On the surface, the Age-Friendly Cities and Communities (AFCC) movement presents an appealing vision of urban planning and social policy. Championed by the World Health Organization and AARP in the United States, these initiatives emphasize positive, hopeful themes: livability, engagement, social participation, walkability and inclusivity. The movement’s constructive, non-threatening framing has made it attractive to municipalities and state agencies seeking manageable ways to address older populations. Despite positive changes such as the installation of new benches or accessibility upgrades, questions remain about whether these efforts address the structural reforms that older adults truly need.
However, beneath this optimistic veneer lies a more complex, nuanced reality. Critical scholarship argues that while Age-Friendly programs deliver visible local improvements, they can function as a depoliticized cover for inaction on the structural reforms older adults need—housing security, living-wage home care, and anti-discrimination enforcement. The emphasis on technical solutions, critics argue, enables governments to sidestep the political choices inherent in social care, housing and labor policy.
The Appeal of Depoliticized Reform
The Age-Friendly movement’s popularity stems partly from sidestepping contentious political debates. Framed as technical rather than ideological, AFCC initiatives provide local officials with pathways to demonstrate concern for aging populations without confronting entrenched interests or expensive commitments. Municipalities can adopt “Age-Friendly” labels and receive official recognition through relatively low-cost improvements like better lighting, clearer signage or volunteer-driven programs.
What we have is a form of policy theater that can impede more substantial reforms by creating the appearance of comprehensive action.
This depoliticized approach aligns well with contemporary neoliberal governance structures. Research on cities like Toronto demonstrates how AFCC programs can be absorbed into austerity-minded local administration, emphasizing cost-efficient, volunteer-based, or market-friendly solutions while avoiding state commitments to expanded public services. The movement’s language of “friendliness” and community engagement masks what are fundamentally redistributive questions about who pays for care, housing and support services for an older population.
The Gap Between Promise and Practice
Buffel argues that while improvements to walkability, signage and programming are important, they don’t resolve the structural exclusions that shape older adults’ daily experiences. The focus on physical infrastructure and social programming, though valuable, often operates independently from addressing poverty, racism, discrimination, housing insecurity and inadequate long-term care systems for many older adults, especially those from marginalized communities. Sidewalk improvements mean little if local residents can’t afford housing, if transportation remains inaccessible, or if they face discrimination in healthcare.
This disconnect is particularly evident in how AFCC initiatives engage—or fail to engage—with older adults who are poor, immigrants, living with disabilities, LGBTQ+, or from racial minorities. These populations often don’t see their realities reflected in age-friendly reports and strategic plans. The movement’s emphasis on broad community engagement can inadvertently privilege the voices of more affluent, connected residents, while marginalizing those who face the greatest barriers to participation in public processes.
The Problem of Policy Laundering
Perhaps most concerning is what some researchers refer to as the “policy laundering” effect of Age-Friendly initiatives. Municipalities can tout comprehensive Age-Friendly plans as major policy deliverables, generating positive publicity and potentially accessing dedicated funding streams, while state and federal responsibility for long-term care financing, affordable housing development, and labor standards remains unchanged. Local officials can point to their Age-Friendly certification as evidence of commitment to older residents, even as broader policy frameworks continue to generate exclusion and insecurity for vulnerable older populations.
This dynamic allows different levels of government to avoid accountability for the structural factors that most profoundly shape aging experiences. Cities implement visible but limited improvements, while state and federal policymakers avoid addressing Medicare gaps, Medicaid underfunding, housing policy failures, and labor standards in the care industry. The result is a form of policy theater that can impede more substantial reforms by creating the appearance of comprehensive action.
Toward More Meaningful Reform
Transforming Age-Friendly initiatives from symbolic gestures into meaningful change requires confronting the movement’s current limitations. However, recent advocacy efforts demonstrate what a more substantive aging policy might look like when it directly engages with structural inequities rather than avoiding them.
Equity must become an explicit, measurable priority, rather than an aspirational one, if age-friendly efforts are to work for everyone.
The Dignity Alliance’s comprehensive approach to long-term care reform in Massachusetts offers an enhancement to Age-Friendly initiatives. Rather than focusing on municipal amenities, its proposal tackles the redistributive questions that AFCC programs do not emphasize—demanding living wages for direct care workers, protecting Medicaid funding, requiring actuarial analysis of future care demands, and establishing cabinet-level governance reform. Their focus on the 90% of older adults who prefer home-based care, combined with attention to MassHealth recipients and immigrant workers, exemplifies the equity-centered approach critics say is missing from Age-Friendly programs.
This state-level initiative illustrates key principles that could transform Age-Friendly efforts. First, equity must become an explicit, measurable priority rather than aspirational. Dignity Alliance’s call for an Office of Older Adult Advocate and mandatory interagency coordination exemplifies accountability mechanisms that could prevent public officials from using Age-Friendly programs as covers for inaction. This requires data stratified by race, income, disability and language, ensuring marginalized older-adult representation in governance structures.
Second, Age-Friendly efforts must move beyond technical fixes to address policy frameworks generating exclusion. Dignity Alliance’s “dual-track strategy” demonstrates how aging policy can simultaneously address immediate institutional needs, while pursuing long-term structural reforms in housing, healthcare and labor policy. This requires linking AFCC initiatives to housing policy reforms like tenant protections and affordable housing requirements, labor standards ensuring living wages for care workers, and healthcare policies addressing discrimination and access barriers.
The Massachusetts example suggests that the problem may not be with place-based aging policy per se, but with the scale and depth of current Age-Friendly approaches. Municipal AFCC programs could become more substantive if supported by state-level structural reforms that provide the policy foundation missing from local initiatives. But, even ambitious state-level proposals face implementation challenges, as evidenced by Massachusetts’s history of “vague aspirations” in previous aging plans that lacked effective enforcement mechanisms.
Conclusion
The Age-Friendly Cities and Communities movement reflects genuine concern about supporting older populations in an era of demographic change. Its emphasis on community engagement, physical accessibility, and intergenerational connection addresses real needs and has produced meaningful improvements in many communities. However, framed as “friendly” and technical, the movement risks channeling policy energy toward low-cost fixes, while letting governments off the hook for the redistributive choices embedded in social care and housing policies.
Recent advocacy efforts, such as the Dignity Alliance’s comprehensive reform proposal in Massachusetts, demonstrate what aging policy can achieve when it directly confronts structural inequities rather than avoiding them. Their approach—demanding living wages for care workers, protecting vulnerable populations, and establishing accountability mechanisms—illustrates the kind of substantive reform that critics argue is missing from typical Age-Friendly programs. The contrast suggests that municipal AFCC initiatives could become more meaningful if supported by broader structural reforms at the state and federal levels.
To be meaningful for marginalized older adults, Age-Friendly efforts must include explicit equity metrics, dedicated funding for outreach and services, and accountability for workforce and housing policies that for now generate exclusion. Without these elements, the movement may continue to serve as what critics describe as a well-meaning but ultimately insufficient response to the complex challenges of creating truly inclusive communities for older populations. The question is not whether Age-Friendly initiatives should exist, but whether they can evolve beyond their current limitations to address the structural inequities that shape how different groups experience aging in American communities.
James Lomastro, PhD, has more than 40 years’ experience as a senior administrator in healthcare, human services, behavioral health, and home- and community-based services. For 20 years, he was a surveyor at the Commission on Accreditation of Rehabilitation Facilities throughout the United States and Canada. Lomastro chairs the Veterans Services Work Group at Dignity Alliance Massachusetts.
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