Global Roadmap for Healthy Longevity (2022) / Chapter Skim
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4 Social Infrastructure for Healthy Longevity
4 Social Infrastructure for Healthy Longevity
Pages 87-128
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From page 87... ...
These conditions include unjust economic structures, poorly designed policies and programs, harmful governing practices, unequal shares of social and economic resources, or a combination of all of these factors and more. Consequently, many activists and scholars argue that SDOH are more accurately framed as "social determinants of inequalities in health." The distribution of resources and opportunities -- for health care, education, a healthy living environment, and employment -- is fundamental to healthy longevity and is directly impacted, either positively or negatively, by public policy.
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From page 88... ...
Promising SDOH solutions, if brought to scale, can have far-reaching positive effects for societies worldwide and contribute to global healthy longevity. The remainder of this chapter describes the key targets that the commission selected based on their ability to catalyze change toward healthy longevity: capitalizing on the prosocial strengths of older people, combating ageism, fostering social inclusion, ensuring financial security in retirement, and achieving digital literacy.
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From page 89... ...
This chapter addresses the key targets related to social infrastructure the commission believes are most integral to healthy longevity. Key targets include capitalizing on the prosocial strengths of older people, combating ageism, fostering social inclusion, ensuring financial security, and improving digital literacy.
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From page 90... ...
report Social Determinants of Health and Well-Being Among Young People, address the relationship between SDOH and younger people. Poverty prevention, education, secure and safe housing, social support systems, and access to integrated health systems at all ages are also important for ensuring healthy longevity.
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From page 91... ...
Impacts of Poverty and Inequality on Life Expectancy Recent research illustrates the critical importance of certain social determinants for achieving healthy longevity. Life expectancy follows a social gradient, whereby the more deprived an area, the shorter the life expectancy of its population (Marmot, 2020)
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From page 92... ...
. The researchers attributed the extra 3 years of life expectancy in Ethiopia to "community-based health strategies, improving access to safe water, female education and gender empowerment, and the rise of civil society organisations" (Freeman et al., 2020, p.
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From page 93... ...
Conclusion 4-1: In designing and implementing policies to promote healthy longevity, it will be essential to acknowledge the cumulative ef fects of social determinants of health across the life course. With equity at the core of these policies, governments can address the historical and structural inequalities that have translated into a poor baseline of health for some populations as they enter the second half of life.
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From page 94... ...
Social capital in communities has been found to have a "buffering" effect that counters the more adverse factors. For example, one study found that Hispanics and foreign-born citizens in the United States have a longer life expectancy than native-born non-Hispanics, which the authors attribute to strong social connections despite lower income levels (Singer et al., 2017)
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From page 95... ...
. Quality relationships with families, kinship and friendship networks, and community ties, as well as the impact of social ties on health, remain important to well-being throughout the life course (Umberson et al., 2010)
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From page 96... ...
Conclusion 4-2: Societies with healthy longevity can capitalize on the emotional stability and prosocial strengths of older people by enabling them in their existing roles and emerging new roles. KEY TARGET: AGEISM AND AGE DISCRIMINATION One of the most significant barriers to achieving healthy longevity is ageism.
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From page 97... ...
. One study found that negative age stereotypes, negative self-perceptions, and age discrimination in the United States led to estimated annual costs of USD63 billion for the top eight most expensive health conditions, and in Australia, estimates suggest the national economy would realize an additional AUD48 billion annually if 5 percent more people aged 55 or older were employed (WHO, 2021a)
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From page 98... ...
. In Latin America, for example, [t]
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From page 99... ...
Interventions for Combating Ageism A recent meta-analysis suggests that "relatively low-cost, feasible strategies involving education and intergenerational contact can serve as the basis of effective interventions to prevent ageism" and address the digital divide that keeps many older adults from using technology (Burnes et al., 2019, p.
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From page 100... ...
Global Report on Ageism outlines two strategies for reducing ageism by dispelling misconceptions about older adults and fostering interaction between different age groups: public awareness cam paigns and intergenerational contact interventions, respectively. Public awareness campaigns are most effective in combating ageism when they provide accurate in formation about older adults and counter stereotypical examples that allow people and organizations to reconsider and update their beliefs.
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From page 101... ...
Recent intergenerational programs brought together older adults and young students to honor the importance of intergenerational cohesion and respect for all age groups. Lectures included information about ageist policies, ways to support older adults in communities, and possible interventions for creating meaningful relationships across generations.
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From page 102... ...
The WHO Decade of Healthy Ageing (2020) report also highlights indicators related to the SDGs but modified to track the progress of older adults specifically.
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From page 103... ...
Although this report focuses mainly on older adults, given the high proportion of young people in many countries and extended life expectancies, understanding these interactions and potential discrimination that occurs between generations is another opportunity for greater insight. KEY TARGET: SOCIAL INCLUSION Isolation is defined as the experience of being alone (a state of objective physical separation)
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From page 104... ...
Identifying these connections can also provide linkages across generations and help promote healthy longevity across the life course. A systematic review examined the effect of spirituality and religiousness as a predictor of quality of life for young people and overwhelmingly found positive associations (Borges et al., 2021)
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From page 105... ...
Without an opportunity for the voices of older adults to be heard and incorporated into community and urban development, it will be impossible to truly meet their needs and optimize the environment for healthy aging across the life course. Engaging people in their own community development is more important than ever today, given the rate of population aging and the availability of older adults as an underutilized resource (HelpAge International, 2016b)
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From page 106... ...
When these ties are robust, with opportunities for interaction among different subpopulations, such as intergenerational social networks, cohesion is strong, and loneliness is less likely. Intergenerational social networks differ among countries and regions, but the dominant norms emphasize the importance of intergenerational connections and the protection they can provide against social isolation and loneliness.
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From page 107... ...
. A systematic review of intergenerational programs examining benefits for children and older adults found improvements in attitude, behavior, confidence, and competence for the children, along with "significant differences in mental and physical health and quality of life for the older adults" (Giraudeau and Bailly, 2019, p.
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From page 108... ...
A recent study found that multigenerational living is on the rise in the United States: one in four Americans now live in a household with three or more generations, representing a four-fold increase in multigenerational households in the past decade (Generations United, 2021)
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From page 109... ...
Efforts to address loneliness and intergenerational cohesion can help promote social inclusion in communities and serve as entry points for addressing other needs, including housing, food, and transportation. Cities and communities are increasingly creating programs to connect people across generational gaps, recognizing the benefits for all participants.
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From page 110... ...
report advocates for ensuring that communities tap the abilities of older people and foster intergenerational cohesion, calling for the inclusion of older adult voices and stimulation of intergenerational dialogue. Related to fostering social inclusion, the WHO report suggests the following metric to gauge progress: • Indicator 5.4.1: Proportion of time spent in unpaid domestic and care work, by sex, age and location, as a basis for provision of public services, infra structure, and social protection policies.
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From page 111... ...
Financial security is an ageless need. Regardless of work history, gender, disability, or position in society, all people require a reliable, adequate income over the life course.
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From page 112... ...
Financial security schemes are an example of equitable income access and transformation of opportunity structures within communities, supporting the most vulnerable people in society. As described previously, poverty can have a critical influence on life expectancy, and differences of just a few miles within a city can translate into several years added to or subtracted from a person's life.
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From page 113... ...
Absent this security, lack of access to necessary resources can have a detrimental effect on people's health and life span. Testing Different Social Protection Models Projections of increasing life expectancy across countries and the continued disparities among racial and socioeconomic groups help make the case for a widespread commitment to financial security for older people, although different cultures and communities may need to customize their financial security schemes to fit their populations' unique needs.
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From page 114... ...
. Interventions to Ensure Financial Security Many countries have tried various interventions to improve the financial security of their residents.
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From page 115... ...
. After years of stalled progress in including these workers in social protection programs, a combination of a top-down and bottom-up approach bringing together international organizations such as ILO and civil society advocacy groups led to better understanding on the part of the government and greater awareness among informal workers.
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From page 116... ...
If people have no income security or resources once they can no longer work, their chances of achieving healthy longevity decline significantly. Ideally, financial security systems would guarantee that all vulnerable people (not just older people)
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From page 117... ...
c. For countries with robust retirement income systems, identify evidence based models for strengthening financial security across the life course.
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From page 118... ...
As older adults seek to leave the workforce and maintain their wealth, research also is needed on alternative approaches for generating engagement in financial competence and knowledge. Financial literacy is one important focus; others include incentives to save for the long term, the long-term impacts of default design for saving, mandatory saving, and the links between life-course health patterns and financial security, all of which need more research.
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From page 119... ...
. While much of that commission's focus is on youth, especially in low- and middle-income countries, interventions beginning with young people and continuing across the life course can have important implications as people age.
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From page 120... ...
Investing in digital infrastructure designed for older people and incorporating age-diverse representation in AI and machine learning algorithms could help to close the digital divide. Finding 4-11: Education to increase digital literacy among older people can help them to integrate into societies with rapidly changing tech nological advances and provide them with increased opportunities for engagement.
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From page 121... ...
Interventions geared toward building social cohesion and social capital within communities can con
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From page 122... ...
2021. Reductions in 2020 US life expectancy due to COVID-19 and the disproportionate impact on the Black and Latino populations.
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From page 123... ...
2016. The association between income and life expectancy in the United States, 2001–2014.
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2017. Inequalities in life expectancy among US counties, 1980 to 2014: Temporal trends and key drivers.
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From page 125... ...
2021. Helping older people achieve financial security.
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2020. Ageism, healthy life expectancy and population ageing: How are they related?
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2010. Social relationships and health behavior across the life course.
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2022. Social protection for informal workers: Trends and changes extending social protection for informal workers in Togo.
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