Central Policy Unit Research Project: Age-friendly Housing Policies
Population ageing is an imminent soical issue in almost all countries. Hong Kong is one of Asia's demographically-aged cities, with the age group of 60 and above increased from about 15% to 19% from 2001 to 2011, and expected to reach 27% in 2021. To Facilitate policymakers to apply the concept of active ageing, the World Health Organization (WHO) proposed an "Age-friendly Cities" Framwork in 2007 by identifying 8 essetial elements (housing, transportation, outdoor spaces and buildings, social participation, respect and social inclusion, civic participation and employment, communication and information, as wll as community sppport and health service) an a detailed checklist on how to establish an age-friendy city. This studt intends to provide an overall picture of the ageing population's situation in Hong Kong, with the focus on the framework of age-friendly cities and particulatly, the elderly housing policy.
This is an exploratory study combining both qualitative and quantitaive researh methodologies. Literature review, interviews, focus groups, public forums and survey were carried out in collecting views from various stakeholders. Representatives of the project team also paid site visits and attended related conferences, seminars and exhibitions to gather more up-to-date information in the fields and have a deeper understanding in specific topics.
The number of elderly households grew rapidly in the past ten years in line with the ageing population. Having "ageing in place as the core, institutional care as back-up" as the underlying principle of the elderly care policy, it is the government as well as the society‘s wish to let the elderly live in the residence of their choice safely andindependently, supported by the provision of required facilities and social services. Agap-analysis of the existing situation in Hong Kong with the WHO framework is conducted in this study in respect of affordability, availability, and adaptability.
Some recent international and regional studies on housing related issues have reported that Hong Kong has been rated top, but in a negative sense. This includes the most unaffordable housing worldwide for 5 consecutive years, the most densely populated in the high income world urban area and the most expensive in the Region to build, all reflecting indirectly on how far Hong Kong has achieved in terms of ‗age friendly housing‘.
It is difficult to attain ‗age friendly housing‘ in Hong Kong because of soaring property prices (affordability), limited choices of suitable housing types for elderlies (availability), as well as cramped and inflexible flats (adaptability). These are mainly due to inattention in the past to have ignored long term population policy, and to allow cumulative shortage of housing supply in public and private sectors. The current Government is therefore facing a severe legacy backlog of housing demand, which leads to the continuous surge of property prices. The situation is expected to continue because of ultra-low interest rates and cost escalation in the construction industry. Besides, undue delay in the application for housing development projects submitted by the private developers has been caused by different and incompatible standards for the review process adopted by different Government departments, thus leading to the slow process of housing production.
Expenditure on social services has accounted for half of public expenditure, and tremendous efforts have been paid by the Government to support the very poor, especially in public housing. However, there are still some more vulnerable groups of elders in the society that need Government‘s concern and redress of the current social policies and systems to assist them. They are the homeless, disabled and lower middle class elders.
On the other hand, software support to achieve age friendly housing is also insufficient, and this may account for a long waiting list for the Residential Care Homes for Elderlies, and a high institutionalisation rate of 7% in Hong Kong, which is among the highest in Asia.
The major obstacles to ageing in place are from limitations in both hardware and software aspects. The small- and medium-sized flats in Hong Kong hinder cross-generational co-residence living arrangement. Most of the elderly flat owners in the lower income group are living in old dilapidated buildings which either need urban redevelopment or substantial renovation which may require their relocation. Besides, the flats they are living in are not purpose built for elderlies. In Hong Kong, the existing general housing stock in both public and private sectors is built on the assumption that occupants will be able-bodied without any physical impairment. In view of the increasing ageing population, there is a pressing need to plan for housing that is appropriately designed for the life cycle.
In spite of the Government‘s advocation for ageing in place, the Long Term Care System in Hong Kong heavily relies on residential care. Compared with the community-care service placements provided by the Government that would allow elders to stay in the community, the resources put into institutionalisation far exceeds that of community care services.
The obstacles to enhance ageing in place include the lack of family support and the shortage of manpower in care-giving. Care provision is challenged by declining family ties, and the increased presence of women in the labour force also leads to a diminishing supply of caregivers at home. While the Government is trying to enable women to work by providing child care services and training, it is also necessary to keep in view the need for home carers for the elderlies, unless a comprehensive family caregiver support programme is formulated. There is also a serious lack of care-givers in the care industry in terms of quantity and quality, and more practical measures are needed to tackle the roots of the problems.
As a conclusion, the necessary home support and health services, including accessible and affordable personal care, health services, homemaking services, home maintenance and adaptation, as well as caregiver respite are still insufficient for elders to opt for ageing in place.
The following is a table summarising the recommendations in Chapter 4. It includes proposals for co-ordination of Government services and issues regarding affordability, availability and adaptability of housing as well as institutionalisation. Proposals for shared responsibilities in actualising age friendliness in Hong Kong are also suggested to be provided by various stakeholders, including families, the Government, Statutory Organizations, District Boards, the community, NGOs, the private sector and the individuals in the society.
The PDF version will include the summary of recommendations.