Paper short abstract:

The fallouts of demographic ageing colliding with rapid urbanization has led to the reimagining of urban policies to protect the interests of older persons. This urgency is manifested in the WHO’s Age-Friendly Cities and Community (AFCC) paradigm. The reliance on Sen’s version of the capability approach without acknowledging its limitations has implications for AFCC as an urban agenda.

Paper long abstract:

1. Amartya Sen and AFCC – an (unrecognized) debt.

WHO defines age-friendly cities as those with “policies, services, settings and structures support and enable people to age actively” (WHO, 2007, p.5). This builds on the WHO’s understanding of ‘healthy ageing’ as “as the process of developing and maintaining the functional ability that enables wellbeing in older age” (WHO, 2015, p.28, emphasis added); ‘functional abilities’ are “attributes that enable people to be and to do what they have reason to value” (WHO, 2023, xv). Functional abilities are built through intrinsic capacities (mental and physical abilities) and the environmental (built environments, social policies related to health, pension, work). [ For reasons that are not clear, and in spite of the obvious debt, Sen's capability approach is not acknowledged as the philosophical inspiration in foundational texts of AFCC]

The focus of this paper raises is whether the limitations of Sen’s version of the capability approach are being transmitted to AFCC vision for cities. Let us take two of the aspects of this version that scholars have critiqued – (1) that defence of market solutions (Gasper and van Staveren, 2003; Selwyn, 2011) and (2) the assumption that individual skills of reasoning result in democratic-plural outcomes (Deneulin, 2011). First, Sen has a steadfast reluctance to question markets as mechanisms for enhancing freedoms (Selwyn, 2011). Given that markets are unavoidable institutions in the modern world, Sen asks how “any reasonably critic could be against the market mechanism…” (Sen, 2000, p.142). Sen is correct to view markets is an upgrade from slavery and bonded labour but fails to acknowledge the constrains a market society set on the range of capabilities a person can value (Selwyn, 2011).

Second, Sen believes that reasoning can dissolve disagreements over principles for organizing societies through examining deeply-held prejudices and entrenched interests. Sen’s assumption that persons unyoked from authority (given the right education and freedom to participate freely) would only reason for equality is unfounded (Deneulin, 2011). Reasoning is filtered through webs of significance which may be seeped in injustice and “individuals who act within an unjust structure may even have a sense of acting justly” (Deneulin, 2011, p.794).

Implications for AFCC.

Recently, WHO has shifted the preferred vocabulary from ‘active ageing’ has shifted to “healthy ageing” which reflect a shift from public provision of health to market interests. The repeated use of “resource” to refer to older persons is revealing. For instance: healthy ageing is expected to enable “older people to remain a resource to their families, communities and economies” (WHO, 2018, p.3 emphasis added). This shift from the active ageing paradigm to healthy ageing is reflected in the AFCC discourses too (c.f. WHO, 2007 and WHO, 2023). The shift towards neoliberal global discourses of health and ageing (for instance shifting responsibility from the state to citizen) have consequently influenced, inevitably, the meanings of age-friendliness. For example, implementation of age-friendly programmes co-exists with steady dismantling of the welfare provisions for older persons and spaces for profit-oriented actors control policymaking (Joy, 2021; Buffel and Phillpson, 2018). Indeed, the acceptance of age-friendly discourses into urban agendas can be traced to, this paper argues, to the accommodation of markets in Sen’s conception of capability approach noted above.

Furthermore, indicator of age-friendliness does not foreground indicators of democracy. Cities could score high on measures of age-friendliness even in authoritarian and fascist contexts. Indicators of accessibility to public spaces and state-supported facilitation of social participation can be positive even when democratic indicators are downsliding. Fascist regimes gaining support from resentments surrounding market-led dismantling of welfare tend to provide welfare when in power, but only to the communities they claim to protect. The consequences for older persons, particularly of those belonging to minorities and dissenters, in the contexts wherein policies institutionalize ethnic and religious supremacy – voting restrictions in the United States, anti-minority laws in India – age-friendliness may benefit only, by design, the older persons belonging to dominant groups.

Conclusion

AFCC is a significant expansion of policy attention to include the interests of older persons in urban agendas. Sen’s capability approach has, like in other domains like education and gender equality, has restrained purely economistic policy styles from dominating policy priorities. Nevertheless, in the context of increasing role of private interests in urban policymaking and steady dismantling of democratic institutions, this paper argues that the the proponents of AFCC should recognize and contain the undesirable consequences stemming from the limitations of Sen’s capability approach.

References.

References

Buffel, T., & Phillipson, C. (2018). A manifesto for the age-friendly movement: Developing a new urban agenda. Journal of aging & social policy, 30(2), 173-192.

Deneulin, S. (2011). Development and the limits of Amartya Sen's The Idea of Justice. Third World Quarterly, 32(4), 787-797.

Gasper, D., & Van Staveren, I. (2003). Development as freedom ¬- and as what else?. Feminist economics, 9(2-3), 137-161.

Joy, M. (2021). Neoliberal rationality and the age friendly cities and communities program: Reflections on the Toronto case. Cities, 108, 102982.

Moulaert, T., & Biggs, S. (2013). International and European policy on work and retirement: Reinventing critical perspectives on active ageing and mature subjectivity. Human relations, 66(1), 23-43.

Selwyn, B. (2011). Liberty limited? A sympathetic re-engagement with Amartya Sen’s Development as Freedom. Economic and Political Weekly, 46(37), 68-76.

Sen, A.K. (2000). Development as Freedom. Oxford University Press

Sen, A. K. (2009). The idea of justice. Harvard University Press.

Walker, A. (2018). Why the UK needs a social policy on ageing. Journal of social policy, 47(2), 253-273.

World Health Organization (WHO). (2002). Designing health financing systems to reduce catastrophic health expenditure, Technical Briefs for Policy Makers, https://www.who.int/health_financing/pb_2.pdf

World Health Organization (WHO) (2007a). The checklist of essential features of age-friendly cities; World Health Organization: Geneva, Switzerland, 2007.

World Health Organization (WHO). (2015). World report on ageing and health. https://www.who.int/ageing/events/world-report-2015-launch/en/

World Health Organization (WHO). (2023). National programmes for age-friendly cities and communities A guide, https://www.who.int/teams/social-determinants-of-health/demographic-change-and-healthy-ageing/age-friendly-environments/national-programmes-afcc