百瑞·威爾遜 岳陽[譯]

介 紹

伴隨中國推行獨生子女政策，全球城市化趨勢加劇了發(fā)達經(jīng)濟體人口老齡化導(dǎo)致的人口結(jié)構(gòu)轉(zhuǎn)變（圖1）。為老年人提供適當(dāng)?shù)某鞘嘘P(guān)懷已成為迫在眉睫的挑戰(zhàn)，但到目前為止的重點主要是為老年人提供充足的居住場所。而近期經(jīng)常被提及的“居家安老”模式以及必要的“社區(qū)式關(guān)懷”在一定程度上彌補了公共醫(yī)療支持的不足。這實際上已將更廣泛的城市公共領(lǐng)域定位為向老年人提供幫助的關(guān)鍵部分。

警示信號

近年來，香港城市設(shè)計學(xué)會越來越意識到城市環(huán)境在滿足老年人口需求方面所面臨的嚴(yán)峻問題。2017年初，政府統(tǒng)計出2016年中期人口統(tǒng)計的官方結(jié)果顯示，人口的年齡中位數(shù)由10年前的39.6歲增加至43.4歲，這引起了嚴(yán)峻的警示。65歲或65歲以上人口的比例從2006年的12%增高至16%。1986年，這一數(shù)字僅為8%。社會老齡化是一個漸進的過程，很容易被人忽視，然而如果我們現(xiàn)在再向前看20年，這種差異就會變得非常明顯，香港65歲以上的人口數(shù)量已達到香港人口的31.1%。

考慮到城市環(huán)境在城市普遍使用及環(huán)境健康方面不理想的情況，學(xué)會決定將注意力集中在現(xiàn)有人口老齡化的城市范圍內(nèi)。學(xué)會優(yōu)先考慮那些致力于思考和投入面向未來發(fā)展的公共或私人開發(fā)項目。我們構(gòu)思了一種三管齊下的方法，首先進行的研究被作為2018年2018 HKIUD大會“樂享退休生活行動—為全民城市設(shè)計”的討論重點。會后明確了行動計劃和目標(biāo)、啟動了一個試點項目，公布關(guān)鍵的城市設(shè)計要素，使老齡人口保持活力、健康和參與，從而繼續(xù)為社會、社區(qū)做出貢獻并減少護理負擔(dān)（圖2—圖10）。

學(xué)會繼續(xù)探索我們的城市如何更具包容性的物質(zhì)和社會問題，以及為什么更好的城市設(shè)計對于加強我們社區(qū)的文化聯(lián)系至關(guān)重要，特別是人口老齡化問題，包括步行、有活力生活環(huán)境、運輸方式、社會參與、醫(yī)療保健和綜合用途發(fā)展。積極的老齡化研究有以下目標(biāo)。

第一，概述優(yōu)秀具有包容性的城市設(shè)計應(yīng)具備的關(guān)鍵的“軟件”“硬件”，例如從政策、步行性、住房等角度來看。

第二，探索如何將來自世界各地的創(chuàng)新項目的最佳實踐研究案例應(yīng)用于我們的城市。

第三，明確在具體政策和城市設(shè)計方面什么可以有效地為香港的老年人服務(wù)。

第四，影響政府如何規(guī)劃城市以適應(yīng)人口快速老齡化的增長。

第五，突出業(yè)內(nèi)專業(yè)人士將面臨的機遇和挑戰(zhàn)。

圖 1 / Figure 12016年中期人口統(tǒng)計圖 / 2016 Population By-census-Graphic Guide

圖 2 / Figure 22018 HKIUD 研討會（2）/ HKIUD Conference 2018 (2)

得到一些事實

“香港城市環(huán)境中的老齡化人口—體驗工作坊”最初于2008年3月舉行，是由香港生命科技大學(xué)、P＆T集團及香港圣公會福利會（SKHWC）聯(lián)合舉辦的一項重要的會前研究活動。工作坊得到約40名目標(biāo)參與者的支持，包括伯納黛特·林（Bernadette Linn）女士（規(guī)劃及土地發(fā)展局常任秘書長），托尼·謝（Tony Tse）先生（建筑、測量、規(guī)劃及景觀立法會議員），西爾維婭·林（Sylvia Lam）女士（建筑署署長），雷蒙德·李（Raymond Lee）先生（規(guī)劃署署長），愛麗絲·萬（Alice Wan）女士（南區(qū)健康及安全協(xié)會有限公司董事會成員）及蘇珊·黃（Susanne Wong）女士（中環(huán)區(qū)民政事務(wù)專員）。參與者能夠試穿香港歷耆者（Eldpathy—empathy for elderly) HK提供的“老年模擬服裝”，該組織鼓勵通過體驗項目參與老年慈善事業(yè)。該設(shè)備是臺灣自行車與健康技術(shù)產(chǎn)業(yè)研發(fā)中心（CHC）的專利發(fā)明，由醫(yī)生、護士、生理學(xué)家和社會工作者等專業(yè)人士開發(fā)，包括一些特殊設(shè)計的障礙，如重物、支架、松緊帶、束帶和一副模糊的眼鏡，讓參與者感受到老年人如何彎曲身體，掌握老年人的身體經(jīng)驗。在志愿者的協(xié)助下，參加者在西區(qū)參與多項典型的戶外日常生活老人活動，例如參觀西區(qū)長者社區(qū)中心，在公園內(nèi)試用社區(qū)設(shè)施和老人健身器材，最終經(jīng)歷了老年人面臨的不同的現(xiàn)實生活困境。

開展這項研究的一個關(guān)鍵部分是建立一個數(shù)據(jù)集（表1—表7），可以重點就老年城市活動的主要障礙和啟示得到收集和呈現(xiàn)。在佩戴老年人模擬服裝之前，工作坊對參與者開展了一項在線調(diào)查，并在體驗之后衡量其對當(dāng)前身體的狀況與他們未來可能的情況之間的感知變化。參與者不僅要了解他們的身體狀況在未來幾年會如何變化，并認識到與此相關(guān)的困難，他們也能夠更好地理解社區(qū)中的老年人。幾乎每個人都有需要照顧的老人家庭或朋友，為這項活動帶來了非常個體化的相關(guān)性和觀點。

第二次工作坊隨后于2018年9月舉辦，參與者由來自香港中文大學(xué)、清華大學(xué)和斯坦福大學(xué)的學(xué)生組成，旨在教育明天的城市設(shè)計師，同時從對比鮮明的年輕體驗者中收集更多數(shù)據(jù)。目前在這里分享的數(shù)據(jù)基于第一次和第二次體驗工作坊期間進行的調(diào)查以及Facebook正在進行的在線調(diào)查。在線調(diào)查作為一個控制組，代表公眾中那些沒有體驗過模擬服裝的人的看法。

那么，香港的城市設(shè)計如何更具包容性，使老年人能夠保持活力、獨立并保持健康更長時間，從而樂享退休生活？設(shè)計師和政策制定者是否完全了解老年人面臨的困難？

圖 3 / Figure 3HKIUD會議安排的體驗活動/HKIUD-Actions for Active Ageing

正式地說，我們需要更多的廁所

這個調(diào)查概述了改善城市環(huán)境所需的一系列重要問題，其中許多問題對于大多數(shù)人來說都是簡單而明顯的。例如，所有3個小組都認為保持積極樂觀，更健康、自由、有能力出行”是老年人“心情愉快和健康”的關(guān)鍵議題。

當(dāng)我們面對“我們的城市環(huán)境如何支持積極健康樂頤年”這個問題時，可以在公眾普遍認知與積極參加模擬服裝的人的觀點之間找出明顯的差異。雖然第一和第二次體驗工作坊的“體驗者”和“學(xué)生”都表現(xiàn)出了一致的結(jié)果，大約三分之二的人認為環(huán)境“并不是他們想的那樣”適合積極健康樂頤年，但未參加的公眾提供了更為積極的觀點，幾乎有一半認為環(huán)境可以接受。第一次工作坊參與者在參加體驗工作坊之前進行的調(diào)查結(jié)果為此提供了支持。因此，對老年人問題認識不正確的觀點一直存在。

調(diào)查的第三個方面試圖確定何種因素可以促進營造老年人友好型城市環(huán)境、舒適的步行環(huán)境，實現(xiàn)便利的交通連接。無障礙設(shè)施的可達性、休息區(qū)的設(shè)置也是各組突出強調(diào)的部分。該研究確定了塑造老年友好型城市環(huán)境的關(guān)鍵因素，將其分為4個子集：第一，安全；第二，體能支援；第三，認知能力；第四，福祉。

在提供安全基礎(chǔ)設(shè)施方面，道路交叉口、狹窄的步道、障礙物的存在和坡度因素對于體驗參與者而言比公眾認知影響更大。同時，臺階和不平坦表面的存在是其中最大的城市安全隱患。設(shè)置更寬敞的路面同時設(shè)置適合的扶手被認為是明智的選擇，而支持性設(shè)施則強調(diào)需要更多地提供廁所和座椅來避免老人不得不長途跋涉的情況。

在認知和駕馭城市環(huán)境的能力方面，第一次工作坊小組的經(jīng)驗是深刻的。在進行了體驗式工作坊之后，大家發(fā)現(xiàn)“難以找到新的場所”的數(shù)量顯著增加，這對于老年人積極參與不熟悉的活動環(huán)境或被要求進入不熟悉的地點構(gòu)成了很強的阻礙。在一天結(jié)束時，老年人可以保持與社區(qū)的聯(lián)系，并能夠在維護良好的基礎(chǔ)設(shè)施中活動，這是他們在城市環(huán)境中最樂于見到的事情。

這些真的重要嗎？

隨著許多發(fā)達國家走向人口老齡化的階段，使城市更加適合社會各年齡段的需要變得至關(guān)重要。實現(xiàn)積極健康的老年生活非常重要，優(yōu)質(zhì)景觀區(qū)域的可達性使得老年人步行出行變得輕松愉快。不均勻的鋪路、臺階，休息機會的缺乏或廁所供應(yīng)不足都可能成為想要散步的老年人的障礙，這使得日光、自然環(huán)境和社交場所會是否成為老年人的負擔(dān)。這是從家到目的地旅程的挑戰(zhàn)，對決策制訂起著關(guān)鍵作用。只要有一件事是錯誤的或困難的，就有可能阻止老年人走出家門，所以物理環(huán)境的設(shè)計至關(guān)重要。諸如是否在座位上放置設(shè)備以幫助上升或下降以及是否選擇不會過熱或過冷的材料等細節(jié)可以產(chǎn)生巨大的差異。

值得注意的是，以下這些都有助于我們理解老年人需要保持活躍和積極這個議題。如果人們在戶外而不是在室內(nèi)，他們更有可能步行。戶外活動也有助于避免社交孤立以及由此帶來的孤獨和心理健康問題。人體還需要維生素D，陽光會影響我們的晝夜節(jié)律，影響睡眠質(zhì)量。提供“虛擬和人工景觀”的技術(shù)永遠無法取代真實的景觀。更好的步行環(huán)境是很重要的，使人感到愉快，為人遮蔭降溫，人們可以通過聽鳥鳴、聞花香、享受天氣和季節(jié)的變化來激活感官。

世界衛(wèi)生組織于2007年提出建議，對建筑環(huán)境進行更好的設(shè)計，創(chuàng)建適合老年人居住的城市，支持公眾健康進入老年。公共衛(wèi)生是一項需要跨所有部門、所有環(huán)境開展工作的工作，城市領(lǐng)域的投資作為公共衛(wèi)生設(shè)施，與密集的糾正性公共醫(yī)療成本相比，其成本極低，效益卻很高。然而，要全面衡量和見證高質(zhì)素的城市設(shè)計供應(yīng)及其經(jīng)常維修費用對社會的投資回報，需要很長時間。香港城市設(shè)計學(xué)會希望能夠使用收集到的數(shù)據(jù)來說服政策制定者及相關(guān)機構(gòu),可達性好,保持活力的城市設(shè)計策略可以被積累被并應(yīng)用在普遍的城市環(huán)境中,而不僅僅在社區(qū)中提供多種多樣的適老化設(shè)施。政府希望繼續(xù)讓年輕一代和長者參與有關(guān)樂享退休生活的公共決策。

圖 4 / Figure 4我們現(xiàn)在的城市設(shè)計足夠讓老人享受退休生活嗎？ / How well does our current urban environment support Active Aging？

表 1 / Table 1對老年人保持心情愉快及健康的調(diào)查（1）/ What do you consider the most important for the elderly to be happy and well (1)

表 2 / Table 2對長者保持心情愉快及健康的調(diào)查（2） / What do you consider the most important for the elderly to be happy and well (2)

Cities notfit for the ageing populations

Barry Wilson

Introduction

Along with the one child policy of China, the demographic shift caused by ageing populations in developed economies has been exacerbated by the global trend to urbanisation. The challenge of providing adequate urban elderly care has become pressing, yet the focus up to now has primarily been on providing adequate elderly residential facilities, whereas the frequently presented preference for cageing in place” coupled with a clear necessity for increased “care in the community”that addresses the shortfall in public healthcare support, has in fact positioned the wider urban public realm as the critical battleground for support of the aged.

The Warning Signs

In recent years the Hong Kong Institute of Urban Design has become increasingly aware of the severe problems facing the urban environment in meeting the needs of the ageing population. This was brought to a stark warning in early 2017 when the government results of the Census and Statistics Department’s 2016 by-census, showed that the median age of the population had increased to 43.4 years, from 39.6 ten years previous. The proportion aged 65 or older had increased from 12 percent of the population in 2006 to a new high of 16 per cent. In 1986 thefigure was just 8 percent.The ageing of society is a very gradual process,which makes it hard to notice, however if we now look forward just another 20 years, the difference becomes critically apparent, with the number of people aged over 65 having gone up to a massive 31.1 per cent of Hong Kong’s population.

Already concerned about the poor urban environment found in terms of universal access and environmental health within the city, the Institute decided to focus its attention to evaluation of the urban realm in the eyes of its existing ageing population in an effort to prioritise both thinking and funding towards what would be needed to start to better futureproof both public and private capital works projects. A three-pronged approach was con-ceived in whichfirstly research would be undertaken that would be available as a focus for discussion at the 2018 HKIUD Conference “Actions for Active Ageing – Urban Design for All”. Thefinal post conference stage would reach clear actions and objectives in terms of kickstarting a pilot project addressing the key urban design factors that would enable an ageing population to remain active, healthy and engaged, thereby continuing to contribute society, the community and reduce burdens of care.

圖 5 / Figure 5選出城市里最危險的5個場地/Which are the Top 5 Hazards in the Urban Environment？

表 3 / Table 3總體原則（一）：安全 / Over=Arching Principle1-Safety

表 4 / Table 4最能提升外出安全的選項 / the Most Helpful in Enhancing Safety

The Institute continues to explore both the physical and social issues of how our cities can be more inclusive and why better urban design is essential in reinforcing the cultural ties in our communities,especially with an ageing population, including ideas of walkability, active living environment,transport modes, social participation, healthcare and mixed-use development. Through its active ageing research, it contains the following aims.

First, outline the key aspects of the different “software” and “hardware” sides to excellent and inclusive urban design – e.g. from policy, walkability,housing, etc. perspectives.

Second, how best-practice case studies from innovative projects all over the world can be applied to our city.

Third, identify what will be needed, in specific policy and urban design terms, to effectively serve the ageing population in Hong Kong.

Fourth, how the government plans for the city to adapt to the rapidly ageing population growth.Fifth, the opportunities and challenges professionals in the industry will face going forward.

Getting Some Facts

“Ageing in the Hong Kong Urban Environment -An Experiential Workshop” was initially held in March 2018 as a major pre-conference research event jointly organised by HKIUD, P&T Group and Hong Kong Sheng Kung Hui Welfare Council(SKHWC). The workshop received support from approximately 40 targeted participants, including Ms. Bernadette Linn (Permanent Secretary for Development - Planning & Lands), Mr. Tony Tse(Member of the Legislative Council for Architectural, Surveying, Planning and Landscape), Mrs.Sylvia Lam (Director of Architectural Services Department), Mr. Raymond Lee ( Director of Plan-ning Department), Ms. Alice Wan (Member of the Board of Directors, Southern District Healthy &Safe Association Limited) and Mrs. Susanne Wong(District Officer of Central and Western).

表 5 / Table 5總體原則（二）：體能支援 / Over=Arching Principle2-Physical Support

表 6 / Table 6最需設(shè)立的老年人輔助設(shè)施 / the Most needed Supportive Facilitiesll

Participants were able to “gear up” with an“elderly simulation suit” provided by Eldpathy HK, an organisation that encourages participation in elderly philanthropy through experiential programmes. The suit, which is a patented invention of the Cycling & Health Technology Industry R& D Center (CHC) in Taiwan has been developed by professionals including doctors, nurses, physiologists, and social workers. It consists of several specially designed impediments such as weights,braces, elastic band restraints and a pair of blurry eyeglasses, which allows participants to feel how the aged bend their bodies and grasp the physical experiences of an elderly person. With the assistance of volunteers, participants were engaged in a number of typical outdoor daily life elderly activities in Western District, for example, visiting Western District Elderly Community Centre,trying out to the community facilities andfitness equipment for the elderly in a park, and eventually experiencing different real-life hardships faced by the elderly.

A key part of undertaking the research was to build up a data set that could highlight priorities in terms of identifying the key barriers and affordances to elderly urban activity. An online survey was developed which was undertaken by the workshop participants both before wearing the elderly simulation suit and following the exercise, the object being to gauge any change in perception between undertaking tasks in their current physical state compared with that of what they might expect in years going forward. Not only do participants get to understand how their physical condition will deteriorate in future years and recognise the difficulties associated with that, they are also able to better empathise with seniors in the community.Nearly everyone has elderly family or friends that need to be looked after, bringing a very personal relevance and perspective to the exercise.

A second workshop was subsequently held in September 2018 with participants comprised of students from Chinese University Hong Kong,Tsinghua University and Stanford University as a means to both educate tomorrow’s urban designers and at the same time collect further data from a contrasting and youthful user group. The data cur-rently shared here is based on the surveys undertaken during the First and Second Experiential workshops as well as that from the ongoing online survey on Facebook which acts as a control group representing the public perception of those who have not had the benefit of having experienced the simulation suit.

So how can urban design in Hong Kong be more inclusive and enable the elderly to stay active,independent and remain healthy longer which is the overall challenge of active ageing? Do designers and policy makers have a full understanding of the difficulties faced by the elderly?

圖 7 / Figure 7方便易懂的信息和清晰的標(biāo)志？ / Easy Information Gathering and Clear Signage

圖 8 / Figure 8總體原則（三）：認知部分 / Over=Arching Principle3-Cognition

表7 / Table 7總體原則（四）：福祉 / Over=Arching Principle4-Well-Beingl

It’s Official, We Need More Toilets

The survey outlines a whole host of important issues needed for improvements in the urban environment, where many are simple and obvious to most it would seem. For instance, all three groups similarly identify “Staying Active for Better Health, Freedom and Ability to Go Places” as the most important issue for the elderly to be “happy and well”.

When the question is asked “How Well Does Our Urban Environment Support Active Ageing?”,however a distinct differential can be identified between the public general perception and the considerations of those who have actively worn the simulation suit. Whilst both the “selected”and “student” participants of thefirst and second experiential workshops showed consistent results,with roughly two thirdsfinding the environment“not really” suitable to active ageing, a much more positive perspective is provided by the general public where almost half consider the environment acceptable. This is backed up by the results of the survey undertaken by the 1st workshop participants BEFORE they undertook the experiential workshop. The suggestion exists therefore that the problems of the elderly are not properly recognized.

The third area of the survey tries to identify what makes an elderly-friendly urban environment,where a comfortable walking environment and convenient transport connections are paramount to all survey groups. The importance of having barrier free access and rest points are also highlighted consistently across groups. The study identified the key elements that shape an elderly-friendly urban environment by dividing them into four subsets.

First, safe infrastructure.

Second, supportive amenities.

Third, cognitive power.

Fourth, well-being factors.

圖 9 / Figure 9體驗式工作坊（1） / Experiential Workshop（1）

When it comes to the provision of safe infrastructure, factors such as road crossing, narrow footpath widths, presence of obstacles and steepness of gradients have a greater importance to the experiential groups than the public perception, whilst the presence of steps and uneven surfaces is considered the greatest urban safety hazard across all sectors.Solving such problems with wider pavements and providing handrails is clearly substantiated whilst supportive amenities highlight the need for more regular provision of toilets and seats as a means to reducing the barrier of having to walk long distances.

When it comes to cognition and the ability of navigating the urban environment, the experience of the 1st workshop group was profound. After undertaking the experiential workshop, a significant increase was observed in numbersfinding it “difficult tofind new places” which would constitute a strong deterrent to actively engaging in the unfamiliar, widening the activity base or being required to attend unfamiliar locations. At the end of the day, maintaining connections with the community and having easily accessible places for a wide variety of activities in well maintained and appropriate facilities is what makes the elderly most happy in the urban setting.

Does It Really Matter?

As many developed countries move towards the problems of ageing populations, making our cities more age enabled to all sectors of society becomes essential. Being active through ageing is important and accessibility to quality landscape areas in particular makes it easy and enjoyable to get out on foot. Uneven paving, steps, a lack of rest opportunities or insufficient toilet provision can all act as barriers to elderly wanting to take a walk whereas access to daylight, the natural environment and sociable places act as affordances. It’s the challenge of the journey from the home to the destination that has a key impact on decision making.Just one thing wrong or difficult can stop elderly getting out and about, so the design of the physical environment is critically important. Details such as having arms on seats to help get up or down and choosing materials that don’t get too hot or cold can make a huge difference.

圖 10 / Figure 10“老年模擬服裝”/"elderly simulation suit"

In better understanding the issues of keeping active it is noteworthy that people are simply more likely to walk if they are outside rather than being indoors. Getting outside can also help to avoid social isolation and the resultant problems of loneliness and mental health. The body also needs vitamin D through sunlight and daylight can affect our circadian rhythms and impact sleep quality.Technology providing a “virtual and artificial landscape”can never replace the real thing. Better pedestrian environments, which are pleasant,shaded and can activate the senses by hearing birdsong, smelling fl owers, and enjoying the change of weather and season are important.

The WHO recommends better design of the built environment to create age-friendly cities that support public health into old age. Public health is something that needs to work across all sectors and all environments and investment in the urban realm as a public health tool is extremely low in cost and high in benefit compared to intensive corrective public medical costs. It takes a long time however to fully measure and witness the return on investment to society at large of quality urban design provision and of its recurrent maintenance cost;perhaps even decades. The Hong Kong Institute of urban Design hopes to be able to use the data collected to convince policy makers and funding bodies of the real and valuable benefits that can be accrued from well considered universal urban design environments, having identified the importance, not just of providing a variety of diverse facilities within neighbourhoods, but also supporting ease of access to them, as the key to maintaining active urban ageing. It hopes to continue to engage both young and elderly generations in public decision making on active ageing issues.