Applying the WHO’s framework for age-friendly environments: older adults’ perspective in a rural setting

BACKGROUND AND OBJECTIVES: The World Health Organization (WHO) has outlined eight domains central to age-friendly environments. Since their introduction in 2007, developments have focused mainly on urban areas. This study explores which factors older adults view as crucial for creating age-friendly environments in a rural Swedish context. RESEARCH DESIGN AND METHODS: This qualitative study consisted of five focus groups with 17 participants. A deductive approach was used for the analysis. RESULTS: Discussions were linked to all eight WHO domains, with a particular emphasis on digitalization, transportation, and discrimination, especially related to digital and social inclusion, which cut across several domains. For instance, digitalization influenced both transportation and communication in rural areas with long distances and limited services. Social inclusion and non-discrimination highlighted the need for greater adaptation within specific domains, especially for people with mobility limitations, declining health, or financial difficulties. Overlaps among domains were evident, such as the need for accessible and affordable transport to enable healthcare access and social participation. DISCUSSION AND IMPLICATIONS: To create age-friendly rural environments, adaptations are needed within all domains in the WHO framework. Digitalization should be emphasized to enable inclusion and reduce discrimination. Accessible and affordable transportation is also crucial for older adults to participate socially, engage civically, and access healthcare. The WHO framework appears sufficient in a rural context. Therefore, we suggest using the framework for age-friendly environments in practice to consider aspects of the environment that older adults perceive as important.