Public Health Can Help Older Americans Live Healthy and Independent Lives

Our country’s public health system, which protects and promotes the health of communities, has contributed to much longer life expectancies. Today U.S. life expectancy at birth is 79 years compared to 55 a century ago. It’s now time for public health to work with aging agencies and other community partners to help our growing population of older adults remain healthy and independent.

Drawing on the skills and functions developed in public health education and practice, a public health system can help promote older residents’ health, including their physical, emotional, and cognitive health, and their ability to engage with their communities. After all, 80 percent of older people have at least one chronic condition such as diabetes or cancer and half have two or more. Managing these conditions is often complicated by isolation and loneliness, financial struggles, and limited access to transportation, healthy food, and affordable housing.

Trust for America’s Health (TFAH) and The John A. Hartford Foundation have developed the “Framework for Creating Age-Friendly Public Health Systems,” which describes five key roles that the 3,000 public health departments across the country could fulfill to address the challenges and opportunities an aging society presents. Below, we outline these roles and include examples from state and county health departments in Florida, Oregon, and California that are building on the Age-Friendly Public Health framework.

1. Connecting and convening multiple sectors and professions that provide the supports, services, and infrastructure to promote healthy aging. The practice of public health requires developing systemic views and helping participants understand their roles in the system. In Florida, the Nassau County Health Department created a multisector Age-Friendly Public Health Advisory Council with representatives from palliative care, parks and recreation, and geriatric physical therapy to define the community’s vision, develop a work plan, and, ultimately, mobilize the community to meet the health and social needs of its older adults. The council produced a county-specific survey, modeled after the AARP Age-Friendly Communities survey, to gather input from residents. In Oregon, state leaders co-located a Long Term Care Program Analyst funded by the State Unit on Aging in the Public Health Division Office, integrating the two state agencies to build capacity for services for older residents.

2. Coordinating existing supports and services to avoid duplication of efforts, identify gaps, and increase access. Public health is committed to identifying and reducing barriers to needed services. To streamline coordination across the public health and aging agencies, Florida’s Okaloosa County Health Department implemented a volunteer-based program, Lean On Me, to prepare customized disaster plans for older adults. Volunteers surveyed clients to assess needs for emergency special shelters, identify home hazards, and connect them with community partners. In Los Angeles, the Health Services, Mental Health, and Public Health County Departments created the Los Angeles County Health Agency Geriatric Workgroup to expand and improve services for older adults by increasing the health care, public health, and social services provider workforce specializing in healthy aging issues.

3. Collecting data to assess community health status (including inequities) and aging population needs to inform the development of interventions. Epidemiology uses data and analytical tools to understand health conditions. Recognizing the importance of data, the Florida Departments of Health and Elder Affairs created “Aging in Florida” older adult county profiles that include data on residents’ longevity, family, and living arrangements, as well as their socio-economic status and access to transportation. Florida County Health Departments are using the data to inform the Community Health Improvement Plans that guide their work. In collaboration with the AARP Network of Age-Friendly Communities and the Dementia Friendly America Network, San Diego County created the Age Well San Diego Initiative. This initiative included resident listening sessions and focus groups to obtain feedback from racially, ethnically, and linguistically diverse communities.

4. Conducting, communicating, and disseminating research findings and best practices to support healthy aging. Public health is committed to developing and disseminating evidence on what improves the health of entire populations. To expand access to healthy aging information, Florida’s Lake County Health Department created a communications strategy to guide collaborative efforts with municipal and community-based partners, which included talking points on how to engage diverse sectors and resources for outreach and evaluation. The leaders of the Los Angeles Alliance for Community Health and Aging host annual membership meetings to showcase best or promising practices related to aging, and with the Office of Women’s Health, cohost annual healthy aging conferences to elevate pertinent issues to a wider audience.

5. Complementing and supplementing existing supports and services, particularly in terms of integrating clinical and population health approaches. With its focus on community and place, public health positions clinical interventions in their larger context, where most determinants of health can be found. The Florida Department of Health seeks to bridge clinical and population health approaches by including older-adult health objectives, including those related to including Alzheimer’s and related dementia issues, in their State Health Improvement Plan. The State Unit on Aging staff person in Oregon’s public health agency collaborates with the state chapters of other partners — like AARP and the Alzheimer’s Association — to develop age-friendly policy, systems, and environmental changes that apply to institutional and in-home care settings, caregiving and worksite wellness, community living, and more.

Trust for America’s Health and The John A. Hartford Foundation are partnering to spread this model nationwide and will soon be offering training and support to help state and local health departments become Age-Friendly Public Health agencies.

Opportunities for public health to improve older adult health and well-being are many and each public health department can prioritize efforts to meet the specific needs of their communities. The five roles identified here offer a framework for public health leaders to pursue an important societal goal — helping our growing number of older Americans live healthily, independently, and productively for as long as possible.

John Auerbach is president and CEO of Trust for America’s Health, a nonprofit, nonpartisan organization that promotes optimal health for every person and community and makes the prevention of illness and injury a national priority.

Terry Fulmer, PhD, RN, FAAN, is president of The John A. Hartford Foundation, a private philanthropy dedicated to improving the care of older adults.