Exploring the age-friendliness of Hong Kong : opportunities, initiatives and challenges in an ageing Asian city

Hong Kong is a small, densely settled Special Administrative Region
of China (the HKSAR). Its 2014 mid-year population of some 7.3 million persons had a median age of 42.8 years, with 14.7% aged 65 and, importantly, 4.4% aged over 80 (Census and Statistics Department, 2015a). These percentages of older persons have increased considerably over the past 30 years, as Hong Kong’s population has aged demographically, and the HKSAR now also has one of the lowest fertility rates in the world. It faces its most rapid period of population ageing over the next 20 years, with the age 65-plus group set to comprise almost 23% of the ‘usually resident’ population by 2024 and 30% in 2034, when the median age will be 50. Indeed, United Nations projections indicate that the HKSAR will probably be the sixth oldest territory in the world by 2050, with a median age of almost 53 years (UNDESA, 2015), 10 years older than at present. Clearly, therefore, with a considerable population that is already elderly and the likelihood of very considerable future increase in the proportion of older persons, questions of age-friendliness on all the main domains of the World Health Organization (WHO)’s (2007a, 2007b) age-friendly cities and communities (AFCC) model are of prime consideration as well as certain local additional AFCC characteristics (Wong et al, 2015, 2017). By August 2017, ten HKSAR districts had embarked on the AFCC commitments and received recognition from the WHO by being included in its list of AFCC communities. Hong Kong is also one of 15 countries and territories involved in pilot testing a set of indicators of age-friendliness, under the WHO Kobe Centre for Health Development (WHO, 2015).

Hong Kong is a highly urbanised small territory of only 1,100 square kilometres and, while about 40% of the HKSAR comprises protected country parks, geographical reasons mean that the population is concentrated in only about 25% of the land area. Therefore, overall population density is among the highest in the world, at 6,690 per square kilometer in 2014. In places such as Kwun Tong, the most densely populated district and located in Kowloon, density reaches 57,250 persons per square kilometer (Hong Kong Government, 2015). Therefore, the majority of the territory’s population lives in high-rise apartments, in public rental (30.4%), subsidised home ownership (15.5%) and private ownership (53.5%) (Census and Statistics Department, 2015b). Public and subsidised accommodation of various sorts is particularly important for older persons, as noted later in the chapter. Older persons are subject to socioeconomic factors such as high property prices plus dense and crowded urban living, and environmental factors including air pollution, noise and urban design, often affecting their wellbeing and adjustment (Phillips et al, 2009; Chau et al, 2013a) (see also Chapter Two).

This chapter aims to introduce selected age-friendly contexts and concerns that arise from the specific social and demographic context in Hong Kong. Having provided the broad local background, the chapter goes on to consider the possibilities of learning lessons from other large cities in the region. The main sections of the chapter outline, first, the organisations and approaches adopted by AFCC initiatives in Hong Kong. The chapter then focuses on those initiatives concerned principally with the broad domains of social inclusion and participation and, especially important in the dense urban setting, those involving housing and accommodation initiatives. Even though Hong Kong has a mainly Chinese population, there are, nevertheless, smaller groups whose ethnic backgrounds place them at a socioeconomic disadvantage and the chapter provides some innovative insights into initial research into this growing local issue amongst the older population. It then introduces some local initiatives to alert or raise awareness of risks to older persons in weather and emergency situations. In conclusion, the chapter considers some of the positive achievements and some of the negative factors that might hinder future achievement of age friendliness locally, including the pressing issue of elderly poverty in a rich city.