In Uganda, solar-powered shipping containers are making medical care convenient for older adults living in rural villages. Thousands of miles away, in England, technology is returning a sense of independence to seniors battling chronic diseases. And in Vietnam, local community centers are meeting the health and social needs of their older residents.
While vastly different, these programs, featured in a new report from AARP and Economist Impact, all have one thing in common: They’re helping to close a growing gap between how long we live (lifespan) and how many of those years are spent in good health (healthspan). And doing so has never been more critical.
Separating aging from illness
People around the world are living longer than ever. Life expectancy in the U.S. is roughly 79 years, according to the Centers for Disease Control and Prevention (CDC). Compare that to the turn of the 20th century, when Americans weren’t expected to make it to 50. Trends in other countries are following a similar track.
But all of those added years aren’t necessarily healthy ones. Chronic conditions like heart disease and diabetes become more common later in life, and these ailments, which affect about 85 percent of older adults, can disrupt the ease of daily activities and upend independence.
Feeling disconnected from society also contributes to the lifespan-healthspan gap. Nearly 1 in 4 adults age 65 and older are socially isolated, which the CDC says increases the risk for a number of health concerns, including depression, dementia — even death.
Forward estimates through 2025 expect the gap between life expectancy and healthy life expectancy will continue to grow in the near term
However, aging and illness don’t have to go hand in hand, experts say. With the world’s 60-plus population expected to double by 2050, “the big challenge now is [figuring out how] to keep people healthier as they age,” says Victor Dzau, M.D., president of the National Academy of Medicine, who participated in AARP’s Global Conference on Redefining Health: New Approaches for How We Live and Age.
10 places where people live the longest
1. Monaco: 89.4 years
2. Singapore: 86.19 years
3. Macau: 84.81 years
4. Japan: 84.65 years
5. San Marino: 83.68 years
6. Canada: 83.62 years
7. Iceland: 83.45 years
8. Hong Kong: 83.41 years
9. Andorra: 83.23 years
10. Israel: 83.15 years
Source: CIA: The World Factbook: “Life expectancy at birth”
“Healthy aging is a lifelong pursuit. It doesn’t begin at age 50 or 60 or 65. Likewise, it doesn’t just happen, and it’s not something you can do alone,” says AARP CEO Jo Ann Jenkins. “We need to empower societies around the world to both embrace the opportunities of aging to the fullest extent possible and address the attendant challenges. That is why we brought together leading experts in health, economics and aging for this year’s Global Conference — to redefine health and develop new approaches to how we live and age so that everybody in every country can have the opportunity to live a long and healthy life.”
Designing a society with older adults in mind
Some communities, cities and countries already have a blueprint for what healthy aging can look like. For example, Singapore — which is highlighted in this year’s “The Aging Readiness and Competitiveness Report” from AARP and Economist Impact — has implemented what Dzau calls “an all-government, all-society approach.”
Representatives from different government agencies (health, housing, transport, etc.) work with each other and with medical experts, community leaders and health care providers to craft policies and programs that benefit older adults. The country has also reorganized its health care system to focus on preventive and holistic care at the local level.
“Everybody has a role to play when it comes to designing a society that supports healthy aging,” says Debra Whitman, AARP’s executive vice president and chief public policy officer. “Breaking down silos and encouraging collaboration drives innovation. And right now, we need all hands on deck.”
Taiwan incentivizes hospitals and clinics to provide high-quality, age-friendly health care, and it has inspired similar efforts in other countries, including South Korea, Austria and Greece. Thailand and Uruguay are building more sustainable long-term care systems to ensure that older adults receive high-quality care that fits their needs, and that workers are equipped to provide it.
“There are plenty of successful examples out there that can be replicated throughout the world,” says Jean Accius, senior vice president of global thought leadership at AARP. “We are at a crossroad where we need to reassess, redefine and reprioritize what health means in a world facing significant demographic shifts. A healthy population is a more productive population, which translates into a more competitive and economically viable population. Restructuring our societies to better serve the health of older adults needs to be a priority.”
3 initiatives that are helping people live better, longer
1. Repurposed shipping containers offer convenient care in rural Uganda. For older adults living in Uganda’s rural villages, accessing in-person health care often means a full day’s walk to the nearest hospital or clinic. But a network of about 70 solar-powered shipping containers from Kaaro Health is bringing medical care closer to people in remote areas. Inside the steel structures, patients consult with doctors via telehealth; they can also receive in-home visits from local health care providers. What’s more, Kaaro Health has trained rural nurses and health workers to provide mental health support for older adults during the pandemic.
2. Communities in Vietnam set up intergenerational self-help clubs for older adults, where health and social well-being are a focus. The centers, which typically have 50 to 70 members, provide music, art and other cultural activities, plus exercise classes, home visits and volunteer opportunities. They also foster economic independence and self-reliance. The vast majority of members report better health, greater access to medical care and improved confidence. There were more than 3,400 locally run centers as of 2020; the government aims to expand that number to more than 10,000 by 2030.
3. Technology helps older adults in England manage their chronic conditions at home and stay out of the hospital. Patients in the city of Liverpool receive training on how to manage their conditions and evaluate their health status at home. They record their own vital signs and are monitored by trained professionals at a central hub. Empowering the patients has yielded some impressive results: Fifty-five percent of the program’s participants report decreased health care utilization, and 90 percent said they have more confidence in their ability to cope with their condition. What’s more, about half (52 percent) reported improvement in their lifestyles.
Source: “The Aging Readiness and Competitiveness Report, Third Edition: Driving Innovation in Healthcare and Wellness/AARP, Economist Impact”
Other community efforts are also revolutionizing healthy aging. Experience Corps, an AARP Foundation program that matches older adult volunteers with school-aged children learning to read, is one example. Research shows that the program not only improves reading skills among the students, it also boosts the physical and mental health of the volunteers.
Program co-designer Linda Fried, M.D., says the health benefits for the older adult participants stems from the creation of new social networks and the structure it provides to a mostly retired population. Also integrated into the program are “ways to help people be more physically and cognitively active,” says Fried, dean of Columbia University’s Mailman School of Public Health and director of the Robert N. Butler Columbia Aging Center. The result: Participants are better able to maintain their strength and mobility and stave off memory loss.
Benefits beyond better health
The benefits of promoting healthy aging run the gamut, both for individuals and society. Keeping people healthier for longer saves on health care costs, says Fried, who also participated in AARP’s Global Conference. Disability numbers dwindle and adults “are able to engage in ways that matter to them and to their families and communities,” she adds.
Encouraging healthy aging can also alleviate burdens placed on family caregivers — in the U.S. alone, about 48 million individuals provide unpaid care to an adult family member or friend. What’s more, investing in healthy aging can reinvigorate the workforce, since a healthier population is a more productive one, Dzau points out.
Add to it the “experience and wisdom” that older adults bring to a job, and Dzau says, “it’s obvious that people can continue to be extremely productive and create a major economy, the silver economy, if healthy.”
With few societies prepared to meet the needs of their aging populations, now “is the moment where we really have to intentionally think about designing for our longer lives,” Fried says.
“We’re excited about people living longer, but we really want them to live healthy lives longer,” adds Peter Rundlet, vice president of AARP International. “The real idea here is that the adoption of these innovations can help with that.”
Rachel Nania writes about health care and health policy for AARP. Previously she was a reporter and editor for WTOP Radio in Washington, D.C. A recipient of a Gracie Award and a regional Edward R. Murrow Award, she also participated in a dementia fellowship with the National Press Foundation.