Infrastructure for 21st Century Aging America

President Trump’s coming tax reform proposal is expected to include infrastructure spending: one of the few issues where there’s the potential for bipartisan consensus and progress. However, while many may be envisioning updating our 20th century highways, bridges and tunnels, a 21st century approach will be to account for our era’s megatrend of an aging society. The aging of America is certain, where the share of adults over 50 will grow from roughly 1/3 today – around 110 million Americans – to well over 40% by mid-century. Yes, we’re living longer, but we’re also experiencing lower birthrates, which ought to guide our decisions for what 21st century American infrastructure looks like.

Aging-focused infrastructure would follow in the American tradition of ambitious projects that engage with the realities of the time. In the 19th century, we built railroads that allowed a young, growing America to travel across the continent and seize new opportunities. Our railroads connected a continent that no other nation achieved – not Europe across its separate nations; not Australia, Canada, or Russia, which are all continent-wide, but without the American vision that resulted in our one nation from “Sea to shining Sea.” Then in the 1950s, it was the Interstate Highway System that was one of the principal enablers for the growth of 20th century America – an economic prosperity that underpinned American global leadership.

So, what is our equivalent today? Perhaps a vision that is built on America’s 21st century demographic realities, connected to citizenship needs and demands as well as goals for continued economic growth. One that will produce age-friendly cities that enable a healthier and more active aging; one that gives solutions to today’s and tomorrow’s citizenship requirements, as earlier infrastructure projects met theirs.

Here are some places to start: meeting needs that include housing, education for life-long learning, elder caregiving, healthier urban environments, and re-imagined transportation design. Nor should we miss that our rural states, too, are in scope – just ask North Dakotans.

We can create the infrastructure for cities and rural environments that enable older adults to continue engaging and contributing to their local communities, while also supporting their healthcare, transportation, and wellness needs. Some leaders are what the WHO has called Age-Friendly Cities, or those in the Milken Institute’s report on the Best Cities for Successful Aging 2017. This report is a list of cities that are achieving these goals, and analysis of how they’re doing it. For some it may come as a surprise that most of the Successful Aging cities aren’t located in traditional retirement destinations like Florida and Arizona, instead they’re in places like Provo, UT, Madison, WI, and Chapel Hill, NC. Why? Though these are college towns, they’re also a great place to age, providing widespread employment opportunities, effective health infrastructure, and a range of innovative housing options. Instead of cordoning off older adults, they embrace them as a vital pool of workers, consumers, neighbors, and community members.

Or consider the growing need for more and better housing options for those 50+. Currently, roughly 40 percent of housing in the US doesn’t have accessibility design features such as extra-wide hallways and doors, lever-style handles, and safety rails. Sure, retrofitting homes to include these features may not be as big (or expensive) as a 2,000-mile wall, but with roughly 10,000 Americans turning 65 each day, it would do far more to improve the daily lives of Americans. Alternatively, cities and states could launch programs to encourage or build intergenerational housing, update public transportation for aging and mobility, and create later-life learning opportunities that flip the education-work-retirement paradigm on its head. That’s what older Americans really want.

Such infrastructure improvements would dovetail with other innovations to address the needs of an Aging America. If housing and transportation enable aging in place, then more people can take advantage of in-home elder care, which meets the fact that 9/10 older adults desire to continue living at home. The resulting cost savings would mitigate or entirely pay off the cost of improving infrastructure, as in-home care is privately funded and has been shown to save billions in avoided hospital costs. Keeping older adults living and working in their communities would also swell the size of the workforce, helping to usher out the outdated notion of retirement and tap the experience of older employees. And it would enable more older American to take advantage of educational programs and training to continually update their job skills.

So, as infrastructure rises to the top of the Beltway agenda, we should re-frame the conversation through the lens of an aging America – the real America, which is ours at least through our 21st century. Political leaders and constituents should ask how potential infrastructure plans can be used to reshape our country – literally – to better match the realities we face. This would launch projects that forge bipartisan agreement and provide practical benefits to tens of millions of Americans for decades to come. It would also show leadership globally, where the one billion over 60 today will reach 2 billion by mid-century, also representing a world of more old than young. If our children and children’s children start making babies again – in the U.S., across Europe, in Asia and every society as it modernizes – than our 22nd century might look different. But for now, any infrastructure build is a waste if it is not designed through the aging society screen.

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