20 contains a number of commitments for improving responses to the special needs of older refugees and internally displaced persons. Particularly noteworthy are the 18 recommendations regarding emergency situations, which are grouped under two broad objectives in the Madrid Plan. The first objective is to ensure equal access by older persons to food, shelter, medical care and other services during and after natural disasters and other humanitarian emergencies. Also relevant to the situation of displacement is the Plan of Actions objective of enhancing contributions of older persons to the re-establishment and reconstruction of communities and the rebuilding of the social fabric following emergencies. Postcards on Human Rights of Older Persons In 1999, the year in which the International Year of Older Persons was celebrated, and the 50th anniversary of the Declaration of Human Rights, the International Activities office for AARP in New York published a collection of postcards from around the world on the theme Human Rights are Ageless. I would like to read two from this selection.

Draft Page The first, from Austria, reads, How glorious to be told that I, as an older person, have the same human rights as all other people! But the Rights of others are also within my stewardship, just as my Rights are within theirs. This means working together more and better. The second is from Pakistan. Old is gold. It doesnt ever rust. Use its potential for improvement in quality of life. References Altman, I., & Lawton, M. P. (1984). Elderly people and the environment: Human behavior and environment: Vol. 7. New York: Plenum.

Buttimer, A. (1980). Home, reach and the sense of place. In A. Buttimer & D. Seaman (Eds.), The human experience of space and place (pp. 166-187). London: Croom Helm. Cooper, C. (1974). The house as symbol of self. In J. Lang, et al (Eds.), Design for Human Behavior. Stroudsburg, PA: Dowden, Hutchinson & Ross. Hayward, D. G. (1975). Home as an environmental and psychological concept. Landscape, 20(1), 2-9. Improving the quality of life of elderly and disabled people in human settlements. (1993). Nirobi: United Nations Center for Human Settlements Lawton, M. P. (1985). The elderly in context: Perspectives from environmental psychology and gerontology. Environment and Behavior, 17(4), 501-519. Proshansky, H. M., Fabian, A. K., & Kaminoff, R. (1983). Place-identity: Physical world socialization of the self. Journal of Environmental Psychology, 3, 57-83. Rapoport, A. (1985). Thinking about home environments: A conceptual framework. In I. Altman & C. M. Werner (Eds.), Home environments: Human behavior and environment (Vol. 8, pp. 255-286). New York: Plenum Press. Rowles, G. (1983). Place and personal identity in old age: Observations from Appalachia. Journal of Environmental Psychology, 3, 299-313. Rubinstein, R. L., & Parmelee, P. A. (1992). Attachment to place and the representation of the life course by the elderly. In I. Altman & S. M. Low (Eds.), Place attachment: Human behavior and Environment (Vol. 12, pp. 139-163). New York: Plenum. United Nations Centre for Human Settlements (HABITAT) in co-operation with the Institute of Public Administration (IPA), New York (2000). Living Conditions of Low-Income Older Persons in Human Settlements.

Endnotes

Second World Assembly on Ageing Madrid, 8-12 April 2002 [http://www.un.org/esa/socdev/ageing/waa/index.html ] International Plan of Action on Ageing (A/37/51) [http://www.un.org/esa/socdev/ageing/ageipaa.htm ]
2

The Valencia Forum: An International Scientific Congress, 1 to 4 April, 2002 [http://www.valenciaforum.com/ ]

3 4 5 6

World NGO Forum on Ageing, Madrid, April 5-9, 2002 [http://www.forumageing.org/ ] Principals of Older Persons (A/46/91) [http://www.un.org/esa/socdev/iyop/iyoppop.htm ]

United Nation FPA Population Issues: Advancing Sustainable Development Population & Demographic Dynamics, [http://www.unfpa.org/sustainable/facts.htm ] The Secretary-General, Message on the International Day of Older Persons, 1 October 2001 [http://www.un.org/esa/socdev/ageing/ageid1sg.htm ]
7

United Nation FPA Population Issues: Advancing Sustainable Development Population & Demographic Dynamics, [http://www.unfpa.org/sustainable/facts.htm ]
8

UNFPA: State of the World Population, 1998 The New Generation, [http://www.unfpa.org/swp/1998/chapter4.htm ]
9

World Health Organization (WHO), Active Ageing: A Policy Framework, [http://www.who.int/hpr/ageing/ActiveAgeingPolicyFrame.pdf ]

10

Right to Adequate Housing, Fact Sheet No.21, The Human Right to Adequate Housing, [http://www.unhchr.ch/housing/fs21.htm ]
11

Office of the High Commissioner for Human Rights, The right to adequate housing (Art.11 (1)), General Comment No. 4, [http://www.unhchr.ch/tbs/doc.nsf/(Symbol)/469f4d91a9378221c12563ed0053547e?Opendocument ]
12

United Nation Housing Rights Programme, [http://www.unhabitat.org/programmes/housingrights/ ]. Additional activities of OHCHR and UNHABITAT in support of his mandate, can be found at http://www.unhchr.ch/housing and http://www.unhabitat.org/unhrp.
14 15

13

Habitat Agenda, [http://www.unhabitat.org/unchs/english/hagenda/index.htm ]

The Valencia report (Second World Assembly on Ageing), [http://www.eldis.org/static/DOC10273.htm ] Final Declaration and Recommendations of the World NGO Forum on Ageing, [http://www.globalaging.org/waa2/ngoforum.htm ]
16 17 18

Report of the Second World Assembly on Ageing, Madrid, 8-12 2002, A/CONF.197/9

World Health Organization (WHO), Active Ageing: A Policy Framework, [http://www.who.int/hpr/ageing/ActiveAgeingPolicyFrame.pdf ] Abuse of Older Persons: Recognizing and Responding to Abuse of Older Persons in a Global Context, Report of the Secretary-General to the Commission on Social Development, UN Doc E/CN.4/2002/PC/2
19 20

Report of the Second World Assembly on Ageing, Madrid, 8-12 2002, A/CONF.197/9