Healthy ageing is vital for development
9 April 2002 - PREVENTION OF NONCOMMUNICABLE DISEASES THROUGHOUT THE LIFE COURSE IS KEY SAYS NEW WHO POLICY ROADMAP
In a rapidly greying world, healthy ageing is vital for countries' economic development, declared the World Health Organization (WHO) today at the Second World Assembly on Ageing which takes place this week in Madrid.
On this occasion, WHO unveiled a new roadmap to assist countries in designing policies to enhance health for ageing people. According to this policy framework, the prevention of noncommunicable diseases, starting already in early childhood, is the mainstay of healthy ageing.
"A healthy population is a prerequisite for economic growth," said Dr Gro Harlem Brundtland, Director-General of WHO. "The predicted explosion of noncommunicable diseases — like heart disease, cancer or depression — in the ever-increasing number of older persons globally will result in enormous human and social costs unless preventive action is taken now. A disproportionate amount of resources will need to be diverted to handle these largely preventable health problems," she added.
A demographic revolution is underway throughout the world. Thanks to unprecedented public health advances and successes in many parts of the world, the proportion of people age 60 and over is growing faster than any other age group. This is due to a combination of both longer lives and declining birth rates. In 2025, there will be about 1.2 billion people over the age of 60. A quarter century later, the number of over-60s will almost double and 80% of older persons will live in developing countries.
The alteration of the age pyramid, however, poses significant new challenges for governments, societies and families in the 21st century. Ageing developing countries are slated to face a heavy double burden of infectious and noncommunicable diseases; yet they often lack sufficient resources, including comprehensive ageing policies, to cope. Industrialized countries, on the other hand, were fortunate enough to become affluent before they became old.
By midlife (age 45), noncommunicable diseases make up the lion’s share of all diseases and are responsible for the vast majority of deaths. Whether rich or poor, industrialized or developing, as countries age noncommunicable diseases become the prevalent diseases. They are potentially expensive to treat and once established, they are long-lasting, as they often cannot be cured.
Challenges posed by ageing, such as the increase in noncommunicable diseases, however, can be surmounted by promotion of healthy lifestyles and appropriate preventive action. A "life course approach" or setting the stage for healthy ageing early on in life is needed. Research is increasingly showing that the origins of risk for chronic conditions, like diabetes or heart disease, begin in early childhood or even earlier. Although the risk of developing a noncommunicable disease or becoming disabled experiences some increases with age, lack of physical activity, tobacco use, alcohol abuse and inadequate diet throughout life are some of the factors that exponentially increase the risk.
Older people, who are healthy, are a precious resource. They are able to make an important and necessary contribution to their families, communities and national economies whether it be through formal or informal labour or volunteer work, according to their own preferences and capacities.
Healthy ageing can be achieved
As demonstrated by the trend towards postponement of onset of disability and disease in the older populations of industrialized countries, it is possible to foster and achieve healthy ageing. The WHO policy response contained in Active Ageing: A Policy Framework (www.who.int/hpr/ageing) launched today, recommends a set of actions in three essential areas: health, participation and security. For instance, WHO advises to:
- Address factors that contribute to the onset of disease and disabilities like poverty, low literacy levels and lack of education.
- Control tobacco use and alcohol abuse throughout the life course.
- Ensure appropriate nutrition and healthy eating starting at an early age.
- Promote physical activity at all ages.
- Create age-friendly, safe environments by making walking safe and implementing fall prevention programmes.
- Increase affordable access to essential, safe medications and assistive devices such as eyeglasses or walkers.
- Promote mental health.
- Reduce avoidable hearing impairment and blindness.
- Provide a continuum of care and support care-givers.
"The right policies will benefit us all. In the first place, they will lead to fewer premature deaths in the highly productive stages of life. Good policies will also lead to fewer disabilities and more people enjoying a positive quality of life and actively participating in society as they age. Moreover, costs related to medical treatment and care services will be lower," stressed Dr Alexandre Kalache, Coordinator, Ageing and Life Course Programme, WHO.
Dr Kalache pointed out the myth that associates old age with increased medical spending. "Rather, it is disability and poor health ¾ often associated with old age ¾ that are costly. Good health in the older population saves money, freeing it up for other needs. Healthy ageing is therefore a central component of the development agenda," he emphasized.
Action on healthy ageing must include a variety of sectors: education, employment and labour, finance, social security, rural and urban development, housing, transportation and justice.
In addition, all policies need to support intergenerational solidarity and set specific targets for improvements in health status of older people. Special attention needs to be focused on the most vulnerable: women, the poor and marginalized and those living in rural areas.
The 2002 World Assembly on Ageing marks a turning point in addressing the challenges and celebrating the triumphs of a rapidly ageing world. WHO is committed to working with a range of partners — from international and other United Nations agencies to the private sector — to implement strong ageing policies at global, regional and national levels. In addition to providing the policy framework, WHO will continue to offer technical advice and will play a catalytic role for health development.