ABSTRACT
The realization of age-friendly communities requires as much demolition as creation: undoing decades of public infrastructure investment, reimagining community design and regulation, extracting the one-track inflexibility from current transportation systems, and reconsidering where health care is provided and how it is financed. Communities are faced with decisive demolition because significant public investments were implemented, and continue to be implemented, without consideration for the needs, wants, and desires of changing bodies and minds. It is overwhelming but necessary to face the reality that policies, programs, and funding at all levels of government—federal, state, and local—largely ignored the increasing longevity that resulted from the dramatic medical, scientific, and public health advancements of the twentieth century. As a result of this century-long lapse, physical barriers to successful aging are now deeply embedded in the built environment, and policy barriers are deeply embedded in public institutions.
