Campus & Community

Big cities are havens for aging population

4 min read

Great capitals of the world are new ‘retirement communities’

The phrase “retirement communities” calls to mind a number of different kinds of places — high-end gated communities or whole cities built from scratch in Sun Belt states like Florida and Arizona. Or perhaps even dismal trailer parks under the hot breath of a developer who wants to turn the whole place into high-rise condos.

For most people, the phrase probably doesn’t suggest the great world cities of New York, London, Paris, and Tokyo.

But it should. That’s what Victor G. Rodwin, professor of health policy and management at New York University’s Graduate School of Public Service, told an audience in Askwith Lecture Hall at Longfellow Hall April 20.

“Already today there are places where almost 20 percent of the population is 65 years old or more,” Rodwin said. Florida is one of them; Italy is another. Others include certain neighborhoods in New York, London, Paris, and Tokyo.

“The trends point to one obvious conclusion — so obvious that most people don’t talk about it — and it’s that cities will be where older people live. We typically talk about population aging as if it doesn’t matter where you live.” But it does matter, Rodwin said. “And not just what city, but what neighborhood.”

Rodwin was speaking at the symposium “Perspectives from the Future: Tomorrow’s World as Defined by Today’s Research and Planning.” The symposium marked the 30th anniversary of the Harvard Institute for Learning in Retirement.

Rodwin and his Columbia University colleague Michael K. Gusmano have been studying the four cities as mega-examples of what gerontologists call NORCs — naturally occurring retirement communities. They’re looking for policy lessons from the experience of these places.

Rodwin noted that the United States and Europe have witnessed a “quiet revolution” in longevity — with life expectancy increasing an average of three months per year over the past 30 years. From 1900 to 2000, life expectancy at 65 has increased from 12 to 18 years.

Rodwin’s four cities “happen to be the largest cities of some of the wealthiest countries in the world,” he explained. These world cities exercise a disproportionate influence on their countries and the rest of the world. And each has a tradition of seeing itself as unique and incomparable, although there’s a long tradition of comparative studies among them.

Despite the claims of what Rodwin called “the urban health penalty literature,” his own research finds the health status of seniors living in cities to be the same as or better than that of those living in the rest of their respective countries. A 65-year-old male in Manhattan in 2000, for instance, could count on 17 more years, whereas the life expectancy of his counterpart elsewhere in the United States was 16.3 years.

Nor should age necessarily be correlated with poverty: New York City census tracts with high proportions of residents aged 65-plus include some of the wealthiest neighborhoods in New York. And productivity in later years, even by the crude measure of labor force participation, is higher than stereotypes might suggest. In Manhattan in 2000, 27.2 percent of men and 13.6 percent of women aged 65-plus were in the labor force. Inner London had roughly similar numbers. In Inner Tokyo, 53 percent of the men and 24 percent of the women aged 65 or more were in the labor force in 1995. (Mandatory retirement laws in France make Paris the outlier here.)

Yet if aging is not always associated with vulnerability, it certainly is sometimes. The 9/11 attacks in New York City, Hurricane Katrina in New Orleans, and the summer 2003 heat wave in France, blamed for nearly 15,000 deaths, are examples of events that lay bare the isolation of some seniors.

In all four of Rodwin’s world cities, local government steps in to fill gaps in national health care and other services for the elderly. One of the challenges is targeting services for the elderly to their neighborhoods.

In keeping with the implicit theme that “all aging is local,” Rodwin and his colleague have mapped the locations of the vulnerable elderly in New York City.

He presented his “vulnerability index,” which scores census tracts by several different measures, including the proportion of seniors living alone, the proportion of those below poverty level, the proportion of those “linguistically isolated,” the rate of “avoidable hospitalizations” (when problems that should have been treated by a primary physician lead to an emergency room visit instead), and the number of “walk-ups” and vacant lots.

When these data are mapped, it’s obvious that the vulnerabilities are clustered geographically in places like Harlem and the Lower East Side.

The event was co-sponsored by the Kennedy School of Government New England Alumni Association Inc.