When it comes to aging well, where we live — and how and with whom — has an outsized effect on our well-being. Even before COVID-19, doctors and scientists identified loneliness as the biggest public health threat to aging well. It accelerates the rate of physical decline, doubles the rate of dementia, and increases the prevalence of stroke and heart attack.
To establish a thriving longevity hub in Massachusetts, those of us developing community-based housing must build more opportunities for older adults to overcome isolation: to live — and age — as part of a community.
This past year, we saw the benefits of such an approach firsthand in 2Life Communities, where we manage over 1,300 affordable apartments in Greater Boston. Our apartments — strategically situated in village-center locations in Brighton, Newton, Framingham, and Brookline — are designed to enable older adults to age in community: to live full lives of purpose and connection to the world just beyond the doors of their supportive, dynamic residences.
For older adults in the state, the height of the coronavirus pandemic was difficult, but for the adults living in a community, not as isolating nor deathly as it would have been had they lived by themselves. In terms of physical health, while 9 percent of Massachusetts residents contracted COVID-19, only 4.6 percent of 2Life’s residents did, and less than 1 percent tragically died from it.
Housing is a primary social determinant of health — a fact Massachusetts has taken seriously for decades. The state has been a national leader in affordable housing and community development since the 1960s. The Section 8 rental assistance program, for instance, was invented here, and we have the most extensive network of state-supported public housing in the country. We also have a network of community-based organizations that has grown from various independent grass-roots efforts to a mature system for housing production that responds directly to local needs.
More recently, the state has instituted guidelines, based on 2Life’s aging-in-community design practice, for developers who use state subsidies about how to create adaptable apartments that accommodate seniors’ needs as they age.
But despite Massachusetts’ past and present leadership, the gap between supply and demand for senior affordable housing remains vast. (When 2Life opened a new 61-unit affordable community in 2019, we had almost 1,000 applicants.) With such high housing and other living costs here, many low-income older adults cannot pay for basic necessities, never mind dine out or participate in cultural activities that keep people connected. According to UMass Boston’s Elder Economic Security Index, in 2019, Massachusetts was first in the country in the percentage of single older adults and third behind Vermont and New York for couples without economic security to afford basic costs of living.
Aging in community may offer one answer to that shortfall. The approach combines affordably priced housing with engaging programs, including fitness, wellness, education, and cultural activities. It also provides key pillars of support, such as 24/7 on-site staff response to emergencies, help accessing entitlement benefits to ensure basic needs are met, tech support, and arranging transportation. These services allow people to remain in their community, minimizing isolation even as new needs emerge. Crucially, this level of care and support can be provided at a fraction of what it would cost to provide these same supports to residents living in single-family homes, to say nothing of what it costs to house someone in a nursing home.
What will it take to make aging in community available to everyone? The state needs more subsidized housing and must pay attention to inequities in the current distribution. Black, Indigenous, and people of color older adults are too familiar with inequities in housing and care. The racial wealth gap has grown over the past 30 years, and the oft-cited $8 median net worth of Black Boston households leaves no financial resources for housing or care. Community-based housing developers need to center the needs of communities of color as we develop more affordable supportive housing for all older adults.
Still another huge gap remains. There is a vast middle class that has too much money to qualify for subsidized housing but not enough to afford private offerings aimed mainly at wealthy elders. We will soon be introducing a new offering, Opus, to begin to fill the middle-market gap in Greater Boston. At Opus, every resident will volunteer their time and talents in order to share the activities they love most with their neighbors. This will help keep costs down and residents’ sense of purpose up, which has been shown to reduce even minor cognitive losses.
Thanks to its network of high-capacity, mission-driven, community-based housing organizations, Massachusetts is poised to become a leader in creating a nationally recognized aging in community approach to housing. And with Housing Choice now law, there is a real chance for the state to accelerate housing production.
The affordable housing tradition is rich in our region. With our supportive housing and senior care ecosystem and experienced leadership, we can serve as a beacon for the nation. Building on this foundation, we can work to deepen local knowledge, keep up with changing needs, and accelerate our production to meet demand with a laser-sharp focus on equity. We just need the will to make it happen.
Amy Schectman is president and CEO at 2Life Communities and president of CHAPA. Elise Selinger is real estate innovation manager at 2Life Communities.