The debate concerning age-friendly cities and communities (AFCC) addresses issues of demographic change at a time of continuing global urbanisation, where inequalities between people and places become central. In many economically developed countries, health and social care policy encourages older people to live in their own mainstream housing. Throughout life people may relocate, primarily to seek employment, but in later years the idea of ‘staying put’ as a good idea has led to discussion in the UK of the lifetime home and, subsequently, the lifetime neighbourhood (DCLG, 2008; Bevan and Croucher, 2011). Both concepts are related to the AFCC mission. Globally and nationally, moving this dynamic form of social policy forward requires recognition of the heterogeneity of the ageing population and the importance of involving people in co-design and co-production of living spaces. Yet the lives of people experiencing disadvantage and faced with long-term health conditions can challenge the positive milieu of a global social policy portrayed as inclusive, particularly when compounded by cultural, social and economic circumstances (WHO, 2007; Phillipson, 2007, 2012).
This chapter tests the inclusivity of age-friendliness for the lives of older people with sight loss living within English urban and rural communities. Vision impairment can be a lifelong experience, but often occurs in later life alongside other long-term health issues. For many people, changing sensory perception will have happened in an environment that is familiar, possibly with their disability unrecognised externally. Everyday living with its routines and activities may alter as people find new ways of coping (Wahl et al, 1999), sometimes with the support of specific social and cultural groups, sometimes through home adaptation and assistive technology, or by a combination of the two. Yet given their changing circumstances, people may still experience forms of social exclusion in places that are not enabling.
Testing the principles of the AFCC
Since 2005, the AFCC initiative has aimed to promote active ageing ‘by optimizing opportunities for health, participation, and security in order to enhance quality of life as people age’ (WHO, 2016a). There are now over 500 cities and communities in 37 countries working towards being more age-friendly as part of the World Health Organization (WHO) Global Network for Age-Friendly Cities and Communities (WHO, 2016b), developing projects enabling participation across a wide range of areas (see Chapter Two, Figure 2.1).