Aging is a dynamic process, and we are all constantly aging. Therefore, the environments in which we live should be constructed to help us stay active, healthy, and connected to our communities during this process. Social systems and programs should reflect the contexts in which we live, the assets and experience we build over time, and the support we require at every point throughout our later years. However, there remain many gaps. These gaps are exacerbated by racial and class inequities in the areas of economic security, health, and others that extend from earlier in life.

In Washtenaw County, Michigan (the home of Ann Arbor, ~40 minutes west of Detroit), the 2010 U.S. census found that 53,000 adults were age 60+. By 2040, thanks to advances in medicine, public health and lifestyle choices, this number will more than double to 110,00. This expansive growth is not limited to Washtenaw County. By 2050, one in four U.S. residents will be over the age of 65 and those 75 and older will comprise more than half the elderly population, making them the fastest growing segment of society. 

To address this dynamic, The Ann Arbor Area Community Foundation is partnering with Root Cause to engage older adults and examine aging-related systems* across Washtenaw County. The goals of this project are to:

1. Deeply understand older adults’ daily lived aging experience
2. Profile how systems are supporting and shaping that experience
3. Identify areas and levers for improvement
4. Guide the Foundation’s future investments in healthy & fulfilling  aging

*We use the term “systems” to refer to the individual and groups of institutions, across sectors, that collectively shape the broader conditions and environments that people live in. In the case of aging, these systems include (but are not limited to) the areas of medical and health care, transportation services, housing, food and nutrition, community spaces, financial services, and public benefits. Systems are complemented by “programs”, which provide the direct services and resources that help people succeed in their given environment by meeting basic needs, filling gaps, facilitating access, subsidizing costs, and combating challenges. Examples of healthy & fulfilling aging programs include home-delivered meal services, intergenerational community centers, and home health services. 

Overview:

The Ann Arbor Area Community Foundation (AAACF) is expanding its work enabling older adults across Washtenaw County, MI to live healthy and fulfilling lives. To guide this work, Root Cause is tasked with mapping the systems that affect various aspects of older adult lives, and providing a set of investment recommendations. 

To capture an accurate picture of healthy & fulfilling aging systems and develop high quality recommendations, Root Cause is: 

1. Facilitating a cross-sector, county-wide Healthy Aging Working Group
2. Defining what “healthy & fulfilling aging” looks like and mapping the critical systems and programs that support it
3. Mapping Washtenaw County as a place, examining demographics and geography
4. Deeply engaging Washtenaw older adults to capture their aging experiences, shape our work, conduct their own research, reinforce an asset-based aging narrative, and prepare to organize for systems change
5. Identifying levers for future investments to improve healthy & fulfilling aging and strengthen aging equity

The work, slated to be complete in December 2020, began in November 2019 with Root Cause and AAACF forming a Healthy Aging “Working Group” tasked with guiding the work through the course of the project– specifically, conducting stakeholder interviews to develop a contextual overview of healthy and fulfilling aging in Washtenaw County. Our place-based profile of the county shows where older adults live, how aging demographics vary across areas of the county, where key resources and services are located, and other data points, helping the Working Group to better understand the county landscape and inform our systems mapping and investment recommendations.   

Two weeks before the COVID-19 pandemic hit the United States, Root Cause had geared up to capture the diversity of aging experiences across Washtenaw County by what we call ‘tracing senior lives.’ We were preparing to personally immerse ourselves in these lived experiences through human-centered design (HCD) and community-based participatory research (CBPR) methods including in-person interviews, focus groups, shadowing, and “walking a mile in older adults’ shoes”. The aim of this work was to gain a full and accurate understanding of their day-to-day lives, particularly how the quality of one’s aging experience correlates with socioeconomic level, race, family situation, location of residence, and other factors. This would in turn help us to refine our definition of health & fulfilling aging, identify local systems and programs that older adults interact with, and recommend areas for healthy aging investments. 

With the onset of COVID-19, Root Cause spent several months shifting the project to a blend of remote methods. We are now engaging a diverse cadre of older adults using phone and video interviews, and participants are capturing their own experiences via photo and video journaling. In a COVID silver lining, we have also found compelling energy around the healthy and fulfilling aging project and a desire for increased involvement. To build on this momentum, Root Cause is currently employing CBPR principles, working with an expanding group of older adults as our “Community Research Partners” to help shape our work.

The value of this approach is that Washtenaw older adults are not just our informants, but rather own the research and are more empowered to act on it to influence improved healthy & fulfilling aging systems in their community. The end result is systems that are shaped not just for older adults, but also by and with older adults.

Through the above work, we have been examining and illustrating the healthy & fulfilling aging-related systems across sectors, how older adults interact with them, and how they work alongside the landscape of aging programs and direct services. We are describing the roles of each system and how they connect together, charting the path of how older adults interact with these systems, detailing their experiences in those interactions, and highlighting bottlenecks, gaps, and access and quality issues. 

In the interest of longer-term systems change, we are also highlighting how these systems support other age groups, and documenting the broader range of community efforts to improve these systems. As we undergo the above activities, Root Cause has been working with local partners and older adults to identify the levers and investments that can better support healthy & fulfilling aging and strengthen aging equity across the county.

To document and analyze the daily lived experiences of older adults in Washtenaw County and the systems intended to support healthy aging, the Ann Arbor Area Community Foundation (AAACF) commissioned the AAACF Washtenaw County Healthy & Fulfilling Aging Research Report, the first research of its kind to establish an independent and objective understanding of what healthy aging could be in Washtenaw County and how to improve the quality of life for all local seniors. AAACF worked with Root Cause to map existing programs and services using both quantitative and qualitative expertise to produce a comprehensive analysis of Washtenaw County’s current senior demographics, documentation of the lived experiences of older adults, and how to improve the senior ecosystem.