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February 19, 2026The Gerontologist0 citationsOpen Access

Applying the WHO's Framework for Age-friendly Environments: Older Adults' Perspective in a Rural Setting

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ANAnna NivestamEEEllinor EdforsGHGita Hedin

Key Points

  • The aim is to identify factors that older adults consider vital for age-friendly environments in a rural setting.
  • Conducted five focus groups with 17 older adults in rural Sweden.
  • Utilized a qualitative, deductive approach for analysis.
  • Discussion covered all eight WHO domains related to age-friendly environments.
  • Participants emphasized the importance of digitalization for social and healthcare access.
  • Transportation was identified as a critical factor affecting mobility and participation.
  • Discrimination and social inclusion were significant concerns, especially for those with health or financial difficulties.

Abstract

Abstract 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 needs 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.

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Cite This Study

Nivestam et al. (2026) studied this question.

synapsesocial.com/papers/6996a7c3ecb39a600b3edba1https://doi.org/10.1093/geront/gnag015
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