By Diane Wu and Alana Officer
For the first time in history, most people can expect to live into their 60s and beyond. This demographic shift can be viewed as an opportunity but requires a transformative shift in health policy and practice to ensure our societies are places in which you can live long and healthy lives. In May 2016, the World Health Organization Member States adopted a resolution outlining a Strategy and Action Plan to coordinate global action towards Healthy Ageing. This article discusses the Strategy and its development.
In almost every country, populations are living longer. For the first time in history most people can expect to live into their 60s and beyond, and those living into their 60s can expect to live on average another 20 years. This is a major achievement of public health, medicine and socioeconomic development, which deserves to be celebrated. These increases in longevity combined with declining fertility rates mean that by 2020, the number of people aged 60 years and older will outnumber children younger than 5 years. Often thought to be a demographic trend solely within the purview of high-income countries, ageing is also a growing phenomenon in developing countries. Even today, almost two-thirds of the 868 million people over age 60 live in developing countries (pdf), and by 2050, that number is expected to increase to 80% (pdf).
Although it is often assumed that increasing longevity is being accompanied by good health, the evidence suggests that older people today are not experiencing better health than their parents or grandparents. Some longitudinal research has suggested that the prevalence of severe disability may have declined in wealthy countries, but this trend does not appear to extend to less severe disability, and may even have stalled. Indeed, a hallmark of older age today is the great diversity in health and functioning. Some 80 year olds may enjoy good physical and mental capacity, while others may be frail and require significant support for the most basic activities of daily living.
The social and economic opportunities that could exist if people can live both longer and healthier lives are enormous. At present these extra years of life are considered as an extended period of retirement but they could be used to reframe the traditional life-course narratives. For example adults may choose to start a new career at 40 or even 60, while younger people may choose to take time out to raise children or care for older relatives and then re-enter the workforce. The choice of retirement as a final endpoint may evolve into more fluid choices throughout the lifespan.
In 2014, the 67th World Health Assembly called on the WHO Director-General to develop, in consultation with Member States, regional and country offices, and other stakeholders, a Global strategy and plan of action on ageing and health. The World Health Assembly recognised that while population ageing can be seen as a success story, it also calls on societies to adapt in order to maximize the health and wellbeing of older people. It acknowledged that the infrastructure in many countries is inadequate, and research to understand and support health of older adults falls far behind that of other population groups. It called for strong, coordinated, multisectoral action to shift our policies and practices to take best advantage of the opportunities that ageing societies present.
The starting point for the development of the Global strategy was the first ever World report on ageing and health, released in 2015 by the World Health Organization. The Report brought together the best available evidence about the current health of older adults. It called for urgent public health action and set out a new comprehensive public health framework to enable all people to age in a healthy way. Healthy Ageing is defined as the process of developing and maintaining the functional ability that enables wellbeing in older age. Functional ability is determined by the intrinsic capacity of the individual (i.e. all of a person’s physical, mental, and social capacities), the environments he or she inhabits (physical, social, economic, and others) and the interaction between these. In line with this framework of Healthy Ageing, the Report sets out what works to create health and long-term care systems and broader environments, which will enable older people to flourish.
The Global strategy and action plan on ageing and health based on the World report on ageing and health and developed in consultation with Member States, United Nations Organizations, technical and scientific experts, WHO staff, national and international partners including organization of older adults sets out a framework for coordinated global action.
The vision of the Strategy is a world in which everyone can live a long and healthy life. Goals over the next five years include implementing existing evidence to maximize functional ability, filling the evidence gaps and establishing partnerships to ensure a Decade of Healthy Ageing from 2020 – 2030.
These goals will be achieved through coordinated action by the World Health Organization, Member States and partners with a focus on five strategic objectives.
Urgent global action is needed to shift our societies to support healthy ageing, for the sake of the health and well-being of everyone. The Global strategy and action plan on ageing and health provides a framework for coordinated action for all of us to age in a healthy way.