The National Academies Press

Currently Skimming:

Pages 1-19

The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.

From page 1... ... This growth is expected to continue into the future, although the decline in life expectancy across many countries adds uncertainty to predictions made before the COVID-19 pandemic. Today's older people already make substantial contributions to their families and communities, and with healthy longevity, even more will do the same in the future. Read the entire page →
From page 2... ... Additionally, scientific advances and technologies are enabling the development of promising therapeutics to delay aging processes and support people facing functional or cognitive decline. A GLOBAL ROADMAP FOR HEALTHY LONGEVITY This report is a product of the National Academy of Medicine's (NAM's) Read the entire page →
From page 3... ... Some efforts will need governmental funding, while others will not. All actors in the pursuit of healthy longevity, shown in Figure S-2, will inevitably face competing demands for time and resources. Read the entire page →
From page 4... ... When older people thrive, all people thrive. The commission faced several challenges in creating an evidence-based global roadmap for healthy longevity. Read the entire page →
From page 5... ... This variation is particularly poignant and challenging in a world facing existential crises, such as climate change, a global pandemic, and threats to global political stability that will compete for the same resources needed to improve healthy longevity. In the face of these challenges, the need to access all societal resources is urgent, and older people are currently a largely untapped resource -- hence the commitment to initiating change through the roadmap. Read the entire page →
From page 6... ... , personal savings, and government coffers. Beyond supporting healthy longevity by addressing social and health needs of Read the entire page →
From page 7... ... The commission argues that increasing workforce participation among people over age 50 in high-income countries by giving people who have the desire or need to work the opportunity to do so is the best way to harness healthy longevity in service to those countries' economies. This strategy will offset predictions that larger populations of older people will harm economies. Read the entire page →
From page 8... ... SOCIAL INFRASTRUCTURE FOR HEALTHY LONGEVITY The importance of social determinants of health has increasingly been recognized, but across many countries, spending focuses on other priorities, such as health care, and not on unmet social needs. Because of the scope and scale of unmet needs, the commission identified key targets for social infrastructure that impact healthy longevity and challenges posed by aging societies (see Figure S-5) Read the entire page →
From page 9... ... Moreover, older people's experience, knowledge, and emotional stability hold the potential to build the social and human capital needed to create and perpetuate healthy longevity. Efforts to foster social connections and build cohesion start in local communities, where informal caregiving for family members, neighbors, and acquaintances is the norm. Read the entire page →
From page 10... ... Healthy longevity requires financial security for older people because they have few options for improving their financial security, especially when in poor health. Societies can adopt successful models for providing financial support to older people, some solely government-funded and others involving incentives to encourage private savings. Read the entire page →
From page 11... ... PHYSICAL ENVIRONMENT The physical environment is the locus for many of the social determinants of health. The physical environment can enable or impede healthy longevity by affecting social engagement and cohesion, safety, physical activity, and access to essential needs. Read the entire page →
From page 12... ... Intentional design of public spaces can strengthen social cohesion, promote urban health and citizen well-being, and support the local economy. Because of their links with healthy longevity, the commission emphasizes the need for green space, walkability, and safety. Read the entire page →
From page 13... ... Climate Change and Environmental Hazards The ongoing impacts of climate change constitute an urgent environmental challenge, as healthy longevity is not possible without a healthy planet. Recent studies predict that the frequency of extreme weather events will increase over the next three decades, with effects across the life course but disproportionate and near-term adverse effects on older people and people with disabilities. Read the entire page →
From page 14... ... Shift health care systems to focus on healthy longevity 6-3. Make available culturally sensitive, person-centered, and equitable long-term care Supporting Structures All Health Systems Integration across public health, health care, long-term care, and social services Public Health Interventions at population and individual level to reduce underlying risk factors for aging and chronic conditions Close collaboration with social service providers, workplaces, and other entities that can promote health Data and analytics systems for surveillance, precision public health, and assessment of the efficacy of interventions Health Care Integrated person-centered care, including care coordination 2022 - 2050 Primary care Comprehensive and shared health records and a goal-based care plan Collaboration with social services to address social determinants of health Primary care systems that provide preventive screening, address risk factors for chronic conditions, and promote positive health behaviors Geriatrics workforce that can adequately care for older people globally Palliative and hospice care Long-Term Care Policy and funding prioritizes care delivery in the setting the person chooses, to the extent possible; respects individual autonomy and maintains dignity; and attends to care quality and the risk of abuse, neglect, and exploitation Care and social supports addressing all needs, including meaning and purpose Supports for families and family caregivers when providing long-term care while making formal care available when needed Technology to support caregivers and people needing care by providing monitoring that allows privacy Goals 7. Read the entire page →
From page 15... ... Achieving healthy longevity also will require strengthened public health systems and close collaboration with other organizations responsible for addressing health and social needs, including social service agencies, environmental safety agencies, employers, and labor unions. Programmatic components of public health systems with important roles in healthy longevity include interventions at the population and individual levels designed to reduce underlying risk factors for both aging and chronic conditions, as well as data and analytics systems for surveillance, precision public health, population-wide interventions, and evaluation. Read the entire page →
From page 16... ... The commission contends that a number of structures need to be established for health care systems to promote healthy longevity, including • integrated, person-centered care, as described by the World Health Organization (WHO) , delivered by a provider who is responsible for coordinating a person's care across settings and, when possible, by an interdisciplinary team; • mechanisms to promote collaborative relationships with social service providers, which can help address social determinants of health at the individual level; • comprehensive and shared health records that include a care plan based on the person's goals, preferences, and values; • health care systems that leverage data systems to inform individual and population care, monitor quality, and identify effective therapeutics and interventions for patient subpopulations; • primary care systems that focus on prevention and care by carrying out essential screening, addressing risk factors for chronic conditions, implementing evidence-informed interventions to address health behav iors, and maintaining functional capacity; • over time, the potential use of precision medicine to tailor the most effective therapeutics to individuals; and • palliative care and hospice for people with high symptom burden and/or advanced illness, and structures to provide hospice care for those with late-stage illness. Read the entire page →
From page 17... ... A critical component of the care workforce for older people consists of those who provide personal care and other supports to people needing long-term care within and outside of facilities. This workforce is overwhelmingly female, often part of the informal economy, and typically very low wage. Read the entire page →
From page 18... ... CONCLUSION Older people currently contribute much to the world, and unleashing their potential through healthy longevity will enable them to contribute much more globally while allowing them to spend more of their later years in good health. Contributions and commitment from countries, communities, and people of all ages will be needed to realize the vision of a world of healthy longevity. Read the entire page →
From page 19... ... Health systems have generally been built to treat diseases. In many high-income countries, the heavy emphasis on acute- and hospital-centered care is poorly suited to promoting healthy longevity through prevention, screening, and management of chronic conditions. Read the entire page →

From page 1...

... This growth is expected to continue into the future, although the decline in life expectancy across many countries adds uncertainty to predictions made before the COVID-19 pandemic. Today's older people already make substantial contributions to their families and communities, and with healthy longevity, even more will do the same in the future.