Healthy and active ageing is more important than ever

In the Decade of Healthy Ageing (2020–2030), the COVID-19 crisis raises the stakes in terms of the need for active and healthy ageing practices across the globe.  The resulting lockdowns and physical distancing practices challenge daily life as we know it. In our bustling, densely populated cities, the changes are enormous and our older citizens are among those most affected. In this crisis, the need for a long-term strategy on active and healthy ageing is more evident than ever.

The fact that most regions in Europe have experienced significant population ageing in the last two decades, and that this trend will continue in the coming decades, further underlines this notion.

Older people and COVID-19

COVID-19 sheds new light on the outcomes of the ESPON ACPA study – Adapting European Cities to Population Ageing. It is evident that the virus hits older people the hardest.

For example, in Spain, 90% of COVID-19-related victims are 65+ years old. A similar situation applies in other countries studied as part of ACPA, such as France (91%), the Netherlands (94%), Norway (96% 60+), Sweden (95% 60+) and the United Kingdom (87%). Unfortunately, data on COVID-19 at a detailed geographical (urban) level are not readily available for all stakeholder cities, and the relationship between COVID-19 and settlement size seems to be complex. In some countries, including Spain, Italy and the Netherlands, cities do not seem to be disproportionally affected.

In France, results are mixed: the city regions of Paris, Strasbourg, Lyon and Lille have the country’s highest COVIDrelated death rates, but other urban regions do not have higher death rates than their hinterlands. On the other hand, there is evidence from some countries analysed that urban populations are over-represented in death counts, such as in Norway, Sweden and the United Kingdom. In the United Kingdom, Salford, a borough in Greater Manchester’s metropolitan area, ranks seventh in the top 10 of the United Kingdom’s 346 regions, based on the number of COVID-19- related deaths per 1 000 inhabitants.

What do we see around us? The role of digitalisation Based on the characteristics of older people in cities, a couple of impacts of COVID-19 on this population group can be observed.

First, we can see that older people form a disproportionally vulnerable target group for the virus. Places such as care homes seem to play an important role in the spreading of the virus. In many countries, COVID-related deaths in care homes were originally not included in official statistics, and pilots in Belgium, France, Spain and the United Kingdom suggest that official death rates are two to five times higher if these deaths are included.

The situation could be worse in cities than in other areas, as preliminary evidence suggests, partly because of the larger population density in urban environments. This means that physical distancing measures are paramount for older people in cities. Digital tools play an important role here. COVID-19 has been a catalyst for the use of digital tools to facilitate physical distancing.

" improving digital literacy for older people should become an even bigger priority: it is no longer simply an advantage buta necessity, to prevent loneliness "

Sceptics claim that these tools cannot replace face-to-face interaction. The COVID-19 crisis is pushing the frontiers of this assumption and proves that we can do more than ever imagined through digital tools.

Recent statistics indicate that certain ethnic minority and migrant groups have been most severely affected by COVID- 19.

Among the countries studied in ACPA, this can be seen in at least Norway, Sweden and the United Kingdom, where people with certain ethnic and socio-economic backgrounds are overrepresented in the number of COVID-19 cases and deaths.

This is manifested spatially in, among other cities, Oslo (Gamle Oslo borough) and Stockholm (Rinkeby-Kista and Spånga-Tensta), where certain neighbourhoods with relatively high proportions of older people of Somali origin have had disproportionately high numbers of COVID-19 cases.

Second, with physical distancing, feelings of loneliness are increasing.

Older people have always been a group at risk of loneliness, but the situation is being made worse by the current crisis, as it requires minimising or even avoiding physical contact. Digital communication tools theoretically provide a solution here, although the majority of older people tend to prefer direct contact.

" COVID-19 has beena catalyst for the use of digital tools to facilitate physical distancing. The COVID-19 proves that we can do more than ever imagined through digital tools "

What can we do next?

To counteract the impact of COVID-19 on older people in cities, action is necessary in relation to multiple aspects. First, improving digital literacy for older people should become an even bigger priority: it is no longer simply an advantage but a necessity, to prevent loneliness. In this regard, Barcelona’s Vincles project – showcased in the ACPA policy handbook – is an inspiring example of good practice (ESPON, 2019a).

Second, the communication of information to older people should be considered. Traditional media such as television broadcasts work for native speakers, but immigrants tend to have trouble understanding these messages. The City of Amsterdam has recently experimented with a ‘social distance bus’ that drives through the city’s most multicultural neighbourhoods (ESPON, 2019b). Loudspeakers on the bus broadcast warnings and medical advice in seven languages (in addition to Dutch): Arabic, English, Papiamento, Somali, Spanish, Turkish and Twi (a Ghanaian language).

Third, it is not just about short-term solutions. A long-term plan is needed. While the COVID-19 crisis came to our cities in an instant, the effects are here for the long term. European populations are still ageing and the share of older people is expected to rise up to 30% in until 2030. The COVID-19 pandemic has made long-term strategies on active and healthy ageing priority number one.

Active and healthy urban ageing requires inclusive and holistic policy-making

In light of the current COVID-19 crisis, planning for agefriendly cities that foster active and healthy ageing seems more important than ever. While older age groups in general have been most severely affected, older people with a lower health status are most vulnerable. Hence, the best way to ensure good health for senior citizens is by promoting healthy and active ageing throughout people’s lives. It is paramount that policy action towards achieving this is taken at all levels of decision-making and planning, ranging from the global level to the levels of cities and local communities.