Promoting healthy aging: a challenge for everyone
For the first time in human history, most people can expect to live beyond 60 years of age. In so-called first-world countries, with high incomes, life expectancy often exceeds 80 years.
This situation will bring about significant demographic, social, and economic changes , profoundly transforming our lives. The main trends that will drive these changes in the coming decades are foreseeable, and we must prepare ourselves to face them and take full advantage of this situation, which presents significant challenges but also great benefits for the entire population.
It's important to recognize that increased life expectancy benefits not only individuals but also society as a whole , given the potential of older people as a resource for future development. We must consider not only the skills and experience they bring but also their significant productive contributions.
The increase in life expectancy will cause significant demographic changes, which poses major challenges, but also great benefits for the whole of society.
Many countries and societies are immersed in a model where the concept of old age focuses on deficiencies, viewing it as a period of vulnerability and disconnection. Thus, functional decline is considered inevitable, and healthcare system decisions are primarily centered on providing purely custodial care for the elderly . Other models emphasize the social participation of older adults, who make significant intellectual, economic, and intergenerational contributions . Although there has been intellectual debate between these two positions, it seems that both contain elements of reality and reflect the values that each seeks to reaffirm.
The truth is that the heterogeneity that characterizes aging, both in its social and biological aspects, means that these two perspectives must be taken into account, since both contain valuable elements for designing the most appropriate policies.
Dr. Irene Lebrusán Murillo
The concept of healthy aging can be defined as the process of fostering and maintaining the functional capacity that enables well-being in old age. Functional capacity encompasses the health-related attributes that allow a person to be and do what is important to them. This functional capacity comprises all the physical and mental abilities a person possesses (intrinsic capacity), the external factors that shape a person's life, such as home, community, personal relationships, and, at a societal level, health and social policies (environment). Personal characteristics such as genetic inheritance, sex, ethnicity, and educational and economic status also play an important role in active aging. Finally, the interaction among all these factors is crucial and allows us to grasp the complexity of the issue we are addressing.
The heterogeneity that characterizes aging means that we must take into account both the care of older people in a purely assistance-based way, as well as their social participation and their intellectual, economic and intergenerational contributions.
Resilience plays a crucial role in the functional trajectory each person experiences throughout their life (functional decline or recovery of ability after a temporary loss). Resilience, or the capacity to withstand adversity, can be defined as the ability to maintain or improve functional capacity in the face of adversity. Again, we can understand resilience as the result of each person's intrinsic capacity and the components of their environment, without forgetting, of course, the interaction between these two factors.
After briefly describing the concept of healthy aging and the main components that define it, we will explain the framework in which we work to maximize healthy aging for all .
How to promote healthy aging?
According to the WHO, public health action is needed in various areas and taking into account several social aspects.
Therefore, actions regarding the environment should focus on:
- Promote behaviors that improve ability.
- Remove the obstacles that prevent participation, compensating for the loss of capacity of some members of the community.
Regarding people who require long-term care, it is necessary to:
- Support behaviors that improve or maintain ability.
- Maintaining dignity by ensuring adequate care in the later stages of life.
The health services are responsible for:
- Initially, to prevent chronic diseases and ensure early detection and control of their progression.
- To reverse or minimize the loss of capacity caused by the pathology.
- To treat advanced chronic diseases as effectively as possible.
With regard to society and the policies that need to be implemented , it is essential to:
Reducing inequality
This strategy must consist of improving the functional capacity of the entire social spectrum and reducing the social inequalities observed among older people, promoting the human rights principle of equality and non-discrimination. The measures to be implemented are:
- Commit to ensuring that all older people have equal opportunities to improve or maintain their health.
- Incorporate the equality component into all evaluations of public policy outcomes, promoting it in all cases.
- Include the participation of older people and other related institutions in defining the interventions and policies to be developed.
Guarantee the right to choose
Older adults should not be considered passive recipients of decisions regarding their well-being and health. On the contrary, respecting their right to choose the priorities and implementation of these policies is closely linked to their dignity, integrity, freedom, and independence . This principle must be followed regardless of the environment in which they live (whether in the community or an institution).
Older people must be able to make their own decisions regarding the improvement of their situation and their health, something closely related to the dignity, integrity, freedom and independence of people.
Promoting aging in the community
The home or environment in which people live is often deeply connected to feelings of connection, security, and familiarity , and is also linked to identity and personal autonomy. People have the right to live and be included in the community, even if they have some type of functional limitation. Often, institutional care facilities have limitations that make them dehumanizing, presenting social and cultural barriers that hinder social interaction. Therefore, one of the key principles to follow in policies related to healthy aging is to promote aging in the community where one has lived , prioritizing that older adults live in their own homes with as much independence as possible. This alternative is not only the best for the individual, but it can also be more financially sustainable. New communication and remote monitoring technologies can promote communication and social integration and facilitate this goal. However, it must be borne in mind that this is not always possible, whether due to geographical isolation, poor housing conditions, or insurmountable health problems.
The importance of urban environments in aging processes
The consequences of ageism
A significant problem is ageism, that is, discrimination against people based on their age . This concept also encompasses various stereotypes and can take many forms, such as prejudice, discriminatory practices, and policies and institutional practices that perpetuate these beliefs. Some experts believe that age discrimination is currently more common than discrimination based on sex or race.
Sometimes, age discrimination is considered logical because it is supposedly based on objective and observable biological decline. However, it is forgotten that there are numerous adaptations that minimize these age-related losses, as well as many positive aspects of aging, such as personal growth and the contributions older people make to society.
The consequences of ageism are more serious than they might initially appear, as it has been shown to lead to lower levels of autonomy, reduced productivity, and increased cardiovascular stress . Furthermore, these stereotypes can become internalized, reinforcing inaction and functional decline.
Stereotypes about older people
Improving the health of older people, a right with great benefits
It is necessary for society to allocate public resources to improve the health of the elderly population , since it is not only a human right for older people to reach the highest possible level of health without discrimination, but there are two other compelling reasons.
- On the one hand, promoting healthy aging fosters the sustainable development of societies by improving equity, enhancing the productive roles of these individuals, and reducing the overuse of services by decreasing chronic illness.
- On the other hand, there is an economic reason , since promoting healthy aging reduces the costs associated with an aging population and increases the contributions made by older people through formal and informal work, taxes, consumption, and resource transfers to other generations. These contributions, contrary to the widespread idea (and stereotype), have been shown in some studies to be greater than the expenses incurred by society as a result of the needs of older people.
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