Skip to main content
NCBI home page
Sage Choice logoLink to Sage Choice
. 2024 Jul 18;44(1):95–105. doi: 10.1177/07334648241262646

Estimating Accessibility Problems in the Swedish Housing Stock Using Citizen Science: The Housing Experiment 2021

Björn Slaug 1,✉, Marianne Granbom 1, Susanne Iwarsson 1
PMCID: PMC11622521  PMID: 39023853

Abstract

Accessible housing for the aging population is important, but large-scale reliable information on accessibility problems in ordinary housing is lacking. This study aimed to describe the prevalence of environmental barriers and analyze potential accessibility problems in the Swedish housing stock and to evaluate the validity and representativeness of housing data collected in a citizen science project. Data on environmental barriers in 1181 dwellings were collected by members of the public. Prevalence of barriers and potential accessibility problems were analyzed using descriptive statistics and ranking methodology. Validity and representativeness were addressed by comparisons with public statistics and research, and analysis of data properties. It was found there are substantial numbers of environmental barriers in dwellings across Sweden that generate accessibility problems for people with functional limitations. The results suggest that with user-friendly data collection tools and instructions, data validity and representativeness can be achieved in citizen science projects involving older adults.

Keywords: older adults, housing accessibility, environmental barriers, citizen science, aging-in-place

What this paper adds

  • • Knowledge about involvement of older adults in a citizen science project targeting housing issues

  • • Knowledge about environmental barriers and accessibility problems in the ordinary Swedish housing stock

  • • Understanding of issues of validity and data quality in citizen science projects

Applications of study findings

  • • Citizen science projects should be considered as a viable way to involve older adults in data collection on issues of importance to them and society overall

  • • Citizen science projects need to include considerable methodological efforts to achieve data of high quality and validity

  • • Housing accessibility for the aging population should be further addressed both in research and by policymakers

Introduction

Despite progressive population aging, housing provision meeting the needs of people as they age is lagging (see, e.g., Schekler et al., 2022), and there is an urgent need to better understand and provide for the diversity of housing requirements of older adults (Vespa et al., 2020). For example, even if accessible housing for people with functional limitations is a key issue for active and healthy aging (Jonsson et al., 2021; WHO, 2018), in most countries the ordinary housing stock does not meet even basic accessibility requirements. By accessible housing we mean housing designed or adapted to support activity and participation, despite reduced functional capacity. Earlier research indicates that inaccessible housing may affect autonomy (Haak et al., 2007), independence (Mahler et al., 2014), and participation (Thordardottir et al., 2018) in later life. Moreover, there is evidence that poor housing accessibility may increase the risk of fall accidents (Hu et al., 2015), mental health issues (Howden-Chapman et al., 2011), as well as mortality rates (Rantakokko et al., 2013).

For complex, societal challenges where any potential solution is only temporary and can always be contested, the term wicked problems has been suggested (Rittel & Webber, 1973). Considering that decades of public debate and policy ambitions to deal with providing accessible housing for the aging population have not resulted in any decisive solutions, this issue bears the characteristics of a wicked problem (Jonsson et al., 2021). Wicked problems are characterized by involving different dimensions and multiple critical variables in an intertwined manner, that have to be analyzed and considered from sometimes conflicting perspectives and interests of several actors. A basic dimension in addressing a wicked problem concerns how the issue is measured and quantified. Reflecting on this dimension, there is a lack of systematic information about the state of accessibility in the housing stock, with scarce knowledge on how person-environment interactions in later life affect housing accessibility. In accordance with the Ecological Theory of Aging and the concept of person-environment fit (Lawton & Nahemow, 1973), individuals with reduced functional capacity are more sensitive to the demands of the physical environment. However, a good person-environment fit can still be achieved by lowering the environmental demands. Better knowledge of the impact of specific housing design features on person-environment fit in later life is therefore critical in improving housing accessibility. Dealing with housing provision for the aging populations, there is also an ethical dimension that relates to equality, personal responsibility and freedom of choice that is necessary to consider. Another important dimension is the empathic dimension, which is critical for communication striving to understand and influence attitudes and feelings about housing accessibility. Jonsson et al.’s (2021) findings indicate that empathetic and creative ways to influence attitudes are vital to changing people’s positions and bridging boundaries.

For more than 20 years we have collected reliable and detailed data on environmental barriers and housing accessibility in several countries (see, e.g., Iwarsson et al., 2006). The largest existing dataset contains data collected by researchers at home visits with different samples of older adults in southern Sweden, which has been used to extrapolate the findings to the national level (Granbom et al., 2016). The findings showed that high proportions of dwellings had substantial numbers of environmental barriers, albeit with significantly lower numbers in later building periods. However, as 75% of the current Swedish housing stock was built before the 1980s when guidelines and building regulations concerning accessibility were introduced, most of the older segment of the population lives in dwellings with substantial accessibility problems (Table 1). Noteworthy, the study by Granbom et al. (2016) showed there were considerable accessibility problems already for older adults with few functional limitations, and markedly more prominent especially for people using mobility devices. In single-family dwellings the entrance was the most problematic housing section, while the kitchen was the most problematic in multi-family dwellings.

Table 1.

Distribution of the Swedish Ordinary Housing Stock 2021. a

Building period Single-family house % (n) Multi-dwelling block % (n) Total % (N)
−1960 41 (861 967) 39 (1 014 992) 40 (1 876 959)
1961–1980 34 (719 121) 34 (882 813) 34 (1 601 934)
1981–2010 20 (430 754) 17 (436 736) 18 (876 490)
2011-w 5 (94 237) 11 (287 190) 8 (381 427)
Total 100 (2 106 079) 100 (2 621 731) 100 (4 727 810)
Open in a new tab

Note. Building year was unknown for 14,356 dwellings in the Swedish ordinary housing stock 2021.

For a long time in Sweden, housing accessibility has been promoted for by senior citizen organizations and advocates for the disability rights movement, though hitherto mainly on the national policy level. Tapping into these efforts to promote housing accessibility, a citizen science project was initiated together with the non-governmental organization Science & Public, with older adults and people with functional limitations as the main target groups—The Housing Experiment 2021. Citizen science means scientific research conducted in whole or in part by members of the public (Heiss & Matthes, 2017; Kasperowski & Brounéus, 2016). It serves the purposes both of gaining scientific insights and knowledge that would be difficult or impossible for professional researchers to gain alone, and to engage the public in scientific activities. With the empathic dimension of the wicked problem of providing accessible housing for the aging population in mind, the ambition of this project was to incentivize members of the public to collect detailed data of environmental barriers in the ordinary housing stock on a large scale, by means of a user-friendly app using research-based questions (Granbom et al., 2023). Underlying ideas of the project were also to engage public citizens in research activities (Wood et al., 2022), and to evaluate their capacity as co-researchers and explore the potential effects on attitudes to housing accessibility (Frögren et al., 2023) as an avenue towards local actioning.

In any research project it is critical to assure the highest possible quality of data, and in academic research there are usually extensive resources invested for that purpose. However, this is not often the case in citizen science, and in a recent study data quality was identified as “the Achilles heel of citizen science projects” (Balazs et al., 2021). This is manifested, for instance, in ambiguous definitions of data quality and unclear procedures of how to achieve it. Data quality issues are also a reason why citizen science projects now and then have been viewed with skepticism and distrust from both researchers and policymakers (Bonney et al., 2014; Kosmala et al., 2016; Nascimento et al., 2018). To gain credibility for citizen science projects it is therefore important to scrutinize data collected by members of the public and to evaluate quality in a transparent manner.

Based on the empirical data collected during the Housing Experiment 2021, the aim of the current study was twofold. First, we aimed to describe the prevalence of environmental barriers in the housing stock in Sweden, and to analyze accessibility problems by relating the data to combinations of functional limitations that are common in the aging population. Second, we aimed to evaluate the validity and representativeness of housing data collected by members of the public.

Material and Methods

The Housing Experiment App

The Housing Enabler (HE), which is a research-based instrument for assessing and analyzing housing accessibility problems in terms of person-environment fit (Carlsson et al., 2009; Iwarsson et al., 2012) constituted the scientific base for the data collection in the Housing Experiment 2021. The HE comprises an environmental (physical barriers) and a personal (functional limitations) component that are combined to quantify potential accessibility problems. The environmental component of the HE consists of 161 potential environmental barriers in and around the home, based on standards and guidelines for housing design as expressed in national legislation and guidelines. For screening purposes, a shortened list of 60 environmental barrier items that are most important to detect housing accessibility problems on population or group level was launched (Carlsson et al., 2009). Using this shortened environmental checklist of the HE as the starting point, 33 items were selected and adapted into a citizen science version of the HE, in a rigorous process (described in detail elsewhere, see Granbom et al., 2023). Focusing on the entrance and indoor environment, items concerning the exterior surroundings (20 items) were not included in the citizen science version, and other items were excluded mainly due to very high prevalence (>95%) confirmed in previous research. Moreover, during this process, some items were split into more than one question, and some were repeated for different locations in the dwelling, resulting in a total of 40 questions in the citizen science version of the HE. However, to make the current study comparable to previous research using the original instrument, the split questions were recombined in the analysis and presentation of results.

For members of the public to collect data, together with the non-profit organization Science & Public we developed a web application (app) for IOS and Android for use on smartphones and tablets. The app was developed in an iterative development process in six phases including participatory activities with researchers, citizen science specialists, tech developers, older adults, and other members of the public. Substantial efforts were made to ensure that the app was easy to use regardless of digital literacy. After usability testing involving older adults that lead to some adjustments and fine-tuning of the interface, the app was evaluated as usable and reliable (Granbom et al., 2023). The app was open to download for free on Google Play and App Store. All instructions needed were embedded in the app. Supporting information was published online in text and video. Although the main efforts were directed at older adults as the target group, the intention was to make it available for all in the public with an interest in participating as data collectors (Figure 1).

Figure 1.

Figure 1.

Open in a new tab

Conducting measurements to answer questions in the Housing Experiment app. Photo by Kennet Ruona.

Data and Data Collection

Descriptive questions in the app were used to collect address zip code and information about type of dwelling, building year, and major renovations. Questions about the residents in the dwelling relevant for accessibility issues, that is, if any of them were 65–79 years old; 80 years or older; used a wheeled walker or wheelchair in the dwelling followed. The 40 Yes/No questions derived from the HE addressed the presence of specific design features at the entrance, in the kitchen, bathroom, and in other parts of the dwelling. For example, the user had to respond Yes/No to questions such as “Do all flights of stairs have bannisters on both sides?”, and measure with a ruler to respond Yes/No to questions such as “Are any of the thresholds one needs to pass at the entrance higher than 15 millimeters?” It was possible for the user to skip questions and still register their responses. Upon completion the responses registered in the app were automatically uploaded to a database, which was updated in real-time on a public project website (The Housing Experiment 2021). Data was collected during 2.5 months in fall 2021.

Recruitment of Participants for Data Collection

Information about the citizen science project and recruitment efforts were made by all partners of the Housing Experiment 2021. Various local and national news outlets were contacted, which resulted in about 20 press clippings, two broadcasts on national radio and one on a national TV channel, with a total reach of 8,637,496 persons. Science & Public informed their members by internal advertising, media coverage in member magazines or directly via email to members and noted more than 80 posts on social media with more than 34,000 impressions. Interest associations focusing on issues relating to either older adults, people with disabilities or housing (such as tenants' and housing company associations) were approached and offered written and video material to use for information about the project. In addition, partnering associations used social media to inform about the Housing Experiment 2021 and attract participants. In line with previous citizen science projects involving the Science & Public organization, there was also an effort to reach teachers at public schools and offer their pupils the possibility to engage in data collection. Although special curriculum-adapted material was also provided, there was however little interest in the public schools to engage in this project. In all, 1181 members of the public participated in the data collection (70% aged 65 or older).

Data Analysis

Descriptive statistics (percentages or median and quartiles) were used to present basic characteristics of the dwellings, and to present number of environmental barriers (min–max = 0–33) by dwelling type and building period. For comparisons of prevalence of specific barriers between dwelling type and building periods, chi-square test was used. All calculations were based on valid answers.

To analyze the barriers generating most accessibility problems at group level we used functional profiles defined through previously reported simulations and statistical analyses of large data sets on functional limitations of older adults (Granbom et al., 2016; Slaug et al., 2011). Four functional profiles with increasing complexity were used: Profile I: limitations in movement only; Profile II: limitations in movement and upper extremity; Profile III: limitations in movement, upper extremity and dependence on mobility devices; and Profile IV: limitations in movement, upper extremity, dependence on mobility devices and loss of sight. For each environmental barrier an accessibility problem score based on the HE methodology was calculated (Slaug et al., 2011). The accessibility problem score is calculated by combining the environmental items with the functional profiles, using a scoring matrix with pre-defined severity ratings (0–4) that are summed up to a total score, which represents a quantification of predicted accessibility problems. Next, ranking lists of environmental barriers in descending order according to the magnitude of accessibility problems generated were produced.

To evaluate validity and representativeness of the data the distributions of type of dwelling and building period were compared to publicly available national statistics (Statistics Sweden, 2023). The ranking order of barriers generating the most accessibility problems was compared to previous research results based on existing data collected by trained data collectors at home visits, extrapolated to the national level (Granbom et al., 2016). To further evaluate validity, we calculated the missing ratio for each of the 40 questions concerning the presence of environmental barriers, considering a missing ratio of at most 5% as acceptable We tested internal data consistency based on the assumption that there is pattern in the distribution of barriers and accessibility problems at national level that should be consistent throughout the Housing Experiment dataset. To test this, we applied a type of split-half procedure (Carmines & Zeller, 1979). That is, we first randomly split the data in two equal subsets, and then tested for differences in the accessibility problem scores for the four functional profiles between the two subsets using Kruskal–Wallis test.

The SAS Software, SAS Institute Inc., Cary, NC, Version 9.4 was used for all analyses.

p-values <0.05 were considered statistically significant.

Results

The total number of dwellings assessed was N = 1181. Type of dwelling was evenly divided between single-family houses (51%) and apartments in multi-dwelling blocks (49%). Regarding building year, the period of the million homes program in Sweden (i.e., 1960–1979) dominated (36%). Ten percent of the dwellings were built after 2010. In 15% of the dwellings there were residents aged 80+ and in 10% there were residents using mobility devices. For details, see Table 2.

Table 2.

Basic Characteristics of Dwellings Assessed by Members of the Public, N = 1181.

Variable % (n) Missing n
Type of dwelling 10
 Single-family house 51 (592)
 Multi-dwelling block 49 (579)
Building period 39
 <1960 28 (317)
 1960–1979 36 (415)
 1980–2010 26 (296)
 2011-w 10 (114)
Renovated 28 (304) 90
Individual using mobility devices living in dwelling 10 (119) 22
Individual aged 80+ living in dwelling 15 (170) 35
Open in a new tab

In total, there were more environmental barriers in single-family houses (median = 16, q1-q3 = 13–19) compared to in apartments in multi-dwelling blocks (median = 13, q1-q3 = 9–16). The highest number of barriers was identified at entrances (median = 5, q1-q3 = 3–6). As to building period, there were fewer barriers in newer dwellings, particularly notable for barriers at entrances (median = 2, q1-q3 = 1–4). See Table 3 for details.

Table 3.

Number of Environmental barriers by Type of Dwelling and by building Period, N = 1181.

Type of dwelling a Building period b Total N = 1181
Single-family house, n = 592 Multi-dwelling, n = 579 <1960 n = 317 1960–1979 n = 415 1980–2010 n = 296 2011-n = 114
Median (quartile 1–quartile 3)
Total number of barriers 16 (13–19) 13 (9–16) 16 (14–19) 15 (12–19) 12 (9–15) 9 (6–12) 14 (11–18)
Entrance 5 (4–6) 4 (2–6) 6 (4–7) 5 (3–6) 4 (2–5) 2 (1–4) 5 (3–6)
Kitchen 2 (2–3) 2 (2–3) 2 (2–3) 2 (2–3) 2 (2–3) 2 (1–3) 2 (2–3)
Bathroom 4 (3–4) 4 (3–4) 4 (3–5) 4 (3–4) 3 (3–4) 3 (3–4) 4 (3–4)
Other location 4 (2–7) 3 (1–4) 4 (2–6) 4 (3–6) 2 (1–3) 2 (0–2) 3 (2–5)
Open in a new tab

aInformation about type of housing missing for 10 cases.

bInformation about building period missing for 39 cases. Total number of barriers = 0 to 33.

No grab bar at shower and/or toilet was the most frequent barrier overall (92%), consistently with a prevalence >90% across building periods. However, in single-family houses stairs the only route at entrance was even more frequent (98%). Significant differences between single-family houses and apartments in multi-dwellings blocks concerned a higher number of thresholds, both at entrances and indoor locations in single-family houses (p < .001). Barriers at entrances, such as stairs the only route, thresholds, steps and short handrails were significantly less prevalent in later building periods (p < .001). See Tables 4 and 5 for details.

Table 4.

Most Prevalent Environmental barriers by Type of Dwelling, N = 1181.

Location Environmental barrier Total % (n) Single-family house % (n) Multi-dwelling block % (n) p-value a
Bathroom No grab bar at shower and/or toilet 92 (1086) 95 (560) 89 (518) .001
Kitchen No surface suitable for sitting while working 87 (1029) 89 (525) 86 (498) .169
Entrance Stairs the only route 83 (982) 98 (578) 68 (396) <.001
Bathroom Wash basin at a height only for standing 83 (981) 82 (487) 84 (487) .398
Other location High threshold/level difference/step 76 (899) 83 (489) 70 (406) <.001
Bathroom Toilet 47 cm or lower 75 (880) 75 (443) 74 (431) .877
Other location Thresholds/level differences/steps between rooms 67 (796) 73 (434) 61 (354) <.001
Entrance Handrails too short 63 (736) 79 (466) 46 (264) <.001
Entrance High threshold and/or steps at entrance 55 (646) 71 (422) 38 (218) <.001
Kitchen Shelves too deep 54 (636) 52 (306) 56 (322) <.178
Open in a new tab

Note. Information about type of housing missing for 10 cases.

aChi-square test. Significant p-values are bolded.

Table 5.

Most Prevalent Environmental barriers by building Period, N = 1181.

Location Environmental barrier Total % (n) <1960 1960–1970 1980–2010 2011-Present p-value a
Bathroom No grab bar at shower and/or toilet 92 (1086) 93 (296) 91 (379) 92 (272) 91 (104) .760
Kitchen No surface suitable for sitting while working 87 (1029) 85 (270) 88 (365) 91 (269) 88 (100) .196
Entrance Stairs the only route 83 (982) 93 (294) 86 (357) 75 (222) 58 (66) <.001
Bathroom Wash basin at a height only for standing 83 (981) 82 (261) 84 (347) 82 (244) 86 (99) .699
Other location High threshold/level difference/step 76 (899) 72 (229) 78 (323) 83 (246) 52 (59) <.001
Bathroom Toilet 47 cm or lower 75 (880) 74 (234) 76 (315) 72 (212) 76 (87) .583
Other location Thresholds/level differences/steps between rooms 67 (796) 78 (246) 75 (310) 57 (169) 32 (37) <.001
Entrance Handrails too short 63 (736) 68 (257) 68 (284) 48 (142) 25 (29) <.001
Entrance High threshold and/or steps at entrance 55 (646) 63 (200) 58 (242) 49 (144) 36 (41) <.001
Kitchen Shelves too deep 54 (636) 59 (188) 53 (221) 57 (170) 35 (40) <.001
Open in a new tab

Note. Information about building period missing for 39 cases.

aChi-square test. Significant p-values are bolded.

The barriers generating most accessibility problems across the four profiles of functional limitations were lack of grab bars in bathrooms, shelves placed too high in kitchens, and stairs the only route at entrances. The ranking patterns were fairly consistent across the functional profiles. In multi-dwelling blocks accessibility problems generated by barriers related to entrance doors (e.g., heavy door without automatic opener; door that does not stay in open position/close quickly) were prominent in terms of ranking, while stairs to upper story or basement with necessary functions were more prominent as a generator of accessibility problems in single-family houses (Table 6).

Table 6.

Rank Order of the Environmental barriers Generating Most Accessibility Problems, by Functional Profile (I–IV) and Housing Type.

Environmental barrier (n = 33) Multi-dwelling block (n = 579) Single-family house (n = 592)
Profile I a Profile II b Profile III c Profile IV d Profile I a Profile II b Profile III c Profile IV d
Entrances
 Narrow door openings e e 24 27 e e 29 30
 High thresholds and/or steps at the entrance 8 10 12 9 7 11 6 6
 Insufficient maneuvering space at doors e e 16 16 e e 12 13
 No resting area in front of entrance door e e 23 26 e e 20 24
 Heavy doors without automatic door opener 6 3 4 7 14 7 15 17
 Doors do not stay in open position/close quickly 5 7 9 6 22 22 28 27
 Complicated/illogical opening procedure 19 12 21 18 25 23 31 29
 Stairs the only route (no lift/ramp) 3 5 3 3 2 3 2 1
 High, low or irregular heights of risers 17 18 29 23 12 15 26 18
 No handrails or only on one side 12 14 20 19 4 5 11 9
 Handrails too short 15 16 22 21 15 17 22 14
Kitchen
 Insufficient maneuvering space around white goods 11 9 14 11 17 13 18 12
 Shelves placed too high 2 1 2 1 3 1 3 3
 No surface at height suitable for sitting while working 13 15 8 10 18 19 8 11
 Shelves too deep 14 4 5 8 19 4 7 10
 Complex maneuvers and good precision required 26 24 32 32 26 26 32 32
Bathroom
 Insufficient maneuvering space where turning is required 18 19 10 12 21 21 14 16
 Insufficient space for stool/bath board or equivalent 23 23 28 29 24 25 30 31
 No grab bar at shower/bath or toilet 1 2 1 2 1 2 1 2
 Complex maneuvers and good precision required 27 25 33 33 27 27 33 33
 Wash basin at height only for standing 9 11 13 14 13 16 17 21
 Toilet 47 cm or lower 10 13 11 13 16 18 13 15
 Shower stall with kerb/level difference 22 22 25 28 20 20 25 26
 Bathtub instead of shower space 16 17 19 22 23 24 27 28
Other areas
 Narrow doors to sitting-out place/balcony e e 18 20 e e 19 25
 High threshold/level difference/step to sitting-out place balcony 4 6 6 4 5 6 4 4
 Steps/thresholds/difference in level between rooms 7 8 7 5 6 10 5 5
 Narrow passages/corridors in relation to fixtures e e 15 15 e e 16 19
 Narrow doors e e 17 17 e e 24 23
 Stairs to upper story with necessary functions 20 20 26 24 8 8 9 7
 Stairs to basement with necessary functions 20 20 26 24 8 8 9 7
 Handrails or only on one side 24 26 31 31 10 12 21 20
 Handrails too short 25 27 30 30 11 14 23 22
Open in a new tab

Note. Top-10 barriers of each functional profile and housing type are bolded (10 cases had missing information of housing type).

aProfile I: Functional profile with limited mobility.

bProfile II: Functional profile with limited mobility and limited upper extremity function.

cProfile III: Functional profile with limited mobility, limited upper extremity function, and dependence on mobility devices.

dProfile IV: Functional profile with limited mobility, limited upper extremity function, dependence on mobility devices, and visual impairment.

eDid not generate any accessibility problem score.

Comparing the results with available national statistics, single-family houses were slightly overrepresented in our sample (51% vs. 45%). There were fewer dwellings built before 1960 in our sample (28% vs. 40%), while the proportion of dwellings from the period of the million homes program was similar to the national housing stock (36% vs. 34%). The barriers generating most accessibility problems were very similar to our previous research. That is, lack of grab bars in bathrooms, shelves placed too high in kitchens and stairs the only route at entrances generated most accessibility problems. In apartments in multi-dwelling blocks, heavy doors without automatic opener and door that does not stay in open position/close quickly were equally prominent in our sample as in our previous research, as were stairs to upper story or basement with necessary functions in single-family houses. The ratio of missing values for the 40 questions concerning the presence of environmental barriers ranged from 0.8% to 1.2%. Test of internal data consistency showed no significant difference between the two randomly split subsets (p-value range = 0.228–0.384).

Discussion

The results of the Housing Experiment 2021 largely confirmed what previous research has found, that is, there are substantial numbers of environmental barriers in the ordinary housing stock in Sweden (Granbom et al., 2016; Pettersson et al., 2018), both in single-family houses and apartments in multi-dwelling blocks. These environmental barriers generate accessibility problems for many older adults. Evaluating the data collected by members of the public, the results suggest that high data quality, validity and representativeness can be achieved in a citizen science project with older adults as the main target group.

The high prevalences of environmental barriers (70–90%) such as no grab bar in bathroom, stairs the only route to enter the dwelling, thresholds, steps or level differences between rooms, kitchen shelves too deep and lack of surfaces suitable for sitting while working in the kitchen are serious because such barriers generate accessibility problem for people with functional limitations (see Table 6). For thresholds, steps or level differences between rooms there was a notable decrease in prevalence over time (32% in the newest dwellings), but for lack of surfaces suitable for sitting while working in the kitchen (88% in the newest dwellings) and lack of grab bars in bathroom (91% in the newest dwellings) there was no change over time at all. To take the consequences of the aging population for accessible housing better into account, the functional profiles based on person-environment fit calculations used in this study are important. That is, with the aging population, there is an ongoing increase of older adults with more complex combinations of functional limitations, such as both mobility and sensory limitations. For instance, the results of the present study suggest that for multi-dwelling blocks, problems related to the entrance, such as heavy doors without automatic opener and doors that do not stay open or close quickly, generate serious accessibility problems and should have high priority even though they are not the most prevalent. Concerning single-family houses, accessibility problems related to necessary functions located at upper stories or in the basement stand out in a similar manner. On a note of caution, the comparison with previous research concerning accessibility problems was based on ranking order in terms of severity of problems for different functional profiles and not the accessibility problem scores as such. Still, the ranking order identified in the present study was found to be consistent with previous research (Granbom et al., 2016).

While many accessibility problems could be avoided by more foresighted design when building new housing and more efficient home modification strategies (Kim et al., 2024; Sheth & Cogle, 2023), these results indicate an alarming lack of action in the housing provision sector. Already 30 years ago, considerable accessibility issues for older people in the Swedish ordinary housing stock were highlighted in public health research (Iwarsson & Isacsson, 1993). Moreover, in 2015 there was an investigation from the Swedish government (SOU, 2015) that suggested several measures to upgrade the ordinary housing stock in terms of physical accessibility, against the background of the aging population. Considering the results of the current study there are no indications that those measures have come into effect, which further underlines the urgency for all actors in the housing provision sector to take joint action to address the issue of accessible housing in a constructive manner.

To understand the longstanding lack of action in a matter of such social urgency that has from time to time even been high on the political agenda, the perspective of wicked problems (Rittel & Webber, 1973) is useful. Although many actors in the housing provision sector seemingly agree that housing accessibility for the aging population is important to address (Jonsson et al., 2021), typical for wicked problems there is not a common understanding of how to define the issue, how best to deal with it and how to determine when it has been sufficiently addressed (Rittel & Webber, 1973). This suggests that for joint actions to materialize in concrete efforts, economic incentives for all actors need to be strengthened and building legislation has to be both sharper and more specific in the requirements. Recent studies and reports in the US also highlight that current programs such Medicaid home and community-based care waivers are narrow and entirely insufficient to deal with the rapidly growing issue of providing accessible housing for the aging population (Schekler et al., 2022; Vespa et al., 2020).

The similarities of the results of this study and publicly available statistics and research as well as the low missing ratios and the internal consistency of data suggest that the Housing Experiment 2021 produced results that are valid and fairly representative for the Swedish ordinary housing stock. A key factor behind this achievement is the participatory methods applied during the development process (Granbom et al., 2023). Representatives of the targeted users had a direct impact when developing the appearance and functions of the user interface. In addition, older adults were engaged in usability tests of the app prototype, and their feedback helped to fine-tune the final version. Due to a presumed lower level of digital literacy among older adults (Frögren et al., 2023), we took extra care to ensure acceptance and user-friendliness of the digital data collection tool, adding helpful instructions and guidance how to assess and enter data. Thus, the efforts made to make the app easy to use, and the outreach to a broad audience using a variety of communication channels appear to have paid off. The low missing ratios further indicate that the app was successful in this aspect.

Scrutinizing the underlying prevalence figures for specific barriers (Tables 4 and 5), they appear to be at the higher end of the spectrum compared to other previous studies (see, e.g., Pettersson et al., 2018). This might indicate that the Housing Experiment participants tended to be those who already had some awareness of the presence of environmental barriers in their homes and therefore were more interested in these issues, and thus, to engage in the citizen science project. The results of a recent study support this reasoning (Frögren et al., 2023). It should be kept in mind though, that this does not diminish the validity of the results; the ranking order of environmental barriers generating accessibility problems is valid and highlights the most significant issues. However, some statistical adjustment for overrepresentation of dwellings with common barriers might be necessary to estimate the true prevalences. Building on methodological knowledge from the current project, additional initiatives attracting larger groups of citizens to be engaged in data collection would allow the use of “Big Data” methods from zoological and ecological projects to further account for variability, representativity and data quality (Brown & Williams, 2019; Kelling et al., 2015).

With the citizen science version of the HE, we have developed and used a lay person’s version of an instrument originally developed for research and professional practice purposes. To the best of our knowledge, there are few such examples. Though the HE has been used in several large research projects over the years (Iwarsson et al., 2007; Kylén et al., 2014; Nilsson & Iwarsson, 2013), the level of detail and the complexity of the instrument makes it time-consuming and resource demanding, which has hampered a wider use of the instrument. With a citizen science version that captures the most important aspects of housing accessibility, the possibilities for use are significantly extended. For instance, municipalities can use the app to involve citizens to inventory dwellings to detect areas where accessibility problems require special attention. Citizens can also use it themselves to be better informed of potential future accessibility problems in their own dwellings, or to put pressure on housing companies, and political decision-makers to address these issues on the societal level (Wood et al., 2023). That is, the citizen science version of the HE has the potential to become a tool for empowerment of citizens in housing provision issues.

In conclusion, targeting all members of the public but with older adults as the main target group, the Housing Experiment 2021 produced valid results on environmental barriers and accessibility problems in the ordinary housing stock, contributing to accumulated knowledge in this research field. Further, the results suggest that with user-friendly data collection tools and instructions, data validity and representativeness can be achieved in citizen science projects involving older adults. A lesson learned is that considerable methodological efforts that must be carefully planned and implemented are necessary to achieve high quality data and valid results. Citizen science is an underutilized approach to involve older adults in data collection on issues of importance to them and society overall, and the Housing Experiment 2021 has potential to serve as inspiration for future citizen science projects.

Acknowledgments

We would like to thank the national senior citizen organizations PRO, SPF and SKPF for their valuable efforts to the Housing Experiment 2021, locally as well as nationally. We also thank non-academic partners from the Thematic Collaboration Initiative Social Rights and Housing for the Ageing Population at Lund University. In particular, we thank the non-profit organization Science & Public, sharing invaluable knowledge on how to design citizen science projects, and the software company miThings, Lund, Sweden for developing the Housing Experiment app.

Footnotes

The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: The Housing Enabler is a commercial product sold by Veten & Skapen HB and Slaug Enabling Development with Susanne Iwarsson and Björn Slaug as copyright holders and owners. The remaining author has no conflict of interest.

Funding: The Housing Experiment 2021 was conducted within the Centre for Ageing and Supportive Environments (CASE), Lund University, and was financed by the Swedish Research Council for Health, Working Life and Welfare (Forte, 2019-0005) and the Ribbingska Foundation in Lund, Sweden.

IRB Approval: IRB00003322 Lund University, Faculty of Medicine

ORCID iDs

Bjorn Slaug https://orcid.org/0000-0001-7386-2224

Susanne Iwarsson https://orcid.org/0000-0002-6670-7952

References

  1. Balázs B., Mooney P., Nováková E., Bastin L., Jokar Arsanjani J. (2021). Data quality in citizen science. In Vohland K., Land-Zandstra A., Ceccaroni L., Lemmens R., Perello J., Ponti M., Samson R., Wagenknecht K. (Eds.), The science of citizen science (pp. 139–158). Springer Nature. 10.1007/978-3-030-58278-4_8 [DOI] [Google Scholar]
  2. Bonney R., Shirk J. L., Phillips T. B., Wiggins A., Ballard H. L., Miller-Rushing A. J., Parrish J. K. (2014). Citizen science. Next steps for citizen science. Science (New York, N.Y.), 343(6178), 1436–1437. 10.1126/science.1251554 [DOI] [PubMed] [Google Scholar]
  3. Brown E. D., Williams B. K. (2019). The potential for citizen science to produce reliable and useful information in ecology. Conservation Biology: The Journal of the Society for Conservation Biology, 33(3), 561–569. 10.1111/cobi.13223 [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Carlsson G., Schilling O., Slaug B., Fänge A., Ståhl A., Nygren C., Iwarsson S. (2009). Toward a screening tool for housing accessibility problems: A reduced version of the housing enabler. Journal of Applied Gerontology, 28(1), 59–80. 10.1177/0733464808315293 [DOI] [Google Scholar]
  5. Carmines E. G., Zeller R. A. (1979). Assessing reliability. In Reliability and validity assessment (pp. 37–51). Sage Publications, Inc. 10.4135/9781412985642 [DOI] [Google Scholar]
  6. Frögren J., Granbom M., Jonsson O., Bergman M., Iwarsson S. (2023). Characteristics and attitudinal changes of senior citizens and persons with functional impairments involved in a citizen science project on housing accessibility. Citizen Science: Theory and Practice, 8(1), 57. 10.5334/cstp.551 [DOI] [Google Scholar]
  7. Granbom M., Iwarsson S., Kylberg M., Pettersson C., Slaug B. (2016). A public health perspective to environmental barriers and accessibility problems for senior citizens living in ordinary housing. BMC Public Health, 16(1), 772. 10.1186/s12889-016-3369-2 [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Granbom M., Slaug B., Brounéus F., Bergman M., Iwarsson S. (2023). Involving members of the public to develop a data collection app for a citizen science project on housing accessibility targeting older adults. Citizen Science: Theory and Practice, 8(1), 1–12. 10.5334/cstp.509 [DOI] [Google Scholar]
  9. Haak M., Fänge A., Iwarsson S., Ivanoff S. D. (2007). Home as a signification of independence and autonomy: Experiences among very old Swedish people. Scandinavian Journal of Occupational Therapy, 14(1), 16–24. 10.1080/11038120601024929 [DOI] [PubMed] [Google Scholar]
  10. Heiss R., Matthes J. (2017). Citizen science in the social sciences: A call for more evidence. GAIA - Ecological Perspectives for Science and Society, 26(1), 22–26. 10.14512/gaia.26.1.7 [DOI] [Google Scholar]
  11. Howden-Chapman P. L., Chandola T., Stafford M., Marmot M. (2011). The effect of housing on the mental health of older people: The impact of lifetime housing history in Whitehall II. BMC Public Health, 11(1), 682. 10.1186/1471-2458-11-682 [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Hu J., Xia Q., Jiang Y., Zhou P., Li Y. (2015). Risk factors of indoor fall injuries in community-dwelling older women: A prospective cohort study. Archives of Gerontology and Geriatrics, 60(2), 259–264. 10.1308/003588415X14181254789088 [DOI] [PubMed] [Google Scholar]
  13. Iwarsson S., Haak M., Slaug B. (2012). Current developments of the housing enabler methodology. British Journal of Occupational Therapy, 75(11), 517–521. 10.4276/030802212X13522194759978 [DOI] [Google Scholar]
  14. Iwarsson S., Isacsson A. (1993). Basic accessibility in modern housing--a key to the problems of care in the domestic setting. Scandinavian Journal of Caring Sciences, 7(3), 155–159. 10.1111/j.1471-6712.1993.tb00191.x [DOI] [PubMed] [Google Scholar]
  15. Iwarsson S., Nygren C., Oswald F., Wahl H. W., Tomsone S. (2006). Environmental barriers and housing accessibility problems over a one-year period in later life in three European countries. Journal of Housing for the Elderly, 20(3), 23–43. 10.1300/J081v20n03_03 [DOI] [Google Scholar]
  16. Iwarsson S., Wahl H. W., Nygren C., Oswald F., Sixsmith A., Sixsmith J., Széman Z., Tomsone S. (2007). Importance of the home environment for healthy aging: Conceptual and methodological background of the European ENABLE-AGE project. The Gerontologist, 47(1), 78–84. 10.1093/geront/47.1.78 [DOI] [PubMed] [Google Scholar]
  17. Jonsson O., Frögren J., Haak M., Slaug B., Iwarsson S. (2021). Understanding the wicked problem of providing accessible housing for the ageing population in Sweden. International Journal of Environmental Research and Public Health, 18(3), 1169. 10.3390/ijerph18031169 [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Kasperowski D., Brounéus F. (2016). The Swedish mass experiments — a way of encouraging scientific citizenship? Journal of Science Communication, 15(01), Y01. 10.22323/2.15010401 [DOI] [Google Scholar]
  19. Kelling S., Fink D., La Sorte F. A., Johnston A., Bruns N. E., Hochachka W. M. (2015). Taking a ‘Big Data’ approach to data quality in a citizen science project. Ambio, 44(Suppl 4), 601–611. 10.1007/s13280-015-0710-4 [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Kim D., Lee M. J., Kang J. (2024). Exploring differences in home modification strategies according to household location and occupant disability status: 2019 American housing survey analysis. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 43(3), 231–241. 10.1177/07334648231202678 [DOI] [PubMed] [Google Scholar]
  21. Kosmala M., Wiggins A., Swanson A., Simmons B. (2016). Assessing data quality in citizen science. Frontiers in Ecology and the Environment, 14(10), 551–560. 10.1002/fee.1436 [DOI] [Google Scholar]
  22. Kylén M., Ekström H., Haak M., Elmståhl S., Iwarsson S. (2014). Home and health in the third age - methodological background and descriptive findings. International Journal of Environmental Research and Public Health, 11(7), 7060–7080. 10.3390/ijerph110707060 [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Lawton M. P., Nahemow L. (1973). Ecology and the aging process. In Eisdorfer C., Lawton M. P. (Eds.), The psychology of adult development and Aging (pp. 619–674). American Psychological Association [APA]. 10.1037/10044-020 [DOI] [Google Scholar]
  24. Mahler M., Sarvimäki A., Clancy A., Stenbock-Hult B., Simonsen N., Liveng A., Zidén L., Johannessen A., Hörder H. (2014). Home as a health promotion setting for older adults. Scandinavian Journal of Public Health, 42(15 Suppl), 36–40. 10.1177/1403494814556648 [DOI] [PubMed] [Google Scholar]
  25. Nascimento S., Rubio Iglesias J. M., Owen R., Schade S., Shanley L. (2018). Citizen science for policy formulation and implementation. In Hecker S., Haklay M., Bowser A., Makuch Z., Vogel J., Bonn A. (Eds.), Citizen science – innovation in open science, Society and policy (pp. 219–240). UCL Press. [Google Scholar]
  26. Nilsson M. H., Iwarsson S. (2013). Home and health in people ageing with Parkinson’s disease: Study protocol for a prospective longitudinal cohort survey study. BMC Neurology, 13(142), 1–9. 10.1186/1471-2377-13-142 [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Pettersson C., Slaug B., Granbom M., Kylberg M., Iwarsson S. (2018). Housing accessibility for senior citizens in Sweden: Estimation of the effects of targeted elimination of environmental barriers. Scandinavian Journal of Occupational Therapy, 25(6), 407–418. 10.1080/11038128.2017.1280078 [DOI] [PubMed] [Google Scholar]
  28. Rantakokko M., Törmäkangas T., Rantanen T., Haak M., Iwarsson S. (2013). Environmental barriers, person-environment fit and mortality among community-dwelling very old people. BMC Public Health, 13(1), 783. 10.1186/1471-2458-13-783 [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Rittel H. W., Webber M. M. (1973). Dilemmas in a general theory of planning. Policy Sciences, 4(2), 155–169. 10.1007/BF01405730 [DOI] [Google Scholar]
  30. Schekler S., Molinsky J., Airgood-Obrycki W. L. (2022). How well does the housing stock meet accessibility needs? An analysis of the 2019 American housing survey. Joint center for housing studies of. Harvard University. https://www.jchs.harvard.edu/research-areas/working-papers/how-well-does-housing-stock-meet-accessibility-needs-analysis-2019 [Google Scholar]
  31. Sheth S., Cogle C. R. (2023). Home modifications for older adults: A systematic review. Journal of Applied Gerontology: The Official Journal of the Southern Gerontological Society, 42(5), 1151–1164. 10.1177/07334648231151669 [DOI] [PubMed] [Google Scholar]
  32. Slaug B., Schilling O., Iwarsson S., Carlsson G. (2011). Defining profiles of functional limitations in groups of older persons: How and why? Journal of Aging and Health, 23(3), 578–604. 10.1177/0898264310390681 [DOI] [PubMed] [Google Scholar]
  33. SOU (Statens offentliga utredningar) [Swedish Government Official Reports] . (2015). Bostäder att bo kvar i: Bygg för gemenskap i tillgänglighetssmarta boendemiljöer [dwellings to stay in: Build for social inclusion in accessible smart living environments]; report of the investigation into housing for older people. SOU. [Google Scholar]
  34. Statistics Sweden . (2023). https://www.scb.se/en/finding-statistics/statistics-by-subject-area/housing-construction-and-building/housing-construction-and-conversion/dwelling-stock/.(accessed August 2023).
  35. Thordardottir B., Fänge A. M., Chiatti C., Ekstam L. (2018). Participation in everyday life before and after a housing adaptation. Journal of Housing for the Elderly, 33(1), 41–55. 10.1080/02763893.2018.1451800 [DOI] [Google Scholar]
  36. Vespa J., Engelberg J., He W. (2020). Old housing, new needs: Are US homes ready for an aging population. Current Population Reports. https://www.census.gov/library/publications/2020/demo/p23-217.html [Google Scholar]
  37. Wood G. E. R., Pykett J., Banchoff A., King A. C., Stathi A. Improving Your Local Area Citizen Scientists and Community Stakeholders. (2023). Employing citizen science to enhance active and healthy ageing in urban environments. Health & Place, 79(3), Article 102954. 10.1016/j.healthplace.2022.102954 [DOI] [PubMed] [Google Scholar]
  38. Wood G. E. R., Pykett J., Daw P., Agyapong-Badu S., Banchoff A., King A. C., Stathi A. (2022). The role of urban environments in promoting active and healthy aging: A systematic scoping review of citizen science approaches. Journal of Urban Health: Bulletin of the New York Academy of Medicine, 99(3), 427–456. 10.1007/s11524-022-00622-w [DOI] [PMC free article] [PubMed] [Google Scholar]
  39. World Health Organization . (2018). WHO housing and health guidelines. https://www.who.int/publications/i/item/9789241550376 (accessed 17 January 2021). [Google Scholar]

Articles from Journal of Applied Gerontology are provided here courtesy of SAGE Publications

RESOURCES