Aging in the neighborhood

• Walking slowly, a third lack something within fifteen minutes

  At a normal pace (4.8 km/h, 1,200 m in fifteen minutes), 7.7% of people aged 65 or over (126,829) lack a health center, a pharmacy or a food shop. Walking slowly (3 km/h, 750 m) the share rises to 33.7%: 557,639 people aged 65 or over and 178,449 aged 80 or over.

• What moves out of reach is the health center

  For half of the people aged 65 or over, the pharmacy is less than 184 m away by street, the shop less than 186 m and the health center less than 613 m. Of the 557,639 people who lack something walking slowly, 484,226 (87%) have a pharmacy and a shop within 750 m. The health center is more than fifteen minutes away for 7.3% at a normal pace and for 33.2% walking slowly; for 428,146 people it lies between 750 and 1,200 m: fifteen minutes away at a normal pace, not walking slowly.

• Barcelona and Valencia, the closest; Seville, the farthest walking slowly

  Walking slowly, 26.3% of people aged 65 or over in Barcelona and 26.8% in Valencia lack at least one of the three; in Seville, 40.3%. Málaga is the only city where the gap also shows at a normal pace: 17.9% lack one within 1,200 m and 6.5% lack all three, in hillside housing estates.

• Very old neighborhoods, far from the health center

  In 1,117 sections, people aged 65 or over make up 27.4% or more of the population (top quintile of the six cities). 380 of them lack at least one of the three within 750 m; 146,281 people aged 65 or over and 48,632 aged 80 or over live there. In Estrella (Madrid) the health center is between 857 and 1,343 m from its 16 very old sections; in La Malagueta (Málaga), more than 1,500 m.

• Living alone and far away

  In 2021, 389,571 people aged 65 or over lived alone in the six cities; 76.6% are women. If, within each district, they are distributed like other older people, about 126,600 would live where, walking slowly, the health center, the pharmacy or the food shop is missing.

• The senior center, even farther away in Madrid

  47.6% of people aged 65 or over in Madrid live more than 750 m from one of its 94 municipal senior centers, against 36.1% with the health center at that distance. In Valencia the share is 31.3% and in Barcelona, with 112 casals and espais de gent gran, 9.5%.

• A nearby clinic is not a health center

  With the clinics, doctors’ offices and hospitals from OpenStreetMap used by the index, 235,561 people aged 65 or over would be without health care within 750 m; with the 345 official primary care centers, 548,975. Measuring access for older people requires the public inventory.

Bring primary care closer to the neighborhoods where the health center is between 750 and 1,200 m away, with regular consultations in municipal facilities, community nursing and home care, and adapt the routes to the health center with benches, shade, longer crossing times or on-demand transport. Start with the very old sections: Estrella in Madrid, Sant Ramon in Barcelona, Marxalenes in Valencia, San José in Zaragoza, Santa Clara in Seville and La Malagueta in Málaga.

The pharmacy and the shop hold on; the health center is the first thing to leave the neighborhood when one walks slowly.