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How environments can promote active aging: results from a case study of two municipalities in Quebec, Canada

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Abstract

Objectives

To address global aging, a paradigm shift is needed from disease prevention and treatment towards active aging, i.e., optimizing opportunities for health, participation, and security as people age. Little is known about how age-friendly environments promote active aging. This study thus aimed to explore how (through which mechanisms and in what contexts) environments can promote active aging and, specifically, positive health, social participation, and health equity.

Methods

Using a realist approach and semi-structured focus groups, a case study was used in two Quebec municipalities known for best fostering active aging. Data also included participants’ logbooks, sociodemographic questionnaires, municipalities’ sociodemographic profiles, and policy documents. A conceptual framework and thematic content analysis were carried out.

Results

A total of 24 participants (9 older adults, 4 health professionals, 3 community-based actors, 5 municipal employees, and 3 elected officials) took part in 5 focus groups. Regarding contexts, both cases were midsize municipalities having an income and education level higher to Quebec’s averages with supportive active aging policies. Two main themes explained how the environments promoted active aging: (1) by ensuring proximity through built (urban planning), social (network structures), services (variety and availability of local and outreach resources), and organizational (active listening to older adults’ needs for active aging) environments; and (2) by fostering transversality through built (universal accessibility, intergenerational spaces), social (intergenerational opportunities for social participation), and political/organizational (unified and complementary policies) environments.

Conclusion

To better promote active aging through age-friendly environments, practices should focus on fostering proximity and transversality, and act simultaneously on multiple environments.

Résumé

Objectifs

Pour faire face au vieillissement des populations, un changement de paradigme est requis allant de la prévention et du traitement de la maladie vers la promotion d’un vieillissement actif, c.-à.-d. l’optimisation des possibilités de bonne santé, de participation sociale et de sécurité pendant l’avancement de l’âge. Peu d’informations renseignent sur comment les environnements favorisent le vieillissement actif. Cette étude visait donc à explorer comment (par quels mécanismes et dans quels contextes) les environnements favorisent le vieillissement actif et, spécifiquement, la santé positive, la participation sociale et l’équité en santé des aînés.

Méthodes

Selon une approche réaliste et des groupes de discussion semi-dirigés, une étude de cas multiples a été réalisée dans deux municipalités québécoises, reconnues pour favoriser un vieillissement actif. Les données incluaient aussi les journaux de bord et les questionnaires sociodémographiques des participants ainsi que les profils sociodémographiques des municipalités et leurs politiques municipales. Les données ont été traitées à l’aide d’un cadre conceptuel et d’une analyse de contenu thématique.

Résultats

Un total de 24 participants (9 aînés âgés de 65 ans ou plus, 4 professionnels de la santé, 3 acteurs communautaires, 5 employés municipaux et 3 élus) ont pris part à un des cinq groupes de discussion. Concernant les éléments de contexte, les deux municipalités étaient de taille moyenne et présentaient des revenus et un niveau de scolarité supérieurs à la moyenne québécoise ainsi que des politiques municipales favorisant un vieillissement actif. Deux thèmes principaux expliquaient comment les environnements favorisaient le vieillissement actif : 1) en assurant la proximité des environnements bâti (aménagement urbain), social (structures des réseaux sociaux), des services (ressources locales et de proximité) et politique/organisationnel (écoute active des besoins des aînés pour un vieillissement actif); et 2) en favorisant la transversalité des environnements bâti (accessibilité universelle, espaces intergénérationnels), social (opportunités intergénérationnelles) et politique/organisationnel (politiques unifiées et complémentaires).

Conclusion

Pour mieux promouvoir le vieillissement actif grâce à des environnements conviviaux aux aînés, les pratiques doivent privilégier la proximité et les approches transversales, en plus d’agir sur plusieurs environnements simultanément.

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Fig. 1

Adapted from Global age-friendly cities: A guide, World Health Organization, Part 3. How the Guide was developed, p. 9, Copyright (2022)

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Availability of data and material

Data will be available upon request to the corresponding author.

Code availability

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Funding

This study was supported by the Canadian Institutes of Health Research (CIHR; # 284179). Mélanie Levasseur is a CIHR New Investigator (salary award #360880; 2017–2022) and Fonds de la recherche du Québec Santé (FRQS) Senior Researcher (#298996; 2021–2025).

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Authors and Affiliations

  1. Direction Régionale de Santé Publique de La Montérégie, CISSS of Montérégie Centre, Longueuil, QC, Canada

    Anne-Lou McNeil-Gauthier & David-Martin Milot

  2. Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, QC, Canada

    Anne-Lou McNeil-Gauthier, David-Martin Milot & Mélanie Levasseur

  3. Research Centre On Aging, CIUSSS de L’Estrie-CHUS, Sherbrooke, QC, Canada

    Mélanie Levasseur

Authors
  1. Anne-Lou McNeil-Gauthier
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  2. David-Martin Milot
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Contributions

A-LM-G drafted the manuscript. D-MM and ML helped draft and extensively revised the manuscript. All authors have approved the final manuscript and are willing to take responsibility for appropriate portions of the content.

Corresponding author

Correspondence to Mélanie Levasseur.

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This project has been approved by the CIUSSS de l’Estrie-CHUS Research Ethics Committee (# 2017–656).

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Written informed consent was obtained from participants before data collection.

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The authors declare no competing interests.

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McNeil-Gauthier, AL., Milot, DM. & Levasseur, M. How environments can promote active aging: results from a case study of two municipalities in Quebec, Canada. Can J Public Health 115, 117–131 (2024). https://doi.org/10.17269/s41997-023-00806-0

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  • DOI: https://doi.org/10.17269/s41997-023-00806-0

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