A massive shift is taking place in the makeup of the world population, and societies are already struggling to cope. By 2030, more people worldwide will be over the age of 60 than under 10.1 Realizing the benefits of an older population—while addressing the difficulties and realities—will be one of the great human challenges of the 21st century.

Cities are ground zero for the demographic shift—eight in 10 US residents 65 and older already live in metropolitan areas, 2 underscoring the need to view population aging with the same sense of urgency as climate change, public safety, homelessness, or any major urban priority.

Healthy aging means living a long, productive, meaningful life and enjoying a high quality of life. Research demonstrates that older adults who adopt healthy behaviors, use preventive health services, and are involved with their family, friends, and communities are healthier and more independent.

Aging in a healthy way is closely linked to older adults’ physical, social, and economic environments, and where one ages is a key determinant of how long she or he will live. Many Americans expect to celebrate birthdays well into their 70s, 80s, and beyond, but not everyone is experiencing longer lifespans. A widening longevity gap across cities and regions poses troubling questions about how health, prosperity, and environment make an uneven impact across the social landscape. In fact, a difference of 20 years separates US counties with the longest and shortest typical life spans based on life expectancy at birth. Globally, a similar gulf exists between longer-living countries like Japan
and India. To narrow the longevity gap and promote purposeful, productive, and healthy aging, cities can take the lead to integrate older adults into policies and planning across multiple domains.

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