PAHO Healthy Aging Conference
April 12, 2012
Good morning and welcome.
For more than a century, the Pan American Health Organization has been a driving force behind many of our region’s greatest public health achievements, from reversing the spread of infectious diseases to improving nutrition, sanitation and access to clean water. And thanks to this kind of progress people are living longer and generally healthier lives than ever before.
In 1980, there were 378 million people in the world aged 60 or older. Three decades later, that figure has doubled. By 2050, it is projected to reach 2 billion -- with older people at about 22% of the global population, outnumbering children under 14 for the first time in human history. And these gains have not been limited to industrialized countries. The most rapid and dramatic demographic changes in the Americas are happening in low- and middle-income countries.
These trends represent a triumph of global public health, modern medicine and economic development. And yet they also pose new challenges.
As people live longer, the shape of our families is changing. Adult children are caring for their aging parents, while raising their own families. Many of us work well past the “traditional” retirement age, by need or by choice, stretching our care giving capacities even further. And these shifts have begun to put new pressure on our countries’ health care systems and social safety programs, pushing policy-makers to find new ways to make limited resources go further.
We also know that as we live longer we’re more likely to develop multiple chronic non-communicable diseases. In the past more people died at younger ages from infectious diseases, accidents, and violence. Today, more and more of the world’s population are living long enough to face cancer, heart disease and Alzheimer’s.
Each year, chronic diseases kill 36 million people worldwide. That’s more than 3 out of every 5 deaths, robbing families and communities of loved ones and costing our economies billions. Many of these diseases like diabetes, stroke, and respiratory disease are projected to affect even more people in the years and decades to come.
For years, our region has helped shape the international conversation about non-communicable diseases -- from the 2007 Declaration of Port-of-Spain -- to the resolution tabled by Trinidad and Tobago on behalf of the Caribbean Community that ultimately led to last year’s UN General Assembly High-Level Meeting.
Now the rest of the world is joining the conversation. And that’s critical because we still have a long way to go if we want to turn the tide on chronic disease. These threats recognize no national or political borders. They touch countries in every corner of the globe and at every stage in development.
So our challenge today is to prepare and respond. The good news is that we know what it takes to build communities where older citizens are not seen as a burden, but as experienced and engaged partners. And the work we do to support healthy aging also presents us with an opportunity to reshape our communities to promote better health at every age.
In the United States, we have embarked on an ambitious agenda to shift the focus of our health care system from waiting for people to become acutely ill to investing in prevention to keep them healthy in the first place.
In 2010, we passed a historic health reform law that improves access to the preventive care people need to stay healthy and the screenings they need to detect diseases early. And we’ve taken big steps to help seniors afford the cost of their medications.
We’re also working with doctors and hospitals to share their best methods for improving their patients' health. Sometimes seemingly small things, like following up with a patient after she's been discharged from the hospital and helping all of her doctors better communicate with one another, make the biggest difference. And we're helping best practices like these spread to every corner of the country, so that everyone has access to the best care possible, no matter where they live.
But we also recognize that ensuring access to quality, affordable care is only one part of the job. Health also happens outside the doctor’s office – in neighborhoods, workplaces and community centers.
Just as important are the steps we can take to engage older people as we do this critical work: involving them in the design, execution, and leadership of programs for seniors -- and refuting any notion that as people age they have less to contribute or become helpless. Our growing population of older people is also increasingly diverse. Respecting this diversity is key to maintaining social connections, reducing isolation, and increasing people’s choices.
Ultimately, what drives our approach is a philosophy that says simply: “Nothing about them without them.”
And you can see it in successful initiatives like Stanford University’s Chronic Disease Self-Management Program -- built on more than two decades of federal research. The program recognizes that older people with chronic diseases should be more than just recipients of care. They should be key decision-makers in their own treatment.
So through workshops in community settings like senior centers, libraries, and at faith-based organizations, older people with a wide array of conditions come together to learn, share and build the skills they need to manage and improve their own health – from exercise and nutrition, to stress management and communicating with their health providers. At HHS, we’ve invested $27 million in grants to help communities implement these proven approaches.
The evidence shows that this program not only improves patients’ abilities to manage their own health, it has also improved health outcomes and even reduced health care costs. It is no wonder that the Stanford program is now available in at least 15 countries around globe.
What this kind of program tells us is that keeping older people healthy yields enormous dividends. When more people can participate more fully and contribute to society, everyone benefits.
And this is where we have an important opportunity to work together to share our best ideas and tools to keep our populations as healthy, productive and engaged as possible.
The United States is committed to learning from our partners across the region and around the globe. The more we work together, the faster we will be able to test new strategies, learn what works, and implement them in our own communities.
One of the striking aspects of my trips outside our country is how much eagerness there is to work together on health issues. When it comes to trade or foreign policy, there are often areas of strong disagreement. But when the discussion turns to tackling our biggest health challenges, there is a broad consensus that nations must work together. And when we do work together, we all benefit.
Healthy aging is an issue which aligns the interests of the countries around the world. A healthier world is one in which every nation will have more productive workers, longer lives, and more vibrant communities.
Too often when we talk about global aging, we talk about its costs. But by keeping our seniors healthy and engaged we have begun to write a new story, where every older person gets the dignity and independence they deserve and every nation thrives.