Comparing age-friendly city and community policies from China and the world: a systematic review

Introduction: Population aging is a growing global policy and health challenge. The World Health Organization's Age-Friendly Cities and Communities (AFCCs) framework has guided efforts to create supportive environments for older adults. Methods: This study conducts a systematic review of AFCC literature and policies in China and global contexts. The goal is to examine how China-a developing country with the world's largest older population and unique challenges from rapid urbanization-compares to other global contexts in its response to aging. Results and discussion: The review reveals key differences of AFCC policies between China and other global regions, which include varying priorities in mobility, employment, and education policies; divergent implementation approaches; broad visions versus specific standards. Some of the differences in context-specific issues are tied to different urbanization phases. On the other hand, shared challenges include financial issues that constrain policy implementation, social exclusion, health disparities, environmental hazards and technological gaps faced by older adults, and limited policy attention to rural and suburban areas. Future directions include integrating AFCC policies into broader financial, public health, and urban agendas; supporting aging-in-place policies; developing culturally responsive strategies; addressing rural and suburban needs; incorporating technology; bridging policy and practice through implementation and monitoring; fostering participatory design of age-friendly spaces; advancing experimental research; and promoting cross-national knowledge exchanges.