Environmental and Policy Systems to Enhance Healthy Aging: Rationale and Evidence

There is growing interest in developing and evaluating environmentally-based policies and programs to enhance health and well-being in a growing and increasingly diverse aging population. Although there is a growing body of research in public health indicating that elements of the built environment, e.g., land-use patterns, housing, and transportation systems, are associated with health, functioning, and mobility, there are significant challenges associated with the development and evaluation of programs and policies derived from that research. The rationale and evidence for environmentally-based programs and policies are reviewed. Special attention is given to the distinction between programs and policies based on “environmental adaptation” and “environmental modification.” Environmental adaptations do not require actual changes to the built environment. Instead, programs, such as safe walking and driving routes, are designed to link older adults to the best features of the existing environment. In contrast, environmental modifications entail actual structural changes to the environment, such as construction, repair, and alterations of sidewalks and roadways. Finally, a research and policy agenda, based on elements of the built environment, is presented to enhance healthy aging