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Where people live the longest

How NEOM could set a new lifespan record for its future Citizens by designing a $500-billion-megacity community of rejuvenation and happiness.

Following the Crown Prince of Saudi Arabia’s Vision 2030 to transition into a post-oil economy, his country has just announced a plan to build a megacity on the coast of the Red Sea, NEOM, with $500 billion pledged by its Public Investment Fund and domestic as well as international investors. This city will be entirely powered on wind and solar energy and free to operate outside of governmental regulations.

An essential element of NEOM’s vision puts living at its foundation and asks, “What will life be like in NEOM?” In this article, we therefore ask how this new city could become “an aspirational society that heralds the future of human civilization” and what innovative solutions are needed for its future ageing population.

 

“Human life will never be understood unless its highest aspirations are taken into account. Growth, self-actualization, the striving toward health, the quest for identity and autonomy, and the yearning for excellence must by now be accepted beyond question as a widespread and perhaps universal human tendency”.

Abraham Maslow, American Psychologist

 

The Middle Eastern and North African (MENA) population is aging rapidly while life expectancy has increased by 16 years since the mid 70’s. In the case of Saudi Arabia, according to the UN, its aged 65 and above will expand from 3% in 2017 to 18.4% by 2050.  Considering these numbers, MENA countries are rapidly entering uncharted territory that will challenge their intergenerational solidarity system which relies mainly on the family, particularly the women, as the primary source of elder care. However, scientific evidence suggests that many countries in the region, and globally, are not yet sufficiently paying attention to an accelerated demographic trend that is displacing the centre of gravity of our societies towards an older population.  Indeed, most governments have not yet designed the necessary infrastructure and social services required to support a larger retired population.

Recent studies show that longevity is increasingly accompanied by emotional and financial insecurity, many years of illness and disability – with health challenges such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes that are well-known in western countries – and a progressive dilution or total loss of elders’ life-purpose. Two other excruciating but frequent outcomes are the disconnection with younger generations and the lack of space to build a legacy, that combined subsequently imply the extinction of incalculable knowledge and loss of cultural heritage.

 

“We are seeing the world challenge preconceived ideas about aging and show that most contemporary seniors want to age with a focus on health and wellness in their communities. With the rapid growth of the aging of the population, these preferences are going to shape urban living for years to come. We must find ways to adapt city life to these new demands, where current options are limited”

Tom DeRosa, CEO & Director, Welltower, USA  

 

To address these challenges, we propose a seven pillar framework that promotes healthy longevity, rejuvenation and happiness for our and future elder generations.

We believe our 7-pillar-framework could help NEOM to succeed in attracting a MENA and international ageing population. It showcases practical solutions and examples that focus on a holistic built environment, prioritize social inclusion and participation, provide access to long-term care, leverage new technologies to promote a healthy environment with sustainable accessibility and advanced urban and personal services, embrace physical activity and healthy nutrition, and eventually generate opportunities for education and lifelong learning allowing new forms of employment and volunteering, by being:

  1. HUMAN-CENTRIC: We focus on our senior citizens by truly understanding and anticipating their needs, expanding their interests and by innovating in an advanced service provision. Hence, the underlying infrastructure and built environment assets need to be smart, affordable, sustainable and accessible. The right infrastructure is therapeutic for the aging population and allows the elderly to maintain a higher quality of life while facilitating everyday needs.
  2. REJUVENATED: We multiply mental and physical health benefits of our seniors by applying latest research, technologies and alternative methodologies which transform aging into healthy longevity. Human to human engagement is key, but technology can play an integral role
  3. THOUGHTFUL: We reinvent the tribal elder system by strengthening community governance across generations, by increasing transgenerational knowledge exchange, long-termism and wisdom through open education, lifelong learning and volunteering;
  4. INTERCONNECTED: We increase connectedness and belonging by providing a physical and virtual environment that fosters intra- and intergenerational social inclusion and participation for our seniors;
  5. RESPONSIBLE: We support our seniors to conserve and regenerate natural resources by providing carbon-positive, green, circular, resilient and affordable solutions and physical assets which will outperform the Sustainable Development Goals;
  6. TRANSCENDENTAL: We help our seniors to maintain purpose and meaning in life through a path of ethics, philosophy and spirituality; and
  7. PROTECTED: We assure our seniors to feel safe and we help protect their financial resources and assets by reducing risks and deploying tangible solutions that prevent harm or value loss, and by promoting a responsible governance of the community’s assets to drive long-term value also for future generations.

Each of the pillars creates value by addressing typical pain points of an ageing population. They all guide the reader towards effective potential solutions as well as examples and case studies:

HUMAN-CENTRIC – Focusing on the senior citizens

According to the Law Commission of Ontario, seniors are discriminated and marginalized by our youth-obsessed society and, as a result, they often see themselves as burdens to their families and their communities, which in turn can lead to negative impacts on their physical and mental health. Therefore, a paradigm shift is urgently required to recognize our elder Citizen’s needs and interests, by innovating in novel advanced urban services and finally by properly planning customized, affordable and sustainable infrastructure assets.

The Fourth Industrial Revolution is bringing new applications that will benefit older adults and their professional and unprofessional caregivers. In 2015, the World Economic Forum’s Global Agenda Council on Ageing stressed how longevity will create new markets and drive economic growth as there will be demand for novel health and extended care products and services. For instance, in the near future, home-assisted living for the elderly could take a very unusual form. Researchers have developed wall-embedded solutions that can track down reading glasses or the front door key, analyse health data, and contact a physician or a call-out service. These solutions can also apply to congregate senior living.

REJUVENATED – Multiplying mental and physical health benefits

According to the World Health Organization, non-communicable diseases are the primary cause of death responsible for 70% of deaths worldwide. These are largely caused by behavioural risk factors such as tobacco use, unhealthy diet, insufficient physical activity and the harmful use of alcohol, and can be obliterated by lifestyle changes leading to better functional ability, increased social participation, longevity, well-being and satisfaction. Latest cutting-edge rejuvenation research even suggest that by using therapies, from traditional practices such as fasting to sophisticated regenerative therapies, the ageing process can not only be slowed down but might be even reversed. This is evident in the controlled environments of assisted living communities in the US, and principles can also be applied to home health. In addition, a next generation of digitalized high-tech patient rooms will leverage patient data from multiple sources (sensors, patient histories, daily activities context, etc.), create advanced patient profiles, predict health conditions and risks for early intervention, and guide and inform care professionals in providing optimized and highly personalised interventions. Digitalisation will establish a preventative and value based care for more Healthy Life Years (HLYs). For instance, in the US, the average patient will spend 17 years unhealthy and 9 years debilitated. The conditions that cause much of this disability such as diabetes, high blood pressure, autoimmune disease and lymphoma are all associated with obesity and are diseases of dietary excess. Health centres that focus on a plant-based diet, healthy environment, constant moderate physical activity and stress reduction like at TrueNorth in California or at the Buchinger Clinic in Germany have repeatedly demonstrated that a reduction of this end of life debility is possible and can revolutionize quality of life and cost of care issues.

  THOUGHTFUL – Reinventing the tribal elder system

Old age was generally valued in native societies, as Robert N. Butler, founder of the International Longevity Center in New York points out. Elderly are source of wisdom, experience, and institutional memory, being yore of adaptive – even survival – value to their societies. The stories grandparents tell their grandchildren often form the basis for a deeper understanding of the structures of society.

The transition into the information age may challenge traditional forms of knowledge transfer between the generations, but it will also open new ways of communication. It could well pull our grandparents back into mainstream discussions and reinstating a tribal elder governance structure based on virtues, compassion, experiential self-knowledge, non-attachment and long-termism to the endurance of humanity may have a revival. This should be strongly considered and not underestimated. Therefore, older people will need to be re-introduced into the political process and regularly consulted by civil stakeholders on how to serve them and society at large better.

INTERCONNECTED – Increasing connectedness and belonging

Social isolation and loneliness can be associated with depression symptoms, poor intellectual performance and cognitive decline, long-term illness and even higher risk of mortality in older adults. According to a study in San Francisco and Oakland, California, older adults highly value mobility, active lives, and social connections. Providing suitable space, infrastructure as well as technologies that increase the interaction between family, friends and community is key to ensure social inclusion and fulfilling participation. Supporting concepts include multi-generational living, ageing in place, shared amenities as well as social engagement such as community events, service and volunteering but also technological solutions that increase connectedness, e.g. affordable self-driving mobility and virtual and communication services.

To physically connect the old with the young, many initiatives are already on the way, for instance, a Dutch nursing home which offers rent-free housing to students or a preschool inside a nursing home in Seattle. This shows that it is a mistake to think that elderly people would prefer to live in quiet, rural, segregated communities. The opposite is true. Many older people want to live in the middle of life, engage with the community, have more options to get around and better access to amenities and cultural and recreational facilities. Welltower owns a community in Seattle, in which there is a senior living component and a graduate school living component in which residents of both share services. Amenities and outdoor space.

RESPONSIBLE – Supporting seniors to conserve and regenerate natural resources

Among all factors contributing to longevity, the environment is extremely important. Environmental factors such as air quality, greenery, temperature, and noise also impact happiness. Key lessons can also be derived from so called Blue Zones, an anthropological concept that describes the characteristic lifestyles and the environments of the world’s longest-lived people.

Carbon-positive buildings, green outdoor spaces, the use of natural materials, circular economy solutions, resilient infrastructure and affordable and walkable access to sustainable services have to be designed to meet and exceed the Sustainable Development Goals.
The qualities of nature need not be solely for those living in rural areas. The futuristic design concept “Home Farm” enables an organic urban farming community to grow their own produce in the city centre of Singapore, offering its senior residents much more than a small plot. According to SPARK architects, Home Farm is imagined as a private company for low-income seniors. The affordable design uses simple materials and modular parts. The concept offers multi-dimensional benefits related to economics, food security and quality, social engagement, health, waste to energy, rainwater collection, place making, and healthcare provision. Farmers-in-residence would have the option of offsetting apartment rental, or other costs through their work.

 TRANSCENDENTAL – Regaining purpose and meaning in life

Purpose in life, as several meta-studies show, can be positively linked to well-being metrics, for instance life expectancy, risk of disease, quality of sleep and healthy behaviours. Recent research suggests that a sense of purpose may play an important role in maintaining physical function, e.g. grip strength and walking speed, and independence among older adults as they age. Furthermore, other studies show that elderly can increase their sense of a meaningful life by staying engaged in activities, helping others, cultivating relationships, and practicing mindfulness and spirituality.

In this context, spirituality can be defined “not just as a religious concept but as the fulfilment of the universal human need for purpose, values and relationships – a sense of wholeness in life.” This spiritual dimension helps people face the emotional and psychological challenges of growing older, such as memory loss, dementia, bereavement, fear of death and might provide answers to fundamental philosophical questions such as “Why are we here? Where do we go?” Elderly people will benefit from a better understanding of questions of life and death. Growing old in many of today’s societies does not offer any answers. With growing “old and wise” naturally comes a better understanding of deeper, more intuitive relationships and connections, which should be allowed and nurtured and may give an additional sense of “self-worth”. A new cross-cultural approach as well as novel methods to end-of-life-anxiety might be one of the fundamental answers. For instance, in one of the largest and most rigorous clinical investigations of psychedelic drugs to date, researchers at Johns Hopkins University and New York University have found that certain psychoactive compounds have the potential to substantially diminished depression and anxiety in patients with advanced terminal illnesses.

 PROTECTED – Feeling safe and protected

The majority of elderly prefer to live autonomously and remain close to their community. Technology, such as high-tech safety and health monitoring devices, and new services for seniors provided by ecosystems of technological assisted care givers, digitalised equipment, smart buildings, robotic elements, and connected urban mobility are able to enhance health and safety so they are able to remain independent longer.

A smart built environment (homes, public spaces and buildings, mobility infrastructure) can host multiple sensing elements such as wearable sensors and integrated ambient sensors. Sensors can monitor everything from home safety such as fire detection – at age 65, people are twice as likely to be killed or injured by fires compared to the population at large – to environmental monitoring such as hazardous gases. Internet-of-things connected gadgets already successfully monitor seniors’ vital signs as well as fall detection. On average, seniors’ falls are responsible for 40% of admissions to nursing homes and in the US every 20 minutes an older adult dies from a fall. Integrated digital payments systems will increase financial security and reduce potential crimes against seniors such as identity theft, fraud, exploitation and financial abuse.

The presented seven pillar framework will be a transformative societal approach of infrastructure and built environment delivery to promote healthy longevity, rejuvenation and happiness for our and future elder generations in the MENA region, and worldwide. However, a significant share of the required credibility to attract private investors’ money will come from how realistically Saudi Arabia takes a major societal challenge such as ageing. To make NEOM a success, unconventional approaches will be required – Incremental change is not an option for NEOM; by redefining the ultimate frontier, leapfrogging innovations in infrastructure and the built environment will finally help to address major societal challenges, from ageing and mass urbanization to climate change. The widespread adoption of new models including this seven pillar framework is intended to improve the way our elders live long lives and impact our communities socially, economically and environmentally.

This place is not for conventional people or conventional companies, this will be a place for the dreamers for the world,” according to Saudi Arabia’s Mohammed bin Salman, “The strong political will and the desire of a nation. All the success factors are there to create something big in Saudi Arabia.”