Exploring the Sustainability of Age-Friendly Initiatives in a Canadian Province

Based on the World Health Organization Age-Friendly Cities and Communities (AFCC) framework, the government of Manitoba, Canada, launched a province-wide age-friendly initiative in 2008. The objective of this study was to explore the sustainability of the AFCC initiative more than a decade later. The study was guided by conceptualizations of sustainability as multidimensional and dynamic, composed of 4 aspects (continued capacity, institutionalization, continued benefits, and development/adaptation), and an ecologic perspective that highlights the importance of contextual influences, and their change over time, on AFCC activities.

The study involved a qualitative, multiple case study design. Semistructured interviews were conducted in 2020 with a key informant from each of 52 AFCC. Interview data were analyzed deductively, guided by the sustainability framework and an ecologic perspective. Census data were used to describe the demographic characteristics of AFCC.

We identified 6 groups of AFCC initiatives that varied in degree from the most to the least sustainable: active, in hiatus, reorganized, stalled, discontinued, and never got off the ground. Both local community factors (e.g., lack of capacity) and broader contextual factors, such as demographic changes and provincial legislations, influenced initiatives' sustainability.

AFCC initiatives can range in their degree of sustainability and can wax or wane over time. Ongoing external support for AFCC (e.g., from provincial or state government) to promote the vision of age-friendliness and to address lack of capacity (e.g., to assist with community assessments) could help with the long-term sustainability of initiatives.