Changes in older adults' perceptions of age-friendliness in Hong Kong: A three-year mixed-methods study

Constructing an Age-friendly City (AFC) has become a major public policy imperative in response to global population aging and urbanization. Yet there is a dearth of empirical evidence on how AFC initiatives can improve perceived age-friendliness among community-dwelling older adults, and on how such initiatives may differently affect older adults with different socioeconomic statuses. Drawing on a three-year citywide AFC initiative in Hong Kong, we conducted a trend study to evaluate changes in perceived age-friendliness in eight AFC domains with 2575 and 2697 community-dwelling older adults in 2015 and 2018 respectively, in addition to 36 focus groups involving 206 older adults. Participants were asked to share their views on changes in age-friendliness in their cities. Survey data were analyzed using linear regression while focus group data were analyzed using thematic analysis. Significant improvements were found in perceived age-friendliness in all eight AFC domains. Low-income older adults saw the greatest improvements in age-friendliness. Thematic analysis revealed that despite improvements, shortcomings persist in domains of housing, civic engagement, and employment. Nevertheless, our findings demonstrate that concerted efforts can improve a city's overall age-friendliness, and that such improvements appear most evident among low-income older adults.