The Rise of the Grey Society and the Need for Age-Friendly Cities
Over 45% of all districts across the country have already entered a completely aged society, where people aged 60 and over account for 20% of the population. According to Assoc Prof Niramon Serisakul, director of the Urban Design and Development Centre (UDDC), the three districts with the highest ratio of seniors are located in Bangkok. These include Samphanthawong (35.4%), Pomprap Sattruphai (34.3%), and Phra Nakhon (33%). This trend is not limited to the capital; other regions such as San Pa Tong in Chiang Mai (32.4%) and Pa Sang in Lamphun (32.3%) also show high concentrations of elderly residents. In Thailand, the number of elders has now reached 13 million.
This demographic shift is prompting cities to adapt and rethink their urban planning strategies. Assoc Prof Niramon emphasized that the advent of the grey society brings multiple challenges, including social and economic vulnerabilities. Many seniors experience isolation due to factors like hectic lifestyles and generational gaps. Additionally, a shrinking workforce is contributing to economic slowdowns.
Addressing Social and Economic Vulnerabilities
The UDDC has introduced AFCC-SHiP, an index measuring cities’ age-friendliness, in collaboration with the Thai Health Promotion Foundation on September 18. This initiative aims to assess how well cities can accommodate the needs of their aging populations. Assoc Prof Niramon noted that cities can be a starting point for change, as more than half of Thais live in urban areas.
Urban environments significantly impact health. Factors such as pollution, lack of green space, and sedentary lifestyles increase health risks. Even with better access to healthcare services, urban residents remain vulnerable to health problems. Non-communicable diseases and degenerative conditions are growing concerns, according to Assoc Prof Niramon.
Challenges Faced by Seniors in Urban Areas
An unsupportive environment can cause extreme suffering for the elderly. For instance, around 5.5 million seniors are injured in accidental falls each year, with a death rate of three per day. The city’s environment, such as pavements and lighting, often lacks features that cater to the needs of older adults. Despite a life expectancy of 74 years, seniors suffer from illnesses for seven years, which accounts for 10% of their lives.
Assoc Prof Niramon highlighted that an age-friendly city enables people to accumulate “health capital” throughout their lives. Such cities are characterized by safety, promotion of physical and mental health, and inclusion. Examples include Akita in Japan, which encourages senior participation through initiatives like the one-coin bus, and Singapore’s silver zones, which enhance road safety for senior residents.
The Role of AFCC-SHiP in Urban Planning
Adisak Guntamueanglee, deputy director of the UDDC, explained that cities should first meet basic needs before focusing on age-friendliness. SHiP, adapted from a global policy framework for age-friendly cities and communities (AFCC), covers four categories: security, health, infrastructure and basic services, and participation.
“SHiP is not just an index. It can be seen as Noah’s Ark or shipping [a word used in Boys’ Love to denote homoerotic pairing] of urban environment and well-being,” Adisak said.
A survey of over 1,000 municipalities and subdistrict administrative organizations revealed that poverty has the most adverse impact on urban residents (19%), followed by housing (14%) and non-communicable diseases (NCDs) (14%). Other challenges include pollution and natural disasters (13%) and lack of social welfare (12%). However, access to healthcare remains a high priority for an age-friendly city.
Assessing Urban Environments
Bangkok stands out as an outlier, with its urban environment largely fulfilling the basic needs of residents. Victory Monument is the country’s most concentrated medical hub. Other high-ranking areas include Phuket, Nonthaburi, Chon Buri, and Chiang Mai. Conversely, Buri Ram, Si Sa Ket, Surin, Kalasin, and Sa Kaeo fall behind.
When it comes to age-friendliness, cities can be divided into three levels. Top-tier cities, such as Bangkok, Samut Prakan, Pathum Thani, and Khon Kaen, are most equipped with age-friendly infrastructure. Mid-tier cities, including Rayong, Prachin Buri, and Nakhon Nayok, have mediocre capacity. Low-tier cities, such as Mae Hong Son, Nan, Phayao, and Bueng Kan, are most vulnerable and need urgent support.
Improving Infrastructure and Services for the Elderly
Adisak emphasized that the urban environment critically impacts the health of residents. It affects the quality-adjusted-life-year (QALY). With access to healthcare, people in Bangkok are more likely to have the best QALY. He called for improvements in infrastructure and basic services for the aging population, while promoting the silver workforce and ensuring access to healthcare.
Dr Suthee Saritsiri, director of the Health Promotion Division of the Department of Health of the Bangkok Metropolitan Administration, mentioned that the city conducted a health checkup for around 200,000 seniors from October 2024 to September 2025. These seniors are vulnerable to NCDs, which are related to paralysis, kidney disease, and heart disease. They also live with dementia, fall injuries, and malnutrition.
Promoting Social Interaction and Health
The BMA has launched several preventive long-term care initiatives to increase social interaction. Currently, there are 490 activity groups with at least 50,000 members. Moreover, seniors have been equipped with smart watches to ensure they walk at least 7,000 steps per day, reducing the risk of NCDs and fostering connections. In the wake of an earthquake in March, the city is also looking to provide more support for older adults living alone in condos.
When asked what the city can do more to address the demographic shift, Dr Suthee said the family institution has been weakened because people focus solely on bread-and-butter issues. “The urban environment should be designed to promote multigenerational activities. Community art and running events are textbook examples of bringing people together,” she said.
