Live Long and Prosper: A Public Health Salute to Strategic Planning for Healthy Aging
September 4, 2024
Overview
With more than 55 million people in the U.S. who are currently 65 or older (a number that is expected to continue to increase for decades), facilitating healthy aging should be a public health priority. There are Federal and State initiatives that can serve as a blueprint for creating programs and collaborations that improve older adult health.
Facilitating healthy aging should be a public health priority. More than 55 million people living in the U.S. are 65 or older; that is 16.8 percent of the population. With birth rates declining and Baby Boomers hitting 65 and beyond, that percentage is expected to increase for decades. Advances in health care and positive effects of public health measures have also led to an increase in life expectancy—the number of people 85 or older living in the U.S. is expected to double over the next two decades. Older adults play a vital role in our communities, racking up volunteer hours, contributing significantly to the economy, and being the grandparents, neighbors, and mentors who bring us joy. September is Healthy Aging Month, a good time to focus on steps the federal and state governments are taking to support the well-being of older adults.
The federal government anticipated the need to plan for an aging population, creating the Interagency Coordinating Committee on Healthy Aging and Age-Friendly Communities (ICC) through 2020 amendments to the Older Americans Act. First funded in FY23, the ICC released its initial report to Congress in May 2024, Aging in the United States: A Strategic Framework for a National Plan on Aging, raising awareness of critical aging issues and setting goals for how the federal government can support the health and well-being of older adults. Mindful of health inequities faced by older adults, the Strategic Framework also “seeks to break the patterns of ageism and ableism that serve as preventable barriers to older adults thriving in their communities.”
The Strategic Framework includes four focal areas for supporting healthy aging: 1) Age-Friendly Communities; 2) Coordinated Housing and Supportive Services; 3) Increased Access to Long-Term Services and Supports; and 4) Aligned Health Care and Supportive Services. Within each area, there are existing law and policy levers that can be accessed to support older adults. Effective enforcement of the Age Discrimination in Employment Act will help keep older adults employed, sustaining their economic security and their sense of purpose. Compliance with the Americans with Disabilities Act will make places of employment and public spaces safe and accessible for older adults, a population more likely to experience mobility-related impairments. But the ICC recognizes that more is needed in the law and policy space to achieve its vision of “an America that values older adults, embraces aging, and recognizes that all people have the right to live with dignity, make their own choices, and participate fully in society.” Creating an Age-Friendly Health System, for example, will require changes to Medicare. The Department of Health and Human Services and the Department of Housing and Urban Development must collaborate to help older adults remain in their homes through proven-effective programs like Support and Services at Home. The Strategic Framework does not endeavor to identify and describe the needed law and policy changes; that is a next step and one in which the public health community should eagerly seek to participate.
Like the Strategic Framework, states across the country are developing strategic plans to address the needs of older adults and facilitate healthy aging. A collaborative of private organizations that focus on older adult health encourages states to develop a Multisector Plan for Aging (MPA), “a 10+ year blueprint for restructuring state and local policies and convening a wide range of cross-sector stakeholders to collaboratively address the needs of older-adult populations.” Of course, MPAs should address needed changes to the health care system, but they must also address social determinants of health, including transportation, housing, and food.
Some states have started slowly into the MPA process. For example, in January 2024, Maryland Governor Wes Moore issued an Executive Order directing the Maryland Department of Aging to create a multisector Longevity-Ready Maryland Initiative that will “positively transform the aging experience for all Marylanders, through collaboration, partnership, strategic investments, and policy changes.” Other states have passed legislation to initiate creation of an MPA. For example, the General Assembly of Colorado passed legislation creating a Strategic Action Planning Group on Aging (SAPGA) to develop a comprehensive, long-term plan to support healthy aging. The Colorado law makes clear both the mission and responsibilities of the SAPGA and allocates funding to support the SAPGA’s work. The group issued its inaugural plan in 2016, with updates in 2018, 2019, and 2020. To learn about action in your state, check out the MPA map and click on your state to find out about executive or legislation action.
The ICC’s Strategic Framework and state MPAs are only the first step in creating communities in which older adults can thrive. These plans are aspirational and vision-setting. Yet they can and should have a direct impact on law and policy designed to support the health of our aging population. The public health community should be excited to join, even lead, these efforts. To learn more about the collaboration between aging services and public health and successful innovations to improve older adult health, tune in to the CDC’s free, virtual National Health Aging Symposium: Innovation Across the Age-Friendly Ecosystem on September 26.
This article was written by Kathleen Hoke, J.D., Director, Network for Public Health Law, Eastern Region.
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