Challenges and local solutions of demographic change in service provision¹⁷

In this chapter local solutions to the adaptation of services and infrastructure to demographic change will be presented, based on the best practices analysed and pilot projects carried out in the framework of the ADAPT2DC project.

5.1. Issues to consider

Most of the analysed solutions concentrate on adaptation to demographic change accepting it as the framework of action, as a more realistic aim compared to changing demographic processes themselves, (such as, increasing fertility rates and attracting migrants). Generally speaking, ageing and shrinking are accompanied by the emerging of a quite standardised sample of needs, such the demand for new health and social services and infrastructures, new mobility and transport systems, new cultural and learning initiatives.

Local solutions to such changes are crucial to tackle consequences of demographic change, as many of the essential services are provided at local and regional levels. Small territorial systems such as regions and settlements have large potentials in adaptation processes. Feasible policy solutions are more likely to be found using a bottom up approach, developed at the local scale than a top-down approach, elaborated by the central government. Therefore the regional and local level is an appropriate arena for designing and implementing policy responses to such demographic processes. Local responses to demographic change will have a grave effect on the area’s economic competitiveness, social cohesion and quality of life.

Voluntary engagement is often key to successful actions, since they involve additional resources and increase the community’s engagement. Therefore support for voluntary engagement in the organisation and financing of infrastructures and services is useful. However, experts in the ADAPT2DC projects warned that too much dependency on voluntary engagement is a risk which does not allow long-term planning.

Policies are rarely brand new products; they are almost always the result of the mobilisation of existing policies. There are already many good examples and projects existing across Central and Eastern Europe. Awareness raising about promising practices can also support future actions. For example Thuringia Future Prize is being awarded every second year to initiatives and projects that are dealing in an innovative way with demographic change. Therefore it is not necessary to invent totally new ideas ; building on existing policies applied in other areas may be useful. However solutions often cannot be ‘copied’ from one area to the other, “one-fits-all” solutions are usually not feasible.  Actions should always be adapted to the physical, geographic (physical geography, settlement structure), economic, social, administrative, legal and cultural (including habits ad tacit routines) features of the given area. In the process of planning, knowledge about the different responsibilities and modes of providing and financing infrastructures and services is critical.

Cost saving was one of the key aims of the actions analysed; however practice proved that measurement of cost saving is difficult. Moreover, actions may not result in direct cost-saving, but in avoiding greater or future costs, indirect savings or obtaining new incomes or non-monetary benefits (e.g. better life conditions, prolonged activity, reduced ecological stress, policy participation etc.), while adaptation may involve initial costs. Moreover, in certain cases the delivery to all citizens of essential care, health, and mobility services and infrastructure comes first than the need for spending review. Thus new investments can be also considered, on the condition that they are oriented to objectives of self-efficiency and long-term feasibility . In the analysis of practices below – wherever possible – cost saving options are presented. For the planning of future actions to adapt to demographic change, integrated calculations of profitability through considering all costs is encouraged. In addition, independent evaluation of the action, including quantitative indicators wherever possible is important.

It is also important to bear in mind that although the improvement of infrastructure and service provision is an important issue for the quality of life of the local population, it is not the main point for people when they decide where to live. Above all stands the question of finding a job. If people cannot earn their living in a region they will hardly move/stay in a region even if this region offers attractive infrastructures and services. Therefore provision of employment opportunities is crucial.

Complexity versus realistic prioritising

Adaptation to demographic change, ideally, requires a complex and vast programme of actions . However, in reality actors have resource constraints: scarce financial resources, limited human and organisational resources and mandates. Therefore, in reality, a selection of priorities is necessary. When selecting priorities the following factors should be taken into account:

• What are the specific problems, needs and assets of the given area? The use of SWOT analysis¹⁸ is an important tool for such an assessment.
• What are the financial and human capacities and mandates of relevant actors?
• How are potential actions interlinked? Areas of such actions are often strongly interlinked, e.g. if social services are spatially reorganised, the issue of transport should be also addressed.

The solution proposed is to find a compromise between the complexity of potential actions and a realistic prioritising. Often a selective and sectorial policy approach is not only a reasonable option but a necessity. Focussing on just a few problems and policy areas at a time is likely to be more realistic.
Further useful guidelines for the planning of actions are provided in Chapter 4 of this e-book.

Review questions

• List some important factors to consider when transferring practices from one area to another.

Orienting questions

• Please choose a theme from the ones below, and consider, who are the main stakeholders in your area when planning actions to adapt to demographic change in the respective theme?  Consider actors from (a) local politics (b) local administration (c) NGOs and religious organisations (d) private actors such as utility providers (e) local citizen groups (f) strong informal leaders (g) institutions representing collective interests (h) actors from neighbouring communities (i) actors from other territorial levels.

5.2. Hard infrastructure

5.2.1. Transport and mobility

Ageing has several implications for the transport system, such as:

• A higher demand from the elderly for collective forms of transport, especially in urban areas, due to a growing number of elderly citizens, who rely more on public transport compared to individual transport forms.
• Rising need for accessible, convenient and affordable public transport and infrastructure (such as barrier-free facilities, longer times at traffic lights for road crossing and limited walking distance to and from stops).
• Higher demand for commercial individual transport (such as taxis) and technology-assisted car driving.
• Changing targets and time schedules, destinations.
• Increased relevance of safety issues.
• Increasing need for the provision of medical and special support services at airports and railway stations.

Meanwhile, shrinking and demographic change-related segregation and marginalisation is likely to result in fewer clients, thus, economic difficulties for public transport providers. However, a functioning transport system is especially important in shrinking regions where part of the needed infrastructure, health care and social services cannot be accessed on the spot; therefore a good connection to settlements providing such infrastructure and services is fundamental.

The transferability of the best practices in the field of transport and mobility is evaluated to be comparably high by experts in the ADAPT2DC project. However, it is important to note that many of the solutions proposed below are not a real alternative but a complementary instrument to improve transport opportunities, as communities are mostly legally obliged to maintain certain transport, in particular pupil transport. However, they are worth considering, as they can be vital tools to serve residents’ mobility needs when public transport possibilities may be reduced. In addition, the development of transport opportunities is relevant both in terms of adaptation to demographic change, and means a possible instrument to slow down/counterbalance such trends: development of transport, the road and rail infrastructure to enhance regional accessibility and connectivity to economic centres is a key factor in affected areas’ economic competitiveness.

The resource need and cost saving opportunities of different actions widely differs. The closure or deactivation of roads is likely to have only moderate influence on controlling excessive spending, while the reorganisation of public transport, the introduction of new, flexible forms of transport may be more realistic and offers a real cost saving option. Most proposed actions require an initial investment but offer an opportunity for longer term cost saving while maintaining local residents’ mobility.

• Introduction of demand-based public transport provision.

Village Mobile in Klaus, Steyrling, Kniewas, Upper Austria

• Merging private and public mobility forms, such as carpooling, spontaneous car passenger systems or making school buses available to other passengers.

CARLOS in Burgdorf, Switzerland

• Combination of goods traffic and passenger services.
• Introduction/development of barrier-free facilities.
• Use of low capacity vehicles.
• Adaptation of routes and time tables for changing needs.
• Avoiding redundant transport stops, lines, turns.

Stop by Need, district Dahme-Spreewald, Brandenburg, Germany

• Attraction of new clients (e.g. tourists).
• Lowering standards and more flexible rules/guidelines, such as, allowing the activation of voluntary engagement of citizens (e.g. as voluntary drivers) in public transport.
• Attraction of public (both national and local) and private funding.
• Flexible transportation solutions to meet the residual demands (e.g. cycling, taxis).

KombiBus, in Saale-Orla-Kreis, Germany

• Promotion of further, flexible forms of transport such as cycling.
• Integrated transport planning, e.g. transportation for specific needs (e.g. to access health and social services of elderly people) combined with existing public transport, flexible fare system.

Bürgerbus Seefeld, Germany

New Public Transport Concept in Salzwedel, Saxony-Anhalt, Germany

• Making of access to public transport a compulsory criterion for planning social infrastructure.

Some of the above techniques create new revenue sources for public transport providers (such as, opening up school transport for other passengers, merging of people and goods transport). Development and application of modern communication instruments is an important support for many of the above adaptation actions.

Orienting questions:

• Are there any settlements/settlement quarters in your area, which have no access to public transport? (I.e. the first public transport stop is further than cca. 500 metres?)
• Are you aware of any settlements/settlement quarters in your area where the schedule of public transport does not meet needs (e.g. lack of access to workplaces, services on time, lack of public transport during the evening)?
• Are public transport facilities barrier free in your area? How did public transport fares change in your area in the past 5 years?
• Who are the (main) public transport provider(s) in your area?
• Were there any changes in the public transport system which affected the public transport offer in your area in the past 5 years (e.g. shutdown/opening of railway of bus lines, rearrangement of schedules)?
• Are you aware of any new, innovative solutions to improve the mobility of local residents (e.g. car sharing, call buses, possibility for other passengers to enter school buses)?

5.2.2. Housing & public spaces

In housing and public spaces shrinkage of population leads to vacancies, which result in:

• a decrease in property value,
• security problems,
• a strong negative image of the area which again decreases the attractiveness, thus the value of properties in the vicinity.

Ageing changes needs regarding housing, but also poses challenges to sustainable spatial development, as it changes demands regarding the type and spatial location of services, institutions, and public spaces.¹⁹

Actions to deal with such a situation include:

• Reorientation from new construction to refurbishment of existing buildings to improve attractiveness and increase property value.
• Adaptation of housing to the needs of residents, to make elderly citizens to be able to live in a familiar environment for as long as possible.
• Adapting to the needs of young families, single parents, etc.
• Vacancy management, in order to find the most effective management solutions of existing, abandoned buildings, which might include:
• function change in order to adapt functions to the needs of the community;
• downsizing buildings to save costs (on longer term) and adapt functions to the community’s needs;
• Demolition of buildings (unused residential, commercial or industrial objects) to save costs, and prevent a (further) decrease in property value, security and image problems. In areas subject to demolishment new green areas may be created that increase the quality of the residential environment. (However, this solution requires a large amount of public funding, which should be at least partly covered by special financial schemes like taxes on the increase of the property values.)

Cost effective innovative solutions on public property maintenance, energy savings by optimisation of public buildings. Vejprtsko, Ústi Region, Czechia

The pilot action of the Ústí region is to propose a governance model for the municipalities in the area for reducing maintenance costs of public buildings . The spending on public buildings can be quite a burden for the municipal budget, one of the main factors are heating costs. But also a more efficient usage of buildings can reduce spending. Vejprty is a mountainous rural area near the border, characterized by small settlements with a predominantly elderly population. The mountain and peripheral features of this area have hindered the development of a local system of both economic activities and services. The area has about 3000 inhabitants and many abandoned unused or partially used buildings after the war and after the fall of communism. The operating costs of these buildings are a burden on the community.  These empty and decaying buildings include a former hospital, nursery school, administrative centre as well as factories and housing. The pilot action refers basically to property in municipal ownership. The aim of the project is to identify buildings most costly to maintain, and develop ideas on lowering costs and finding new usage. In the initial stage of the project energy audits were made for the 3 most costly but variously used buildings and studies conducted on the needs of the municipality and local residents so as to identify relevant new functions for affected buildings (such as, business centre, health care centre and social housing). A general savings optimization was proposed and the material prepared summarizing various options of energy measures from basic insulation to the implementation of so called “smart” buildings.

The last step in turn is the possibility of funding energy measures from external sources, as the municipalities do usually not have enough of their own funds. At length cost reduction will be reached through energy savings and meaningful use the object, therefore decreased maintenance costs. The proposed governance model is a set of steps towards the efficiency of public buildings and thereby public funds. The money that is not spent can be used for investment in other community activities.

Schematically, the governance model consists of the following steps:

1. Analysis of strategic documents
2. Economic evaluation - analysis of the costs of operation and maintenance of objects in relation to the budget
3. The proposal to improve the current situation in relation to energy saving measures
4. Energy audits and certificates of selected public buildings
5. Study of the use of objects and draft timetable for the implementation of the proposed activities

The ’Cost effective innovative solutions on public property maintenance, energy savings by optimisation of public buildings’ was launched in Vejprtsko, Ústi Region, Czechia, as a pilot action in the ADAPT2DC project.

Further information:
http://www.kr-ustecky.cz
Michaela Řeháková
rehakova.m@kr-ustecky.cz
tel: 00420 475 657 938
Ing. Jana Nedrdová
nedrdova.j@kr-ustecky.cz
tel: +420 475 657 944

The hamlet of Bussana Vecchia, Italy

Innovative tools to manage the overdimensioned public infrastructure (Maribor)

Land use management in Litzendorf, Germany

Reduction of Public Dwelling Stock, in Germany

Vacancy cadastre Remptendorf/Saale-Orla District, Germany

• Expansion of the residential rental market . It is an important tool to make the local housing market more flexible, being able to adapt to demographic change but is can also support measures to counterbalance it: good quality and affordable housing supply effectively supplements measures to vitalise the local economy, to attract new residents in the area.
• Improvement of energy efficiency, thus decreasing housing costs, improving living conditions and acting against climate change.
• Development of facilities for community-based care to promote a shift from institutional care of elderly and other vulnerable population groups (such as, people with disabilities).
• Change in the approach of spatial planning. In the past decades, spatial planning was focusing mainly in managing growth. However, demographic change needs a change in such an approach: instead of the current growth-oriented strategies decline -oriented ones may be more relevant. In shrinking areas, developments should be turned to brownfield areas instead of greenfields. Instead of suburbanisation, development should be focussed on the establishment of a compact settlement structure . Main features of a compact settlement structure are:
  • a variety of functions,
  • harmonious spatial mix of functions, no excessive distance between workplaces, housing, commercial and recreational areas,
  • relative density,
  • clear boundaries, lack of urban sprawl.

In ageing societies more attention should be paid to the specific needs of elderly population and people with disabilities and with restricted mobility when shaping the land use structure of settlements.  In order to prevent shrinking, child- and family friendly settlements need to be developed in addition to economic measures creating employments.

Revitalisation of the City Centre, Güstrow/Mecklenburg-Western Pomerania, Germany

Spatial planning is also a key to the adaptation to demographic change in rural areas, where shrinking and ageing makes the reorganisation of infrastructure and service provision unavoidable, as such actions may include a spatial rearrangement of infrastructure and services .
Spatial rearrangement of infrastructure and services may include:

• spatial concentration of functions and ensuring access of all citizens to the central place where functions are located,
• spatial distribution of functions, with a strong co-operation between communities to ensure access to services and infrastructure to all citizens.

Decision regarding spatial concentration or distribution should be based in the given area’s characteristics, especially in terms of settlement structure, physical geography and transport connections.

Policies aiming to decrease regional differences may play a role in demographic restoration, or at least in slowing down shrinking and ageing.

Integrated and efficient planning of infrastructure in rural areas, Lommatzsch and surrounding communes/Saxony, Germany

Orienting questions

• What is the ratio of public housing in your area? What is the ratio of owner occupied housing?
• Who is responsible for the public housing stock in your area?
• In case there is vacant public property in your area: Who is responsible for the management of vacant public property in your area? How does it manage vacancy?
• Are there any examples in your area for:
  • function change – what happened?
  • downsizing buildings (either partial demolition or closure of parts of the building and/or function change of other parts of the building)
  • demolition of buildings – what happened to the area managed after the demolition?
• Were any programmes carried out to improve energy efficiency? What kind of buildings were involved?
  Is there urban sprawl in your area?

In urban areas:

• Were any actions taken in the past 5-10 years that aimed to develop a more compact urban structure in your area? If yes, list a few such actions!
• Were there any actions that aimed to create a more elderly friendly built environment in your area? What were these actions?
• Were there any actions that aimed to create a more family- and child friendly built environment in your area? What were these actions?

In rural areas:

• Were there any actions that aimed a spatial rearrangement of functions as a response to demographic change in your area? What kind of actions were taken?

5.2.3. Water/sewage treatment

Adaptation of such network infrastructure to the effects of demographic change is challenging, as the resource demand for the modification of technical infrastructure is usually high . However, due to the increasing per capita costs and potential technical problems (e.g. in case of loss of clients of water provision systems) such adaptation may be necessary in order to ensure the long-term operability of systems.

Demographic change leads to the decrease in the need for water provision and sewage treatment which renders formerly designed systems financially difficult to maintain . In order to cope with arising problems the following methods are recommended:

• Reduced, refitted, re-organised facilities and infrastructure (including cutting back of infrastructure if relevant).
• Development of decentralised or semi-centralised systems, as centralised systems may have much higher fix costs and cannot be adapted rapidly to changing population numbers. Especially in dispersedly built areas not every house needs to be connected to a central sewage plant, if there is an effective local solution for waste water management.
• In certain cases, centralisation seems a good solution, e.g. construction of a big sewage water treatment plant taking over sewage water of the neighbouring communes, which costs split between involved communes.
• Cooperation in management and service provision between providers and decentralised networks . This unifies dispersed markets into larger ones, which is an important step to mitigate the financial burden caused by oversized infrastructure, and helps to reduce costs.
• Creation of new income sources : linkage of energy generation and sewage water treatment creates revenue sources for providers.
• Introduction of flexible technical solutions.  

Efficient purification plants, Bad Ems/Rhineland-Palatine, Germany

EuWAK – Natural gas and hydrogen produced in purification plants, Bottrop, North-Rhine-Westphalia, Germany

• Introduction of efficient management, e.g. autonomous planning, announcement and construction management of building activities.
• Development of a more efficient energy supply.

Review questions

• What are the main effects of ageing on transport needs?
• What are the main effects of shrinking on transport needs?
• List a few adaptation techniques that can improve the mobility of residents in areas subject to demographic change!
• List a few techniques that can be used to adapt water/sewage treatment facilities to demographic change!

Orienting questions

• How many percent of housing is connected to the sewage network in your area?
• How did the price of water and sewage treatment change in your area in the past 5 years? How did it change compared to the national average (if such data are available)?
• Are you aware of any new, innovative solutions to adapt water/sewage treatment facilities to demographic change in your area?

5.3. Social infrastructure

5.3.1. Health and care

Although the number of inhabitants is likely to further decrease in the coming years in most regions in CEE, the demand of health care and long-term care will increase due to higher life expectancy .

These challenges include:

• Increasing public health expenditure for health and longterm care as a consequence of the increased number of people requiring such care. Cost of service delivery in health care is expected to also increase due to standards imposed by the national health care funding system in all countries.
• Decreasing number of ‘active’ individuals . Decrease in the number of people actually active in the labour market decreases tax revenues, and impede economic growth, which poses major problems for public finances. There are several policies on the national levels aiming to improve the ratio of active earners. Reforms of the pension system, and especially retirement age, and pushing back various forms of early retirement as well as channel back people who are able to work but are presently inactive into the labour market are actual issues in the CE countries.
• Increasing demand for quality services, since health and care are Services of General Interest (public good) that is obligatory to provide by law and have to be delivered and secured by the authorities.
• Lack of country doctors . The provision with health care is particularly problematic in declining regions because doctors have to take care of more and more people living on a great territory, and the communes dispose over less and less money to secure health care. This situation makes it rather unattractive for young doctors to settle, especially in rural areas.
• Lack of care staff (nurses)  in care homes

Main challenges relating to health care and long-term care are not only determined by demographic changes and the financial implications for public expenditure, but also by the often poor financial situation of elderly people .  For instance  even if the health care service itself is free of charge for them, transport to the doctor or payment for the medicines might cause financial difficulties for them.

Recommendations:

• Supporting health prevention and personal responsibility.
• Supporting home care services to reduce public costs, and help the people to live and function independently as long as possible in their familiar surrounding (e.g. with the help of AAL Systems - Ambient Assisted Living Systems).

Adaptation of housing to promote independent life/Arzberg, Oberfranken, Germany

Thüringen Stipendium, Germany

• Introduction of ICT technology into homes (Smart Homes, Telecare, Telemedicine) as part of care for the elderly.  The services comprise ICT that include alarms, internet and telephone-based systems that monitor the well-being of older people.  It can help in reducing the risk of accidents and increasing the safety, independence, and quality of life of the elderly. Using ICT in health care focuses either on information provision or risk management (avoids travel costs and times).

TelLappi - Securing health care in remote areas, increasing and utilising new technologiesd

Telemedical services for senior citizens as a tool for optimising healthcare costs in Malopolska, Poland

• Use not needed infrastructure for mobile/local practices and combines it with other offers (health and social centre).

Centre of Culture and Leisure for Senior Citizens in Nowa Huta, Poland

• Better coordination of the existing health care system (with new technological solutions) Cost saving is based on limiting direct travelling to patients and using the technology instead of an on-site practice.

Mobile Dentist

• Building strong cooperation between regional health care and transport providers (provide health care in the closest agglomeration and connect the region to it).
• Incentives for young doctors “learning by doing” via mentoring system . The organisation of mentoring practices (e.g. by more experienced doctors to their younger colleagues) is important, as it can facilitate the process of integration and support of the staff in the field of health care.

Family Doctor Academy - Attracting young doctors to work in rural areas as family doctors

Want to know more? Useful links, further projects in this topic:

• DC NOISE Demographic Change: New Opportunities in Shrinking Europe
• Q-AGEING Quality ageing in an urban environment
• HELPS - Housing and home care for the elderly and vulnerable people

Orienting questions

• How provision of health care is managed in your area? Who are the main stakeholders in the field of long-term care?
• How is the provision of health care financed in your area? How public health expenditure changed in the last 5-10 years in your area?
• Were there any shutdowns or reorganisations of institutions providing health care and long term care in your area? If yes, what was the result of such actions in terms of the finance and quality of the given services?
• Is there public debate on improving the quality of (public) health care in your area?
• Are there any settlements/settlement quarters in your area, which have problems with staff provision in health care?
• Are you aware of any new, innovative solutions to improve the health care and long term care of residents (e.g. ICT technologies, Telemedicine, mobile practices, etc)?

5.3.2. Childcare and other social services

Social services is often one of the first sectors that suffer from the consequences of demographic change since the decrease of inhabitants leads to fewer incomes for the communes. Additionally, the provision of social services is sometimes not perceived as absolutely necessary in comparison to health care or water provision. Often communes see only one way to cope with demographic change – cutting of expenditures through omitting voluntary offers in the area of social service, decreasing communal investment and cutting of jobs in administration.

In fact provision of adequate social services – especially child care services – in order to assist women returning to the labour market may be an important factor to mitigate negative demographic trends . Female labour market participation improves the activity rate, thus meliorate the support burden of the active age groups.

Recommendations:

• Cooperation between public and private stakeholders for the bundling of resources.
• Realisation of multifunctional facilities and a flexible organisation within public facilities.
• Spatial bundling of services in multifunctional centers . However spatial concentration only improves/maintains the delivery of social services if the improvement of the physical accessibility of multifunctional centeres takes place at the same time.
• Introduction of new forms of child nursing services or at least a flexibilisation of operation times of childcare institutions. It is more and more necessary due to the stronger flexibilisation of working hours and working models.

Promoting the return of women to the labour market by launching integral nursing services for children in Észak Alföld, Hungary

• Bring child care and care for the elderly together in one building using the same infrastructure and employees and offer programmes where both can profit from each other.

Intergeneration house “Fruits of Society” in Murska Sobota, Slovenia

The case of the secondary school of Herbsleben, Germany

• Decrease standards (such as, the minimum number of children that are needed to keep a nursery open).

Orienting questions

• How is the provision of social services managed in your area? Who are the main stakeholders?
• Were there any shutdowns or reorganisations of institutions providing social services and child care services in your area? If yes, what was the result of these actions in term of the finance and quality of services?
• What is the system of maternity leave in your area? (Length of paid maternity leave, entitlements, amount of financial support, possibility of paternal leave, possibility of work while on maternity leave etc.)
• Do child care services meet the demand in your area? (Quantity of places, accessibility of services etc.) If not, what are the main shortages?
• What is the rate of female labour market participation in your country and in your area? Is there a potential in the promotion of the return of women into the labour market? If yes, how could child-care services assist women in it?
• How widespread is part-time work in your area?
• Are there any settlements/settlement quarters in your area, which have problem with staff provision in social services?
• Are you aware of any new, innovative solutions to improve social services (e.g. multifunctional facilities, flexibilisation, etc.)?

5.3.3. Local supply

Changing demand caused by ageing and shrinking also affects the providers of local supply and services.  The decreasing number and purchase power of the clientele of local shops may lead to their shutdown, especially in depopulated rural areas, while the elderly and poor people are the less capable (physically and/or financially) to travel to a further shop or shopping centre to fulfil their needs.  In addition these kind of places (shops, post offices, etc.) have a symbolic significance as they function as ’agoras’, local meeting points for the communities, thus their presence is important for the liveability of the given community.

Recommendations:

• Involve citizens and their voluntary work with additional fundraising for new activities. 

DORV Bundling of local and social services, usage of an abandoned building and establishing a central meeting point in the village

• Promotion of entrepreneurship may be an effective tool to improve the economic base in ageing and shrinking regions, as well as to improve local supply. E.g. promotion of self-production (such as, self-production of food and energy) reduces costs, creates new job opportunities and facilitates a healthier life style for residents.
• Focus on regional products (less dependency from global chains and regional marketing that attracts tourists).

Village Shop Allgaeu Krugzell

• Maintenance and development of communication networks in areas affected by demographic change is important in order to prevent marginalisation, provide cost-effective services and support measures to counterbalance shrinking and ageing. Such actions include, among others, an extensive broad-band provision and maintenance of post services through the development of new organising models
• Using ICT technology and mobile services.

Mobile Citizens Advice Bureau

• Introduce innovative financing opportunities (time bank, cooperatives, community supported agriculture).
• cooperation between public and private stakeholders for bundling of resources, realisation of multifunctional facilities and a flexible organization within public facilities 
• Spatial bundling of different services in one place - one person takes care for several institutions/duties.

The multiservices center in Ostana (Po valley)

As public administration is key in service provision as well as implementing actions to adapt to demographic change, solutions applied in the public administration are relevant. Such solutions may include:

• demographic check for planning new infrastructure;
• demographic coaching: professional support on issues related to demographic change for those responsible in communes.

Demography coaches in Saale Orla District, Thuringia and in Oberfranken-Ost Bavaria, Germany

5.4. Transferability and best practice pursuit²⁰

Based on the clustering of NUTS3 territories; made up in a joint computation of the PCR (proxy cost ratio) as well as economic, spatial and demographic variables; one may see a potential to seek for territories of similar characteristics. The variables taken into consideration for the demographic performance of a territory are:

• the proxy cost ratios (PCRs) of public service costs within the different infrastructure sectors
• the population change (years 2000-2010)
• the long term population change (years 1990-2011)
• the average rate of natural population increase (years 2000-2010)
• the elderly to active population ratio (year 2008)

A set of different cluster-types was generated for social care, health care, public housing, water and sewage and public transport²¹. The territories that share resembling characteristics can be used in order to enable a better future transfer of solutions and best practices among Central European regions. In other words, for instance those interested in solutions over water and sewage management and adaptation to policy or operational schemes, should at first focus on areas characterised by similar economic, spatial and demographic variables and only then refer to relevant supply-side solutions over the practices.

Map of clusters of similar territories in Central Europe according to health care proxy cost and other variables [image]

In case of health care, for type A the majority of territories represent intermediate and rural areas where ageing is much higher than average and natural increase as well as long-term population change have low values. Type B is dominated by intermediate territories with highest values of long-term population change. Type C most of all offers a picture of urban territories where PCRs, population density and GDP per capita present the highest values. Type D is characterised by lowest PCRs, GDP per capita and natural increase. These are mainly rural territories. Finally type E represents the lowest values of ageing and population density as well as highest natural increase. In case of health care sector, we can observe clear division of Central European countries on group in which clusters type E and D are dominant, and group with clusters type A and B. The first group consists of Poland, Slovakia, the Czechia and Hungary. The second group consist of Germany, Italy. However in this countries there are some territories of different types. Austria and Slovenia are most diverse countries taking into account clusters types.

Map of clusters of similar territories in Central Europe according to water and sewage proxy cost and other variables [image]

In case of water and sewage services type A represents both rural and intermediate regions with low levels of: GDP per capita, ageing and population density. Intermediate regions dominate in type B which is characterized by the highest levels of natural increase and population change as well as the lowest PCRs. Type C is a mix of different territories where natural increase is low and all other variables are close to an average. The specifics of type D – of mixed territories – are the highest values of ageing and the lowest values of natural increase and population change. Mainly urban territories form the type E. They present the highest values of PCRs, GDP per capita and population density. Most of territories in Poland, Czechia and Slovakia are of the same type, i.e. A, except large urban areas of type E. The remaining Central European countries are very diverse, some “islands” of similar clusters types can be observed; for example in Hungary or Eastern Germany. In Italy different types dominate in North-West (type E), central (type C) and South (type A) regions.

Map of clusters of similar territories in Central Europe according to public transport proxy cost and other variables [image]

In transport services type A is dominated mostly by urban territories. They present the highest values of PCRs, GDP per capita and population density. Type B consists mainly of intermediate and rural territories, characterized by the highest values of population change. Similarly type C consists of intermediate and rural territories but their specifics is the lowest population change and natural increase as well as significant ageing. A mix of different territories in type D is characterised by the highest values of natural increase and the lowest values of GDP per capita, population density and ageing. In Poland, Czechia and Slovakia most territories are of type D, except large urban areas, which represent clusters of type A. We can also observe clear internal differences in Germany, Slovenia and Austria.

Review questions

• What are the main effects of ageing on demand for health care and long term care?
• List a few techniques that can be used to adapt health care services to demographic change!
• How can health care be provided in declining regions?
• What are the main effects of shrinking on the supply of social services?
• List a few adaptation techniques that can improve the provision of social services in shrinking regions/cities!
• List a few techniques that can be used to adapt housing to demographic change!
• How can spatial planning react to demographic change in urban areas?
• How can spatial planning react to demograhic change in rural areas?
• List a few actions in public administration that can support adaptation to demographic change!
• How can voluntary engagement support adaptation actions, and what are the risk associated by the involvement of voluntary engagement?

Orienting questions

• Were there any shutdowns of local shops and services in your area in the last 5 years?
• Were there any local protests against these shutdowns?
• Were there any new solutions (spatial bundling in multifunctional centres, cooperation/voluntary work of local residents in order to provide such functions again?
• How common is voluntary engagement in your area? Which population groups are mostly active in voluntary actions?
• Are you aware of any new, innovative solutions to improve public administration on the spot (e.g. ICT technology)?