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Aging and Environment in Role of Rural Older Adults

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 P. Iamtrakul and S. Chayphong / GMSARN International Journal 15 (2021) 236 - 243

Aging and Environment in Role of Rural Older Adults

P. Iamtrakul* and S. Chayphong

Abstract— Many countries are entering the aging society which is considered a significant population structure
change. This aggravating situation challenges for a sustainable solution, particularly understanding the context of the
city which could help for suitable recommendations about the elderly care with different forms and patterns of the built
environment inaccurate identification and correct understanding. Therefore, this article focuses on rural older adults
by conducting the site investigation together with a questionnaire survey of the total 1,200 homes of older people and
was investigated at Ban Phaeo district of Samutsakorn Province, Thailand. The results showed there are different
characteristics in each community under the context of 4 dimensions: 1) housing characteristics; 2) transportation; 3)
public facilities; and 4) social and economic. With different unique characteristics of elderly houses, especially, social,
economic, transportation, and housing aspects which allow a variety level of living conditions and access depending on
accessibility and the affordability for basic social services. The provision of a suitable environment has become the key
issues to provide solutions for effective interventions to support rural healthy aging according to the specific needs of
communities.

Keywords— Environment for aging, older adults, aging friendly, rural.

living of the elderly.

1. INTRODUCTION By creating a framework for urban development to
facilitate the livelihood of the elderly is very important in
Thailand will have 20 million elderly people (aged 60 order to meet the aging society and upgrade to a
and over) and about one third of the population [1]. sustainable senior society by using clear policy push
Increased longevity and life expectancy have brought integrated with the application of modern innovation, to
changes in the epidemiological profile of the population, smartly accept the aging society. This will be step
with an increase in the prevalence of non-transmissible towards becoming an aging, sustainable, integrated
chronic degenerative diseases, falls, and functional society, innovation, in response to the vision of Thailand
disability, such as reduced muscle strength and body 4.0 which focuses on the development of an innovative
balance [2]. The increasing life expectancy combined economy to achieve creating an environment for an
with declining birth rates has caused many concerns aging society. Therefore, essential to point out examples
about the impact of an aging population. The of management for adaptation in the context of the area,
consideration must be paid to the future generations that especially in rural areas. The study attempted to assess
will struggle to meet and brings effect in many the cases of aging group of Samutsakhon province,
dimensions. The situation of the rising trend of the Thailand which could be representative of the
elderly is an important issue in the planning of urban aforementioned situation. When considering the trend of
ecological systems and the urban environment to support the study area with its demographics change, it was
the livelihood of the elderly group of people within the found that the elderly population in Samutsakhon
community, moreover the development challenges province during 2015 - 2030, has an aging index of
requiring multiple components. In particular, the 129.92 percent. Sooner, it will become a completely
integration of planning with the environment needs to be elderly society in 2025 and will increase by another
prepared for the built environment and technology 53.25 percentage in the year 2030. Furthermore, the
adaptation providing to the users that need to have an situation is in the decline stage due to lacking elderly
appropriate and consistent planning with the need of plans to support the aged group both public services and
users and form of built environment of the city. As such, infrastructures together with unemployment situation,
to create good health care behaviors and prevent disease- high cost of living and the environmental quality
causing behaviors of the elderly together with promoting problem that are deteriorating from industry sectors in
the elderly to look after and be self-reliant at home by the study area [3].
developing an environment that is conducive to self- Therefore, this article focuses on the study of aging
and environment in role of rural older adults for the
recommendation to create an appropriate environment
Pawinee Iamtrakul and Sararad Chayphong are with Center of that is conducive to the elderly living in the context of
Excellence in Urban Mobility Research and Innovation, Faculty of rural communities. This is due to the reason that it is
Architecture and Planning, Thammasat University, Pathumthani 12121,
critical to understand the experiences and social values
Thailand.
*
Corresponding author: Pawinee Iamtrakul; Phone: +66-2-986-9605; by rural older adults to be adapted with built
E-mail: iamtrakul@gmail.com.

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environmental planning and development. as differences in the nature of social relations [11].
People living in the outskirt areas also face greater
2. LITERATURE difficulties in accessing health and social care services
[12]. The remote areas have been at a disadvantage in
2.1 Environment Context
terms of opportunities for economic development and
Health and well-being are not only determined by our prosperity that population in this group seeking
genes and personal characteristics but also by the opportunities for employment in the cities rather than job
environment into which we are born and live throughout creation in farther areas. This situation has resulted in
the life course. An essential environmental belonging to many houses left for only the elderly and children living
the built environment is strongly influence on the quality since working people need to travel to the city areas to
of life older people in the neighborhood [4]. The find job opportunities. The rural area with current access
condition of the elderly who still have problems in both may not sufficiency provide to correspond the needed
economy and society environment that lead to the services for older people who have lived, worked;
relationship between ageing and morbidity, mortality, consequently, they aged in rural areas at risk compared
disability, perceived quality of life and health to those living in urban areas. Moreover, it will be
expenditures [5]-[6]. The built environment is not only considered more serious when focusing on lower-income
related to health through physical activity, it is also or poverty, low wages, poor working conditions, lack of
connected to health through other aspects: falls, health facilities which often scattering in rural areas. This
pollution, social interaction, safety, economical and differences in socioeconomic background can also have
climate issues [7]-[8]. The elderly requires an different needs that require different services, for
environment with special facilities and services that example, in terms of leisure activities in rural areas, lack
respond to changes in body and society as they age. The of facilities, lack of access to information [13]-[14].
development of an elderly-friendly city is therefore More consideration should be put to improve medi-care
important in promoting good quality of life, potential, for the aged in rural area and establish a medical
independence, and economic participation which will treatment subsidy system and a medical support system
lead to sustainability in the development of elderly- or provide sufficient public facility appropriately for the
friendly cities with 3 main components and divided into aged in rural areas.
8 points [9] as follows;
1. Built environments that affect living outside home 3. METHOD AND STUDY AREA
safety and participation in society include housing, 3.1 Method of Study
transportation, and outdoor spaces and building.
The samples of this study were restricted to
2. Social environment elements reflect good minds respondents living in the Ban Phaeo, Samutsakhon,
and emotions that are social participation, respect and Thailand. This is due to the potential of level of
social inclusion and civic participation and employment. contribution of this site which achieve practical
3. Community and health support consists of integration and participation of government agencies, the
sanitation and social services that involve community private sector, the education sector and local
support/health services and communication/information. communities in the study area together with context of
Therefore, it requires for suitable guidelines for taking rural communities. Since most of community in sub
care of the elderly to have a good quality of life which districts are predominated by a natural environment with
must be able to live enthusiastically with their family in a general low density of population. When considering
the community. These must be incorporated and number of elderly people in Samutsakhon Province, it
promoted to have access to various services which is can be illustrated in percentage compared with the total
necessary for living both health, economic, social and population as shown in Table 1. With the lowest number
environmental appropriately. It is important to ensure in term of population, the proportion of elderlies in Ban
communities and regions that experience noticeable Phaeo demonstrated the highest trend when compared to
population aging are prepared and adequately resourced other districts.
to provide older people with adequate accessibility to the
services they need. Table 1. Number of elderly people in Samutsakhon
Province, 2018
2.2 Aging in Rural Area
Aging and old age period is characterized by the District Total Number of elderlies
intensification of changes to the person’s physical state. population
N %
Urban/rural differences in the proportion of people are
that divide different ability in access to essential services, Samutsakhon 246,080 38,152 15.50
particularly sanitation [10]. The differences in
Krathum Baen 133,158 20,736 15.57
classification of the city from the village can be indicated
differences in professions, natural environment, size of Ban Phaeo 81,025 16,614 20.51
community, population density, homogeneity and
heterogeneity of inhabitants, social diversity and Total 460,263 75,502 16.40
stratification, spatial mobility and social activity as well Source: HDC, 2018

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The samples included respondents who were aged 60 transportation purpose. It makes the area suitable for
years and over. The sample size was calculated cultivating various plants and fisheries, including some
according to the number of populations in Ban Phaeo coastal aquaculture, as well as industrial and residential
district with a total population of 97,005 persons in 2017 businesses.
which was determined the sample sizes by using the In addition, the settlement of Ban Phaeo is still a
formula of Taro Yamane [15]. By defining the sampling sparse settlement, most of which are agricultural and
error of 0.01%, finally, the minimum number of sample natural areas which are different from Krathum Baen and
groups was received of 400 samples. Therefore, to cover Mueang Samutsakhon districts (Fig.2). Both Krathum
the number of sample groups within this research, the Baen district and Mueang Samut Sakhon district have
data collection was designed to gather a total of 1,200 been developing their economic characteristics based on
samples for better explanation and covering majority of prospective natural and cultural tourism as well as
rural respondents in the study area. The face to face industrial growth. While the economic characteristics of
interview was conducted together with the site Ban Phaeo District is mainly on agricultural
investigation in an exploration of association context to development, with the context of those areas affecting
elderly people. The data gathering process was supported the lives of the elderly in terms of access to public health
by working closely with authorities from Ban Phaeo services and social interaction. Their socio-economic
district of Samutsakorn Province, Thailand. activity has been hindered by the lack of people to
The framework of the study as depicted in Fig. 1 maintain infrastructure and basic services since their
demonstrated the factors of study which focused on the resident population was leaving the area.
context of rural aging environment in 4 dimensions: 1)
housing characteristics; 2) transportation; 3) public
facilities and 4) social and economic. By taking these
factors into the analysis, the explanation about the
characteristics of the urban environment could be
performed through the assessment of accessibility,
service area and service characteristics. The detail of
analysis will be explained in the next section.

Fig. 2. Distribution of settlements in the study area.

Fig.1. Framework of Study.

3.2 Study Area
When considering its spatial context and urban
environment, it was obviously seen relative unplanned
situation while most cities in developed countries have
neighborhood environment to supports the elderly group.
The study area of this study, Ban Phaeo District could be
used to represent the context of a rural community which
is different from another two districts in the province.
The general characteristics of low-density development
could be considered with particular reference to
agriculture which is the basis of the livelihood of most Fig. 3. Housing and elderly proportion.
rural families. This pattern has been causing differences
in their lifestyle and social activities as well as
accessibility to basic social services to life. With the Especially, when focusing on the distributed
terrain characteristics of lowlands, the district is divided settlement in the study area (Fig. 3), it revealed that
into two parts with the Damnoen Saduak canal flowing majority of aging group settled in Ban Phaeo District
along the east-west direction. The area is characterized with approximated about 20.51% compared to others.
by the fertility of the soil and water resources, which are Most of elderly prefer to stay at home and enjoy farming
linked by rivers and spread throughout the area both more than perform other social activities due to long
natural canal and man-made waterways for cultivation. distance and difficult in traveling. Therefore, the living
The network of irrigation helps to drain water and use for environment is a must to consider for allocating of an

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appropriate plan or public infrastructures/facilities that one-story houses, most of the operating conditions was
could facilitate the livelihood of the elderly in deteriorated but aged people have no problem or
accordance with their physical, social and economic difficulty with going up and down. In the case of two-
context. storey houses, most stairs have steep slopes and disrepair
(in some cases), including no handrails on the sides of
4. RESULTS OF ANALYSIS the stairs.
- In terms of access to housing, the important point is
Considering of aging and environment in the role of rural that some elderly houses do not have direct access to
older adults for the recommendation to create a road networks, only 2-3 bamboo stems lay across the
supportive built environment, this study was conducted
canal or narrow pathways along the canal that required
to provide an in-depth analysis approach in term of built
untypical access from neighboring areas including
environment analysis in the different context of rural
rowing thier boats into the house. All these cases
communities in Ban Phaeo district. The detail of analysis
demonstrated the elderly who are living alone and with
is explained below. low incomes are unable to pay for effective living
4.1 Housing Characteristics facilities, particularly local transportation.
From the survey of the environment and living 4.2 Transportation
conditions of the elderly, it was found that the built
The elderly requires an assistant in term of built
environment and residence of the elderly in Ban Phaeo
environment, facilities and special services that can
District lack a lot of proper planning for supporting the
respond to their changes in physical health and society as
elderly's living. Due to the rural living context that is they aged. Therefore, the development of a city to be
demonsrated its characteristics of low density and simple friendly to the elderly lifestyle is important. Especially,
way of living. This social norm has been passed from
in transportation and related facilities of connectivity,
generation to generation, living in collective manner
this has a direct effect on quality of living outside their
which is familiar to most of local people in the site.
home. The key consideration is to design to be safe and
Thus, the current disruptive of social changes to be living can be conveniently accessed. The built environment
alone is one of the main obstacle for this district. must be designed by contributing to the responsive
Moreover, in the future, the population of the elderly will
physical condition with universal deliberation to
increase and will step into a complete elderly society
limitations of the elderly condition which must have
soon. It is a must to prepare for a supportive built
additional supporting facilities, e.g., seats for the elderly,
environmental plan to facilitate and maintian the living
bus calling system, etc.
condition of this fragile group. By surveying the study
area and analyzing the collected data, the problems of
housing condition is the first priority to be taken into the
consideration. This is due to some of elderly people
living alone and most of them are home bound base, thus
the layout and facility of housing must be provided in
according with the universal design approach to
accommodate the physical condition of aged group.
There are many types of housing in Ban Pheo, including
single houses, apartment, townhouses, including
temporary residences. In the case of general residences,
the most found are 1-storey residences (62.3%), followed
by 2-storey residences (36.8%) and 3-storey residences
(0.2%), respectively. Building material can be divided
into 4 types comprising of wood (39.8%), cement
(35.5%), semi-timber&semi-mortar (24.4%), gypsum
(0.3%), galvanized roof/wall (0.1%). The materials of the Fig. 4. Accessibility of path.
houses depend on their affordability of community
people. For a case of Ban Phaeo District, it was found that
- For the bathroom, there is a high risk of usage which there are few options of travel mode which have difficult
demonstrated in several conditions such as slippery access in some areas. When considering accessibility to
flooring, no handrails and no emergency buttons in the the study area, this study adopted the geographic
bathroom. However, the various elements in the information system with the space syntax analysis tool
bathroom includes a shower, sinks, or bathtub, all by using the axial map to demonstrate transportation
depends on the limitation of socio-economic of different networks to show the relationship of the area with the
houses. potential access based on network analysis. The most
- Furthermore, the housing ladder is another important potential path was shown in different level ranging from
risk factor that should be taken into account and the use low to high accessibility value which presents the
conditions that are conducive to the limitations of the potential routes for accessble. From the analysis in Fig.4,
elderly's physical performance. it was found that the routes with the highest access
- In each staircase of the elderly house, in the case of potential are the main and secondary roads. The route

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with the least access potential is sub-roads in the area

represented by the lighter grey area. Besides the analysis
results correspond to the condition of the networks in the
study area, the path characteristics presented complicated
connectivitly along natural water sources as well as
several major roads in some communities demonstrated
the transportation routes with the condition of
unaccessible to the residences, as the path width is only a
1 meter walkway.
Therefore, in planning of the environment for an aging
society, the emphasis should be placed on the
comprehensive connectivity plan for all forms of the
elderly due to its direct access by affecting social
interaction factors and attach to the usage of basic
community services, especially public health services.
The mode of transportation in Ban Phaeo District is Fig. 5. Density and services areas of public health.
considered to be a relatively few options. By surveying,
it was found that the majority of the elderly travel are
non-motorization mode (21.6%), motorcycle (11.1%),
private car (5.5%), and boat (1.6%). Water transportation
in the residential areas along the main canal and sub-
lines are popular mode and most of residents still use
boats for travel as the common means of transportation.
However, these modes of travel which are widely used
are not conducive to the elderly's travel. Especially
motorcycle taxi and boat taxi are provided with lack of
safety systems for traveling.
4.3 Public facilities
When the consideration was proided for public facility, it
should allow the elderly to live pleasantly in their own
houses and friendly communities design while the Fig. 6. Density of Pubic Park and Recreation Areas
government should responsible for facilitating the elderly
to live in their communities with sufficient services such
as quality hospitals, arranging social activities for the
elderly, appropriate health examination. Every
community must have access to public health services
thoroughly and sufficient and provide appropriate service
with efficient and safe level. When considering in terms
of spatial use of health care services, the service radius of
the hospital unit both Ban Phaeo hospital and health
promotion hospitals can be seen the comprehensive
Fig. 7. Recreation Areas in the Communities.
coverage in all areas as depicted in Fig.5. But when
focusing on traveling and accessibility issues, it can be
seen that in some areas of the residence show relatively
low access potential due to the unfavorable
transportation routes for traveling. However, the various
facilities in the government area of Ban Phaeo district
has given importance to the elderly but the efficiency of
the facilities usage is still under standard and unsafe for
connections as it should be in neighborhood distance
with friendly environment.
Besides, green spaces is another important factor for
seniors. Since most cities have typo of constructions that
prevent the elderly from using green spaces and
recreation areas. The provision of green space is
considered as an important aspect of the aging city which
should be suitable designed and allocated for both
utilization and access to attract the elderly in daily Fig. 8. Density of Temples.
participation. Both daily and recreation usage will help
for social interaction in the neighborhood while improve However, public areas for recreational activities or
mentality condition of aged group. exercise in Ban Phaeo District was found in unsuitable

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condition for the safely access and convenient as shown Orchard community: characteristics of activities within
in Fig.6 and Fig.7. The exercise place is located along the area are agriculture, farming. The social meetings
the secondary roads that is about less than 1 meter from will be conducted within the family and 6) Isolated
the roadside. Besides, most surfaces are in poor community: characteristics of activities within the area
condition for walking and cycling which is a main are agriculture, farming in which the settlements would
obstacle for the elderly including deteriorating operating be located in their own agricultural areas farther from
conditions due to the lack of maintenance. neighbors.
This is also due to the facility location is far from
home and the activities are not diverse and attractive.
Therefore, organizing public spaces for activities and
recreation is a challenge in designing and planning to be
better access and more attractive for daily use with
variety of activities and facilities. With this
consideration, more number of aged group can reach and
have changed their behavior of usage to create more
healthy society. In addition to public health and
recreation area. The temples are also important which is
considered as a public area as depicted in Fig. 8. This is
the area that provides spaces of activities for the elderly
with the main activities being performed such as making
merit, paying respect to monks, organizing festivals, etc.
The distribution of temples are equally distributed in
every district which play a key role on promoting social
cohesion for community people.
4.4 Social and Economic Aspects
When considering socio-economic factor, it was shown
that most of the respondents of age group in our study
area is female which is in the early age group with the
age range between 60-69 years. Most of them are
considered to be poverty group with income less than Fig. 9. Levels of Interaction of the Elderly in Different
Characteristics of Community Forms.
2,000 baht (68.8%). The majority source of income is
from elderly fund and low-income fund that were
supported by the government. The characteristics of However, in summary, by focusing on social
majority of residential areas were in rural communities interaction problems, it indicated that the elderly living
with the average household members are relatively in concentrated communities tend to participate in social
higher than in the urban area. It presents the average activities regularly such as elderly club, festival on
number of household size of 3-5 people per household. important religious days, make merit, skills development
This information reflects the limitation of access to basic and career promotion activities, exercise, etc. In the
services due to the relatively low ability to pay. opposite way, it is different from the elderly group that is
Therefore, planning a responsive environment by far from the community or areas with difficult access to
considering all socio-economic group in term of social travel and connect to other public services. Most of
inclusive would help to promote social capital through which are adjacent to the house or orchard and do not
more interaction of people in the community. The more participate in social activities in which most of these
socializing plays a key role to help stimulate the groups, according to their physical fitness can fully help
energetic environment, reducing feelings of loneliness themselves [16]. Presently, feeling disconnected from the
that would help the mental state result in good health. outside society has become the biggest problem among
The living conditions of the elderly were found diverse the elderly, especially the elderly living in the
characteristics of the settlement which are related to the countryside. Nowadays, with the growth of the city
participation in social activities as demonstrated in Fig. which causes the rural population will be driven out of
9. There are 6 characteristics of communities in Ban the area due to the economic and social driving force. It
Phaeo District which include: 1) Urban community: the can be obviously seen from the phenomenon of working
main activities within the area are commerce and have a group traveled to the city to get job and searching for
variety of activities that are easily accessible, 2) good quality of life, resulting in the elderly being alone
Suburban community: characteristics of major activities in the countryside and many houses became abandoned.
within the area are agriculture and farming basis which The quiet neighborhood became an aging society when it
can access by road and canal, 3) Subcenter community: was at home [17]. Loneliness is an important factor that
characteristics of activities within the area are mixed can make shorter life, particularly in the context of a
residential and commercial which can access by road and rural area with low density of activities. Therefore,
canal, 4) Rural community: characteristics of activities planning approach in the provision of facilities allocation
within the area are residential. Social gathering spaces together with built environment to promoting the
are located in the alley, street of the residence. 5) creation and operation of the activities to sustaining

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living condition and neighborhood environment must be to enhance the quality of life for seniors. Therefore, more
in low cost solution which integrates all contexts of consideration needs to be placed on incentivizing
aging communities. individuals and organizations engaged in elderly services
such as assisted living, residences for seniors, assistive
5. CONCLUSIONS AND RECOMMENDATIONS devices, etc. that will definitely help with an
improvement of the quality of life of the elderly.
Besides, most of the settlement of Ban Phaeo is
considered to be a rural settlement, their major land use
ACKNOWLEDGMENT
of an agricultural and natural area which is different from
Krathum Baen and Mueang Samut Sakhon districts. This study was supported by a grant from National
With a low concentration of settlements, it resulted in a Research Council of Thailand (through Thammasat
lower status of the economic characteristics with plenty University) from Integrated Budget for Research and
of natural resources, orchards, tourist attractions of the Innovation. The research project is entitled of “The
floating market, and industrial plants. While the promoting of innovative urban ecosystems towards an
economic characteristics of Ban Phaeo are mainly on integration of environmentally sustainable and socially
agriculturally based reflected on land utilization and also inclusive for aging societies” under the research plan of
living conditions, it affects the livelihood of the elderly “Elderly care system and its urban ecosystem
in terms of accessibility to public health services and development” (TU2017015).
social interaction. Especially the distributed settlement in
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