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Age Friendly Cities

Author: Judith M. Wilson
December, 2018 Issue

The Baby Boomers are graying. In fact, 10,000 of them are turning 65 every day, in a wave that started in 2011 and will continue until 2029, when the youngest reach the standard retirement age, according to a report by The Pew Research Center in Washington, D.C. Their sizeable number makes them the largest demographic group in the North Bay—and throughout the country—and in a new perspective on aging, local communities are tackling the issues it creates head-on and seeking the World Health Organization’s (WHO) official Age-Friendly designation to guide their efforts.

WHO released its policy framework on active ageing in 2002, and its goal is to enhance the quality of life for older adults by optimizing opportunities for health, security and engagement in their communities. The policy is based on the principles of independence, participation, dignity, care and self-fulfillment, as defined by the United Nations, and the global network now has 700 members and is growing. The nonprofit American Association for Retired People—better known simply as AARP—is WHO’s American affiliate and helps facilitate age-friendly status for communities in the United States. Once a city or county is accepted, it makes a commitment for five years, which allows them to create action plans, and if all goes well, it will renew its pledge and continue for another five years.

Marin and Sonoma counties have official Age-Friendly status, and Live Healthy, an initiative of Napa County’s Livable Communities, is incorporating the same elements to develop new strategies for meeting the needs of its aging population. Sausalito earned the Age-Friendly designation in March 2014, becoming the first city in the North Bay and the third in California to do so, and Corte Madera, Fairfax, Mill Valley, Novato and San Rafael followed. Healdsburg submitted an application in August 2018, and other municipalities are actively exploring the concept.

Age-Friendly Sonoma

Sonoma County achieved its status as an Age-Friendly community in 2016 and contracted with nonprofit Council on Aging to find ways to make the county a more livable place for seniors and to work with cities and towns on implementation of an Age Friendly plan for Sonoma County. Social Services Director Renee Tolliver explains that her agency, working with many additional organizations as partners, provides education, promotes awareness and offers services in four areas: financial, legal, nutritional and social. Social programs include case management, senior social clubs, disaster assistance, elder abuse advocacy and mental health services. Financial services provide bonded and licensed financial managers for seniors who need money management assistance. In most cases clients bills are paid and bank statements reconciled at Council on Aging’s office. Other times, a financial manager goes to a senior’s home and provides the services there. Additionally, Council on Aging can act as trustee or conservator. The legal services provide estate planning, including: trusts, wills, powers of attorney and advanced health care directives. The largest program to address nutrition is Meals on Wheels. The meals include one-third of the day’s nutritional requirements, and the person making the delivery to a senior’s door can check on that individual’s welfare.

“Sometimes the delivery person is the only contact a senior has all day,” says Tolliver. She points out that the service provides social interaction and can keep recipients from becoming isolated, allowing them to stay in their homes for as long as possible.

She adds that in an age-friendly community, it’s vital for elders to stay engaged. Council on Aging’s first health and wellness program, the Sonoma Wine Country Games, which runs in June each year, gives the older set a chance to compete in the sports they love, stay physically active and socially connected. More than 1,000 athletes participate in at least 13 different sporting events at a variety of venues throughout the county, with most in Santa Rosa. Each athlete or team preregisters, and tournaments are one or two days, depending on the sport. “Our largest sport is women’s soccer, where we had 26 teams of women ranging in age from 50 to 75 competing,” says Tolliver. And in October, for Fun in the Fall, Bubbles & Bocce took place at Chateau St. Jean Winery in Kenwood, and the Oakmont Golf Club hosted a golf tournament and awards ceremony.

One of the biggest challenges in Sonoma County is housing. Many seniors own large homes, which might be their single largest asset, but they have difficulty maintaining their homes. Council on Aging often refers clients to Share Sonoma, a nonprofit that arranges home-sharing with carefully-defined services in exchange for rent as one solution for seniors who are house-rich, but cash-poor. A sharing arrangement might allow Millennials, who are also housing-challenged, to get reduced rent in exchange for chores, benefitting both generations.

Elders have skills and knowledge to share, says Tolliver, and should they opt to continue their careers, they have a lot to contribute. She observes that diverse work teams are proven to be more productive. “Sidewalks that are wide enough for a wheelchair are wide enough for a stroller,” she says. In addition, walk signs at traffic lights that give seniors sufficient time to cross also make it easier for parents with young children to cross the street. “It’s important to recognize that what’s good for the very young and good for the elderly is also good for everyone in between,” says Tolliver.

Age-Friendly Marin

By 2030, one in three adults in Marin County will be 60 or older, and currently seniors comprise 27 percent of the population, making it one of the oldest counties in California. In recognition of their predominance, the Marin County Board of Supervisors, with supervisors Kate Sears and Dennis Rodoni taking the lead, proclaimed 2018 the Year of the Older Adult. In August, the county submitted an application to join the WHO/AARP global network of age-friendly cities and communities, to focus on the county departments and unincorporated areas.  “They’re a very pro-aging board of supervisors. They were all in support of it,” says Lee Pullen, director of Aging and Adult Services.  It took three weeks for the application to be accepted, making Marin the newest member of the local network. “If we look at the map of Marin, we’ve pretty much got the puzzle completed. We’ve blanketed the county now,” says Pullen, who finds a spirit of cooperation, camaraderie and partnership among the participants.

Pullen is required by federal law to have an advisory board, and the Marin Commission on Aging, which has 23 members, fills that role. “Whoever set this up was brilliant,” he says. Each of the county’s 11 towns and cities appoints a representative. There are an additional two members who are designated to work on state legislation, and the remaining 10 are appointed by the board of supervisors to whom the commission reports. In April, they submitted a report titled Older Adult Housing Report in Marin: Planning for 2030. It addresses the housing challenge that results when aging adults fall into the economic gap because they earn too much to get assistance, but don’t have enough to meet their basic needs. Pullen sees lifelong residents of Marin who have saved, retired and rented their whole lives, doing everything right. However, “They weren’t able to recover from the Great Recession,” he says, and 10 years later, they can’t pay their rent and have to leave the area for somewhere more affordable. “We lose such value when people have to move out of the county,” he says. He describes it as a social justice issue and would like to see adults age 60 and older valued, able to get help when they need it and to live the way they choose. In addition, he believes being inclusive is good for the economy. “We want them to go out and enjoy Marin,” he says. “Older adults are an economic driver as well.”

Livable Napa

Napa County prepared for outreach to older citizens by looking at demographics. “I realized we have more people over 60 than under 20,” says Kristin Brown, deputy director of health and human services, who oversees Comprehensive Services for Older Adults. Napa’s work is based on AARP’s framework for Livable Communities, a term that is replacing Age-Friendly, because it is more inclusive.

Dr. Jennifer Henn, Ph.D., Public Health Manager, Chronic Disease and Health Equity Unit, explains that Napa is using the eight domains of Age-Friendly communities to structure health assessments. “We see those domains as representing social determinants of health,” she says. And in the process, they are engaging community partners to collect a wide range of information. “We want data that tells a story about livability in Napa County,” she says, giving housing as an example because it allows making connections that show how it relates to health.

It’s also considering ways to incorporate principles of the Blue Zones, which are areas of the world, where people typically live into their 90s and beyond in good health, because healthy practices are part of their lifestyle (See “Blue Zones” on page xx). Karen Relucio, M.D., Napa County health officer and public health director, explains that the Blue Zones’ Power of Nine and Age-Friendly’s eight domains of livability intersect and have common components, such as an environment that encourages physical activity and healthy eating and social interconnectedness. It’s easier to make healthy choices when they are easily available.

The age-friendly initiative in Napa is at the county level so far, and it is a multi-sector, collaborative effort that includes county employees, community-based organizations, education, public safety and philanthropy. The Healthy

Aging Population Initiative, HAPI, includes more than 30 agencies in Napa Valley who work with older people and the disabled, and as a coordinating collaborative, it helps to avoid overlap and encourages different entities to work together. Among HAPI’s accomplishments is the Older Adults Survey, which it first implemented in 2005 and updated in 2015. Results from thousands of responses from older adults in Napa County were used to direct work on issues such as transportation, fall prevention and medications.

“We also invited participation from the cities,” says Relucio. She reports that the City of Napa is updating its general plan, and representatives of the city planning department are attending meetings. “It’s using a collective impact approach to move the needle on the issues that impact the health of the community,” she says. Brown gives curb cuts in sidewalks, as an example, because they help people pushing strollers or using bicycles as well as those with wheelchairs. “It doesn’t cost any more money,” she says, and it creates a community that’s walkable and benefits everyone.

Also on the to-do list is increasing awareness, because most people don’t think about the fact that everyone is aging. “We should all have buy-in on this,” says Brown. It’s important to educate the community, she adds, so people will understand that it’s not just about building a community for seniors. “It’s going to benefit everyone,” she says. And according to Relucio, ultimately, she sees a livable communities roadmap that will improve health equity across the board, regardless of age, ability, race/ethnicity or zip code. 

Healdsburg leads

Healdsburg submitted its application to become an Age-Friendly city in September, and in mid-October, it had a big age-friendly gathering and picnic on the plaza to celebrate. “We will be the first in the county, which is super, super exciting,” says Anna Grant, active adult and senior services supervisor. “It means our council is making a commitment to the city.” She explains that the designation is a five-year process, and the city will spend two doing an assessment and creating action plans and the other three on implementation. “It’s pretty eye-opening. A lot is going on that is already age-friendly,” she says, but it’s helpful to have specifics from outside to make sure they’re doing it right.

Among the practices in place, “We’re a very walkable community,” she observes, with wide, well-lit sidewalks and crossing signals long enough for someone to walk across with a cane. A variety of parks, some with walking paths, meet everyone’s needs. Among them is Fitch Mountain Park and Open Space Preserve, which has places to exercise and the opportunity for seniors to teach children about the environment and animals that live there. Also among the city’s amenities is a temporary art space next to Bear Republic, where artists of any age can display their work.

“Housing is a hot-ticket item right now,” says Grant, because the city has an affordable housing requirement, and builders have to meet certain requirements, which is important in an age-friendly community. And “the transportation program is huge,” she reports. Currently, it has a free-fare bus that allows riders to hop on and off anywhere in Healdsburg. “Everybody rides for free,” she says, whether it’s senior or teens. The city has also approved a volunteer program, which includes purchasing a fleet of city-owned electric vehicles and installing charging stations, so volunteer drivers can take seniors to appointments or activities at the senior center. The city’s transit occupancy tax is providing the funding for the program, which will help to reduce isolation. “These transportation options are a shining star in what’s going to make Healdsburg so fantastic,” says Grant, who reports that the electric vehicle program will be in full operation in 2019.

The Neighbors Network of Healdsburg also helps with rides, meals and other tasks from walking dogs to raking leaves. The volunteer program will replicate these opportunities for the community to help one another. “Capturing that spirit of generosity that is alive and well in Healdsburg is what a livable community is all about,” she says.

Creative Novato

A small committee of Novato citizens applied to AARP and WHO (World Health Organization) to obtain Novato’ s Age-Friendly designation, which the City of Novato was awarded in April 2017. Gloria Dunn-Violin, a speaker and writer on retirement and aging, explains that before she became a member, Madeline Kellner, Marianne York, Jean Gunn, Michael Hagerty and Beth Livoti worked together to fill out the application and fulfill other requirements for designation.

Gunn, Livoti and Hagerty presently represent Novato on the Marin Commission on Aging; and Livoti and Gunn are involved with Novato Villages, one of a network of volunteer organizations that provide member services for people who are aging in their own homes. With support from Novato council member Denise Athas, the committee will confer with planners and work with other parts of the community to make sure future development is age-friendly. “Age-Friendly Novato is planning to bring age-friendly into the community in many ways,” says Dunn-Violin, is author of Revivement, Having a Life After Making a Living.

The committee is working on a strategic plan and will incorporate its accomplishments to date. “We’ve just added disaster-preparedness as a ninth domain,” says Dunn-Violin, adding that if all residents are ready, they will know what to do if a disaster strikes. Its biggest project, which is well underway, is the creation of a mural to bring together all generations and foster a spirit of community. The mural will include Novato’s values of inclusion, respect, diversity, participation, kindness and other desirable qualities. It will also show the generations interacting with each other to make Novato a great place to grow up and grow older together. The idea is to start developing the notion that different age groups can come together and support each other in many ways while seeing the best in one another. “With this kind of project, I’m hoping people can participate in activities with other generations and build relationships,” she says, observing that it can work both ways. For example, an older person might teach children about gardening or math or history, and a younger person can teach older adults how to use their phones, computers or other technology. You should look at want you to learn, and find the best person to teach you, regardless of age, she advises.

“We fall short when not using the best of everyone.” The completed mural, consisting of three panels, will measure 8-by-12 feet and is slated for completion by the end of the year. It will be on display at the Margaret Todd Senior Center in Novato, but its design will allow it to travel to community events. “We want this to continue as a developmental piece to promote and encourage the values that are in the framework of the mural,” says Dunn-Violin, who observes that we miss a lot if we don’t include everyone.

Projects like the mural are leading the way in bringing change. “We’re transforming the way our society looks at older adults,” says Pullen, who believes we’re missing out on opportunities to take advantage of the insight and wisdom that older people can offer when we don’t include them. Ultimately, he wants to see ageism disappear and our communities become age-neutral places so people can enjoy the quality of life and have the basics, whatever decade of life they’re in. It’s a vision for livable communities with the diversity that makes a place richer. And age-friendly practices are a way to make it happen.


Blue Zones are areas of the world where residents typically live to be 100 years old or more in good health and lead active lives. National Geographic researcher Dan Buettner identified five Blue Zones—the Barbagia region of Sardinia, the Greek island of Ikaria, the Nicoya Peninsula of Costa Rica, Okinawa in Japan and Loma Linda, California, which has a large population of Seventh-Day Adventists. A research team then searched for common denominators and identified the Power of Nine—the characteristics that exist in all the Blue Zones and appear to contribute to healthful longevity.

The Power of Nine

Move naturally: Instead of working out, movement is part of the everyday experience and occurs naturally in activities such as gardening and housework.

Know your purpose: Having a sense of purpose gives you a reason to wake up in the morning.

Down shift: Blue Zone residents take time out daily to shed stress, whether it’s taking a nap, praying or going to happy hour.

80 percent rule: People in Blue Zones stop eating when they are 80 percent full and their last meal of the day is the smallest.

Plant slant: Beans are the cornerstone of a Blue Zone diet, and the consumption of meat is limited.

Wine at 5: Except for Seventh Day Adventists, adults drink alcohol regularly, but moderately.

Family first: Loved ones come first. Blue Zone residents commit to a life partner, give their children time and love, and keep parents and aging grandparents nearby or in their own homes.

Belong: Most Blue Zone residents belong to a faith-based community.

Right tribe: Being part of a social network that values healthy behavior supports practices that allow people to age in good health.


Age-Friendly Domains

Cities that are members of the World Health Organization’s Global Network of Age-Friendly Cities base their practices on eight domains of livability.

• Outdoor spaces and buildings

• Transportation

• Housing

• Social participation

• Respect and social inclusion

• Civic participation and employment

• Communication and information

• Community support and health services

The Village Network

Villages are nonprofit volunteer organizations that provide a variety of services, such as transportation and home repairs, for seniors who become members and pay an annual fee. The support allows them to age in their own homes, and many villages offer social and educational activities as well.

The first village was in Boston’s Beacon Hill, and from there the movement grew and spread across the country. Villages in the North Bay include the Village Network of Petaluma; Marin Villages, an independent nonprofit that is the coordinating agency for villages in Mill Valley, Novato, Ross Valley, San Rafael, Tiburon and Larkspur-Corte Madera; and Sausalito Village.



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