‘Over 45% of all districts across the country have already entered a completely aged society. Three districts with the highest ratio of seniors are in Bangkok,” said Assoc Prof Niramon Serisakul, director of the Urban Design and Development Centre (UDDC).
In a completely aged society, people aged 60 and over account for 20% of the population. According to the UDDC, seniors are most concentrated in Samphanthawong (35.4%), Pomprap Sattruphai (34.3%) and Phra Nakhon (33%) in Bangkok, followed by San Pa Tong (32.4%) in Chiang Mai and Pa Sang (32.3%) in Lamphun. In Thailand, the number of elders has now reached 13 million.
“It is a wake-up call for cities to adapt,” she said.
As a result, the UDDC unveiled AFCC-SHiP, an index measuring cities’ age-friendliness, in collaboration with the Thai Health Promotion Foundation on Sept 18.
Assoc Prof Niramon said the advent of the grey society is bringing about multiple challenges. In terms of social vulnerability, many seniors experience isolation. A combination of factors, including hectic life and generational gap, leads to lack of support for the elderly. In terms of economic vulnerability, a shrinking workforce is also resulting in economic slowdown.
“However, cities can be a starting point for change. As more than half of Thais live in urban areas [according to the UN World Urbanisation Prospects], cities can provide a textbook example for adaptation,” she said.
Assoc Prof Niramon said the urban environment impacts a person’s health. A wide range of factors from pollution, lack of green space to sedentary lifestyle can increase health risks. Even with better access to healthcare services, urban residents are still vulnerable to health problems and despite a decline in seasonal illnesses, non-communicable diseases and degenerative conditions are a growing concern.
“This is a big transition. Behaviour and degeneration affect our health,” she said.
Assoc Prof Niramon drew attention to how an unsupportive environment can cause extreme suffering in old age. For example, there are around 5.5 million seniors who are injured in accidental falls each year, with a death rate of three per day, according to a study by Chulalongkorn University’s Faculty of Nursing. The city’s environment, such as pavements and lighting, is not friendly to elders.
“Despite our life expectancy of 74, we suffer from illnesses for seven years, which accounts for 10% of our life,” she said. “It is clear that we age fast.”
Assoc Prof Niramon said an age-friendly city will enable people to accumulate “health capital” throughout their life. It is characterised by safety, promotion of physical and mental health and inclusion. For example, Akita in Japan encourages senior participation through several initiatives, including the one-coin bus and the multigenerational city hall. Meanwhile, Singapore’s silver zones enhance road safety for senior residents.
“Urban environment and well-being have a complex relationship. It requires a tool for analysis and assessment. AFCC-SHiP will be a helpful compass for building good cities. Old age isn’t the future. It is here and now,” she said.
Adisak Guntamueanglee, deputy director of the UDDC, said cities should first be able to meet basic needs and then gear towards age-friendliness. SHiP is adapted from a global policy framework for age-friendly cities and communities (AFCC). It covers four categories, including 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,” he said.
A survey of over 1,000 municipalities and subdistrict administrative organisations across the country shows that poverty has the most adverse impact on urban residents (19%), followed by housing (14%) and NCDs (14%). Other challenges include pollution and natural disaster (13%) and lack of social welfare (12%). However, access to healthcare is a high priority for an age-friendly city.
An overall analysis found that “Bangkok is an outlier”. Its urban environment, including physical and socioeconomic aspects, can mostly fulfil 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. On the other hand, Buri Ram, Si Sa Ket, Surin, Kalasin and Sa Kaeo fall behind.
When it comes to age-friendliness, cities can be roughly divided into three levels. Top-tier cities are most equipped with age-friendly infrastructure, for instance, Bangkok, Samut Prakan, Pathum Thani and Khon Kaen. Mid-tier cities have mediocre capacity, for example, Rayong, Prachin Buri and Nakhon Nayok. Low-tier cities are most vulnerable and need urgent support, such as Mae Hong Son, Nan, Phayao and Bueng Kan.
“Urban environment is highly critical to the health of urban residents. It impacts the quality-adjusted-life-year (QALY). With access to healthcare, people in Bangkok are more likely to have the best QALY,” he said.
Adisak explained that these findings show a relationship between urban environment and senior well-being. Still, it should take into account socioeconomic differences — the poor in bigger cities experience more health vulnerability than those in smaller towns. He called for an improvement in infrastructure and basic service for the ageing, while promoting the silver workforce and ensuring access to healthcare.
Speaking at a public forum, Dr Suthee Saritsiri, director of the Health Promotion Division of the Department of Health of the Bangkok Metropolitan Administration, said the city conducted a health checkup for around 200,000 seniors from October 2024 to September 2025. They are vulnerable to NCDs, which are related to paralysis, kidney disease and heart disease. Also, they live with dementia, fall injury and malnutrition.
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, it has equipped seniors with smart watches to ensure that they walk at least 7,000 steps per day to reduce the risk of NCDs and foster connection. 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 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.