Integrating knowledge on green infrastructure, health and well-being in ageing populations: Principles for research and practice.

Ageing and urbanisation pose significant challenges for public health and urban planning. Ageing populations are at particular risk from hazards arising from urbanisation processes, some of which are in turn exacerbated by climate change. One approach for mitigating the negative effects of urbanisation on ageing populations is the leveraging of the beneficial effects of urban green infrastructure as a public health intervention in the planning process. We assessed the potential of available theoretical frameworks to provide the context for such leverage. This involved active engagement with academics and practitioners specialising in ageing, green infrastructure and health and well-being through a knowledge-brokering approach. We concluded that an integrated and comprehensive framework on the socio-cultural-ecological determinants of health is lacking. To address this, we present a set of principles for overcoming challenges to knowledge integration when working at the intersection of green infrastructure, ageing, health and well-being. Our findings-and the co-production process used to generate them-have wider significance for trans-disciplinary research into the benefits of the natural environment to human health and well-being as well as other complex and interconnected topics associated with global grand challenges.

Precarity and the Pandemic: The Impact of COVID-19 on Single Men Living Alone.

BACKGROUND AND OBJECTIVES: Existing research reveals that single men living alone are at a heightened risk of isolation and precarity. This study traced the impact of the pandemic on the daily lives of a group of single men over three waves of the COVID-19 pandemic in the United Kingdom. RESEARCH DESIGN AND METHODS: A qualitative longitudinal study with older people aged 50 and older (n = 102), interviewed by telephone in 2020-2021. This analysis focuses on a subsample comprising single men (n = 16) who lived alone and were interviewed three times (n = 48). The men were White British, Black, and Asian, aged 58-88 years, and were identified as facing difficulties in their lives arising from long-term health problems and or/social isolation. Participants were asked about the impact of, and response to, three lockdowns. Data were analyzed using themes identified in the secondary literature using thematic and longitudinal analysis. RESULTS: For single men living alone, precarity intensified during the pandemic due to worsening physical and/or mental health combined with restricted access to relationships and activities. Key moments in the life course influenced how these men experienced and viewed the impact of COVID-19. DISCUSSION AND IMPLICATIONS: This analysis sheds light on the deepening precarity of older men living alone during the pandemic, highlighting the emergence of new vulnerabilities for some. The findings emphasize the need, given the likelihood of future waves of the pandemic, to target support at those living alone, particularly in relation to the provision of community health services, social infrastructure, and combating digital exclusion.

COVID-19, Inequality and Older People: Developing Community-Centred Interventions.

This paper considers the basis for a 'community-centred' response to COVID-19. It highlights the pressures on communities weakened by austerity, growing inequalities, and cuts to social infrastructure. This paper examines the disproportionate impact of the pandemic on low-income communities, whilst highlighting the extent to which they have been excluded from debates about policies to limit the spread of COVID-19. This paper examines four approaches to assist the inclusion of neighbourhoods in strategies to tackle the pandemic: promoting community participation; recruiting advocates for those who are isolated; creating a national initiative for supporting community-centred activity; and developing policies for the long-term. This paper concludes with questions which society and communities will need to address given the potential continuation of measures to promote physical distancing.

'I never really left the university:' Continuity amongst male academics in the transition from work to retirement.

This study investigates the transition to retirement of male academics. It applies approaches drawn from Cumulative Advantage and Disadvantage (CAD) principles to expand Continuity theory by examining evidence for continuity and inequalities in the lifestyles of the respondents. Biographical-Narrative interviews with 20 retired academics in Brazil and the United Kingdom were conducted and analysed using Thematic Analysis. An exploration of the same occupational group in different cultural and social contexts was carried out to capture a diversity of CAD influences on retirement outcomes. The experience of continuity was individualised to each participant due to their unique combination of advantages, and their subjective interpretation of their experiences. Cumulative processes identified in this study related to (1) occupational roles played in their career; and (2) organisational level policies and practices for retirement. At the level of individual retired men, cultural and social context factors were not perceived as influential in the achievement of continuity in retirement. Continuity theory is still supported, but alone offers limited explanations of the diversity of experiences in the transition to retirement of male academics. A consideration of the role of cumulative processes and systemic dynamics, including how individuals respond to their experiences in retirement, shows how these different factors interact and affect retirement and ageing. Further studies should investigate the processes identified with other occupations, as well as women and minority groups.

Precarious Aging: Insecurity and Risk in Late Life.

Population aging and longevity in the context of declining social commitments raise concerns about disadvantage, inequality, and the well-being of older people. In this short piece, we use the concept of precarity as a lens to understand new and sustained forms of insecurity that affect late life, and we illustrate how these risks, when experienced over time and in relation to conditions such as austerity, can deepen disadvantage.

Preventing social isolation in older people.

The extent of social isolation amongst older people has emerged as a major concern for health and social policy. Although the social and health outcomes of social isolation are well documented, evidence regarding the prevention of isolation in later life remains scarce. This article addresses this by presenting the findings from a literature review focusing on the identification, assessment, prevention, and intervention strategies relevant to social isolation in older age. The paper first addresses the issues of identification and assessment, using an ecological framework to identify the risk factors for social isolation at four levels: individual, relationship, community, and societal. It then reviews different types of interventions to reduce or prevent social isolation in later life, including one-to-one, group, service provision, technology-based, neighbourhood, and structural interventions. The paper discusses both the opportunities and the constraints associated with these different approaches. The discussion highlights future directions for research, emphasising the need for a cultural change from 'cure' to 'prevention' of social isolation across the life-course, and the importance of acknowledging greater diversity within the ageing population.

Age-Friendly Communities Initiative: Public Health Approach to Promoting Successful Aging.

Older adults consistently prefer aging in place, which requires a high level of community support and services that are currently lacking. With a rapidly aging population, the present infrastructure for healthcare will prove even more inadequate to meet seniors' physical and mental health needs. A paradigm shift away from the sole focus on delivery of interventions at an individual level to more prevention-focused, community-based approaches will become essential. Recent initiatives have been proposed to promote healthy lifestyles and preventive care to enable older adults to age in place. Prominent among these are the World Health Organization's Global Age-Friendly Communities (AFC) Network, with 287 communities in 33 countries, and AARP's Network of AFCs with 77 communities in the United States. In an AFC, older adults are actively involved, valued, and supported with necessary infrastructure and services. Specific criteria include affordable housing, safe outdoor spaces and built environments conducive to active living, inexpensive and convenient transportation options, opportunities for social participation and community leadership, and accessible health and wellness services. Active, culture-based approaches, supported and developed by local communities, and including an intergenerational component are important. This article provides a brief historical background, discusses the conceptualization of the AFC, offers a list of criteria, narrates case studies of AFCs in various stages of development, and suggests solutions to common challenges to becoming age-friendly. Academic geriatric psychiatry needs to play a major role in the evolving AFC movement to ensure that mental healthcare is considered and delivered on par with physical care.