(Please note that this is my personal take at the discussions that took place in Dubai as part of the Global Agenda Council on the Challenges of Gerontology put together by the World Economic Forum, and builds on the work of my colleagues, but it does not represent a formal document or statement of position. Simply put, we would like to engage your brain in defining the challenges and outlining/ executing the solutions).
Context: The Challenges of the Aging Society
The world is aging. This is occurring in two ways: through shifts in the age structure that will eventually lead to many more people reaching older ages than ever before, and through continued success in extending life. Less than 100 years ago, life expectancy was between 30 to 40 years. Today, close to 800 million citizens are 60 and over.
And aging in healthier ways. Aging has incorrectly been associated with decline and decay, when in fact many people live healthy into older ages. There has been a synchronous extension in life expectancy and quality of life — the average 65-year-old today is much healthier, physically and mentally, than the average 50-year-old of 100–150 years ago — when most existing institutions were envisioned and created.
Healthy life can be further extended with existing knowledge. The fact is the onset and progression of fatal and disabling diseases, disorders, and disability can be postponed using well-researched basic measures of public health, environmental and behavioural changes, and medical technology interventions. The same methods may be used to improve or maintain mental and physical functioning.
Our healthcare and retirement systems are on bankruptcy track — their premises are outdated. Existing institutions, policies and attitudes do not reflect the points outlined above, having been developed for a society that no longer exists. We need to get on the right track: aging populations represent potential resources that are currently untapped or underutilized.
The current disease-based research agenda compounds the problem: emerging biomedical research holds the promise of slowing down the biological processes of aging — thereby contributing to lower prevalence rates of a spectrum of diseases. Yet, given existing funding paradigms, there is not a well-integrated and funded research plan in place to drive the agenda.
Solution: Capturing the Longevity Dividend with a Healthy Aging Agenda
Getting our institutions and policies in the right track ‑given the growing extension of healthy life- can pay a series of economic, health, and other life course dividends. A course change can have a significant return on investment, and the absence of this course change will have a series of negative consequences globally. We need to capture the longevity dividend to benefit people of all ages, as well as older adults- stop thinking Burden, start thinking Human Capital to be maintained and deployed.
To capture this Longevity Dividend, we need to move the agenda forward in three complimentary areas:
1) Promote Healthy Lifestyles that help Maintain Physical and Cognitive Functional Abilities:
- Partner to Raise the Prevention Agenda: we need adopt a cross-sector life course approach to health promotion, engaging not only the health and insurance system but also the education system and the media sector. In healthcare, we need to integrate medical care and public health approaches to prevent and ameliorate chronic diseases and conditions — geriatric medicine offer a valuable template for health care redesign that would be beneficial for all.
- Invest in Lifelong Learning: investing in education at every point in the life course, encouraging life long learning.
2) Redesign Environments to Foster Health, Engagement and Financial Security:
- Redesign Retirement Policies: redesigning the current retirement paradigm through enhanced flexibility offers a win/ win/ win scenario — for employers, employees, and society at large.
- Provide opportunities for productive engagement: create new generative roles and a host of opportunities for productivity and engagement by elder adults. These would confer huge societal benefits on unmet global needs, and if designed correctly, will promote the health of an aging society. One example is the “experience corps” model.
- Redesign Cities: redesigning cities to support healthy aging and independence and engagement. One of the transitions that will take place is that a significant portion of future cohorts will live in cities. Hence, we need to create necessary environments and transportations that will accommodate this trend.
3) Develop an integrated Healthy Aging Research Agenda: the disease-specific model needs to be supplemented by advancing research design to slow the biological processes of aging. We need to raise and integrate resources to invest in research for innovation in new social experiments, retirement and pension policies that work, continuum of living circumstances that encourage living in place, development of enhancements that encourage physical and cognitive functioning, basic biological research on aging, all built on a strong social compact.
There are 2 promising areas to start moving this agenda forward:
1) Propose a new Millennium Development goal: Include these pressing issues as one of the Millennium Development Goals, optimizing a full healthy life course and harnessing the opportunities of an aging world, including building effective approaches.
2) Propose a Healthy Aging agenda for Global 2000 companies: in partnership with the appropriate Councils, suggest research-based practices and policies: — Health promotion in the work place.
— Flexible retirement policies.
— Defining new roles for older adults and civic engagement.
— Invest in life long learning.
— Develop new technologies, products and services for an underserved, and growing, market.
Now, your turn:Ã‚Â can you help define the challenges and outline the solutions?