Healthy Aging in Canada: A New Vision, A Vital Investment. From Evidence to Action
"Social connectedness has a positive effect on health. People who remain actively engaged in life and connected to those around them are generally happier, in better physical and mental health, and more empowered to cope effectively with change and life transitions. Distress, isolation and social exclusion increase substantially the risk of poor health and loneliness, and may even act as predictors of death."
Healthy Aging and Wellness Working Group. (2006). Healthy Aging in Canada: A New Vision, A Vital Investment. From Evidence to Action. A Background Paper for the Federal, Provincial and Territorial Committee of Officials (Seniors). Ottawa, Ontario: Author.
The group states: “Each of us is aging. And as a population, Canada is aging faster than ever before. Today, people aged 65 and over make up some 13 percent of the Canadian population. By 2031, there will be approximately 9 million seniors, and they will account for 25 percent of the total population (Statistics Canada, 2005). Older Canadians are living longer and with fewer disabilities than the generations before them. At the same time, the majority of seniors have at least one chronic disease or condition. Our health care system primarily focuses on cure rather than health promotion and disease prevention. A focus on the latter is needed in order to help people maintain optimal health and quality of life. Doing so is also one way to manage health system pressures. If we are to reap the benefits of the many contributions that seniors make to their families, communities and nation, and to curb health care costs associated with chronic disease, healthy aging must move to the forefront of the social policy agenda. If left unaddressed, the aging of the population will have far-reaching social, economic and political impacts (Statistics Canada, 2005) that will far outweigh the cost of investing in healthy aging now.”
A Vital Investment:
In addition to the demographic and political imperatives of an aging population, there are several key reasons to invest in healthy aging:
1. Seniors make a significant contribution to the richness of Canadian life and to the economy. Older people provide a wealth of experience, knowledge, continuity, support and love to younger generations. The unpaid work of seniors makes a major contribution to their families and communities. Some 69 percent of older Canadians provide one or more types of assistance to spouses, children, grandchildren, friends and neighbours (National Advisory Council on Aging (NACA), 2001). Older Canadians make an important contribution to the voluntary sector and to the paid economy. More than 300,000 Canadians 65 or older were in the labour force in 2001 (Statistics Canada, 2001). Working longer requires good health.
2. Healthy aging can delay and minimize the severity of chronic diseases and disabilities in later life, thus saving health care costs and reducing long-term care needs (Laditka, 2001). Chronic diseases account for an enormous human and economic burden in Canada. The prevalence increases with age and is highest among older people in vulnerable communities (e.g., Aboriginal and economically disadvantaged groups) (Public Health Agency of Canada (PHAC), 2005a). Chronic diseases are responsible for 67 percent of total direct costs in healthcare and 60 percent of total indirect costs ($52 billion) as a result of early death, loss of productivity and foregone income (PHAC, 2005a).
3. The evidence compels us to build on existing opportunities, to put in place interventions that are known to be effective, and to show leadership by supporting innovative approaches. Experience provides us with some models and successful interventions that can be replicated in different settings. In addition, there are opportunities to build on existing strategies in aging and healthy living that are already underway in most provincial/territorial, federal and local jurisdictions.
4. Canadians of all ages believe that efforts to enable seniors to remain healthy and independent are “the right thing to do.” Established values such as independence and interdependence, social justice and respect for families with multiple generations help to define Canadian society.
While recognizing that healthy aging depends on all of the broad determinants of health (including income, housing, protection from abuse etc.), in 2005, the F/P/T Ministers Responsible for Seniors endorsed the need for action on five key issues, based on their impact on seniors health, the availability and effectiveness of interventions, the costs associated with treatment for health problems associated with these factors and their potential to reduce health inequities. These areas of focus are social connectedness, physical activity, healthy eating, falls prevention and tobacco control.
Part II of this paper addresses each of these focus areas: what we know and don’t know, promising practices, and directions for policy and practice. A key aim of government policy should be to enable and encourage people to stay physically active throughout the life course, to remain socially connected in later life, to establish healthy eating patterns and have access to healthy food choices, and to refrain from risky behaviours such as smoking, overeating and activities that can lead to falls and injuries (WHO, 2005).
Healthy aging is “a lifelong process of optimizing opportunities for improving and preserving health and physical, social and mental wellness, independence, quality of life and enhancing successful life-course transitions” (Health Canada, 2002). This definition takes a comprehensive view of health that includes physical, mental, social and spiritual well-being.
Social connectedness has a positive effect on health. People who remain actively engaged in life and connected to those around them are generally happier, in better physical and mental health, and more empowered to cope effectively with change and life transitions. Distress, isolation and social exclusion increase substantially the risk of poor health and loneliness, and may even act as predictors of death (Wilkins, 2006; World Health Organization (WHO), 2003).
Social engagement is an important consideration in social connectedness. The benefits of social engagement are collective as well as individualistic. In Canada, as well as several other countries, there is a growing interest in the linkages between social engagement and social capital. Social capital is defined as the “resources that emerge from the networks of social interactions based on norms of trust and reciprocity”. These resources facilitate the achievement of collective outcomes expressed in terms of well-being, health, safety, democracy, or the acquisition of economic or human capital (Franke, 2003).