Healthy Aging

We all want to stay healthy and independent as we get older.  Adopting healthy habits and behaviors, staying involved in your community, using preventive services, and managing health conditions can contribute to healthy aging.  Communities want to be thriving places for people to grow up and grow older.  People want to age in a place, in the community where they have spent their life, in a place they call home. 

What is healthy aging?

The Centers for Disease Control and Prevention’s (CDC) Healthy Aging Research Network defines healthy aging as the development and maintenance of optimal physical, mental and social well-being and function in older adults. Effective health promotion addresses individual behavior as well as community support systems and environmental conditions that support healthy choices for adults.

Healthy aging is most likely to be achieved when:

• physical environments and communities are safe,
• attitudes and behaviors known to promote health and well-being are adopted and maintained by individuals, and
• health services and community programs are effectively used to prevent or minimize the impact of acute and chronic disease.

CDC indicates the most effective public health strategies for improving the health and quality of life for the 50 plus population are:

• promoting healthy environments and lifestyles,
• closing gaps in the delivery of clinical preventive services, and
• meeting the needs of older adults with cognitive impairment and their caregivers.

The Tennessee Department of Health promotes healthy aging to support the quality of life of older adults.

How can communities promote healthy aging and livable communities?

A livable community is one that promotes physical activity, is safe and has convenient, affordable housing; available transportation options, enhances personal independence, provides social opportunities for the resident to engage in the community’s civic, economic and social life, and allows residents to age in place.  The American Association of Retired Persons (AARP) offers partnership opportunities for state and local public health departments to promote well-designed, livable communities for all ages.  For additional information go to AARP Age-Friendly Communities Selection Criteria.

The federal initiative, National Prevention Strategy , developed by the National Prevention, Health Promotion, and Public Health Council provides evidence-based Recommendations for Healthy and Safe Community Environments and promotes the creation of social and physical environments to maintain good health for all.  Many strategies are identified for developing livable communities that promote mobility, including pedestrian and bicycle safety, urban design and land use policies that support physical activity for older adults, and aging in place.

The Partnership for Sustainable Communities was an interagency initiative between the Department of Housing and Urban Development (HUD), Department of Transportation (DOT) and the Environmental Protection Agency (EPA). Through the partnership, HUD, DOT and EPA coordinate initiatives to help communities nationwide improve access to affordable housing, increase transportation options and lower transportation costs while protecting the environment. The Partnership agencies periodically offer funding opportunities and you can visit each agencies webpage to learn more:

• HUD offers funding opportunities to help communities realize their own visions for building more livable, walkable and environmentally sustainable regions.
• DOT offers funding opportunities to support more livable walkable communities.
• EPA offers grants to support activities that improve the quality of development and protect human health and the environment.

Why is physical activity important for older adults?

According to the National Institute on Aging (NIA) and the World Health Organization (WHO) exercise and physical activity can combat and reduce the risk of heart diseases, stroke, diabetes and other chronic diseases that are associated with aging, providing a better quality of life.

CDC indicates one-third of older adults do not get regular physical activity.   CDC stresses the importance of promoting healthy environments and active lifestyles through the creation of healthy communities to make it easier for people to pursue healthy behaviors. For example, in communities that provide safe walking and biking trails, residents are more likely to get and be more physically active by walking or biking regularly.

The NIA is working with public and private organizations to empower older adults to become more physically active through their Go4Life campaign. Go4Life provides information and motivational tools through their interactive website for people 50-plus to move more and increase their physical activity. The campaign features partnerships with community organizations and agencies.

The National Institute of Diabetes and Digestive and Kidney Disease provide information and resources that older adults can take to improve their health, including moving more.  The Walking... A Step in the Right Direction! and the Fit and Fabulous as You Mature programs both provide information about the health benefits of walking and how to start a walking program in your community.

Along with keeping our bodies in good shape, we want to keep our minds healthy too.  Physical Activity may protect brain health according to ALC’s Brain Health as You Age website.  Get at least 150 minutes of exercise each week. Move about 30 minutes on most days.  Walking is a good start.

How can we implement fall prevention and safety?

Centers for Disease Control and Prevention (CDC) reports treating falls is very costly and is likely to rise. In 2013, direct medical costs for falls totaled 34 billion. Annually, millions of people are treated in emergency rooms because of falls and fall injuries are among the 20 most expensive medical conditions.  Among older adults, falls are the leading cause of both fatal and nonfatal injuries. Falls are the main reason people lose their independence.  

CDC recommends four actions individuals can do to prevent falls:

1. Exercise to improve your leg strength and balance.
2. Ask your doctor or pharmacist to review your medicines.
3. Get an annual eye checkup and update your glasses.
4. Make your home safer by removing clutter and trip hazards, putting railings on stairs, adding grab bars in the bathroom and having good lighting, especially on stairs.

To prevent injuries, there are a number of things individuals can do.  Older adults should learn about and deal with risks for falls and participate in fall prevention programs. The CDC’s Stopping Elderly Accidents, Deaths and Injuries (STEADI) Initiative for Health Care Providers tool walks health care providers through assessing a patient’s fall risk, educating patients, selecting interventions and following up.

The Tennessee Department of Health’s Stepping ON Falls Prevention program can reduce falls while building confidence in older people. Stepping On is designed for people who are at risk for falling, have a fear of falling or those who have fallen before. Throughout Tennessee workshops are facilitated by trained volunteer leaders. Classes are highly participatory.  Participants are trained to manage their health behaviors, reduce their risk of falls and maintain active and fulfilling lives.

Why is proper nutrition important for older adults?

Many health issues associated with aging can be controlled and delayed by eating healthier. Designing and building healthy communities can ensure access to affordable and healthy foods and create outlets for fresh fruits and vegetables, such as community gardens and farmers markets.

Based on Federal Government dietary guidelines, What's On Your Plate? Smart Food Choices for Healthy Aging (PDF) provides healthy eating information for older adults. The National Institute on Aging (NIA), part of the National Institutes of Health (NIH) guide includes tips on nutrients, food groups and grocery shopping as well as healthy sample menus.

Because adults 50 and over continue to remain gainfully employed, it is important to consider ways in which worksites can promote health and wellness in the workplace. One way to do this is to implement food service guidelines such as those developed for federal government worksites.  CDC’s Healthy Food Environments website provides guidelines that are designed to make healthier food choices and physical activity opportunities more available for employees throughout their work day.

The Tennessee Department of Health receives grants from the U.S. Department of Agriculture to operate the Farmers Market Nutrition Program (FMNP).  In designated counties , the FMNP provides locally grown fruits, vegetables and herbs to families with limited resources and is available to seniors.

How can we promote preventive services for adults 50-64?

A healthy lifestyle and the use of preventive services, makes many chronic diseases preventable.  According to the CDC, chronic diseases are the most prevalent, costly and preventable health problems.  Chronic diseases are the leading causes of death and disability, responsible for 7 out of 10 deaths each year. Clinical preventive services, including cancer screenings and immunizations for flu and pneumonia, can prevent disease or find disease early, when treatment is more effective. CDC states greater use of these services could prevent thousands of deaths among older Americans each year. However, only about one-third of adults aged 50 to 64 and less than half of those aged 65 or older are up to date on a selected set of recommended screenings and immunizations.

Effective health promotion addresses individual behavior as well as community support systems and environmental conditions that will support healthy choices for adults. The CDC, AARP and the American Medical Association (AMA) have joined together to highlight key issues, strategies and resources for promoting broader use of preventive services for adults 50-64 in the report, Promoting Preventive Services for Adults 50–64: Community and Clinical Partnerships (PDF).  At the core of this Report are 14 key indicators for monitoring the use of clinical preventive services among adults aged 50 to 64: four disease screenings (breast, cervical, colorectal and cholesterol), two immunizations (Influenza and pneumococcal vaccinations), and six risk factors (physical inactivity, smoking, binge drinking, obesity, high blood pressure and moderate depressive symptoms) that combine several select clinical preventive services.

The state’s goal is to put healthy options within reach for all Tennesseans, and offering Chronic Disease and Diabetes self-management workshops is one way to ensure that people with chronic diseases have the support they need to access those options and live well.  The Tennessee Department of Health offers two evidenced-based programs:  Living Well with Chronic Disease Self-Management Program (CDSMP) and Diabetes Self-Management Program (DSMP).  The  Living Well with CDSMP is a two and a half hour workshop given, once a week, for six weeks, in community settings such as senior centers, churches, libraries and local health departments. People with different chronic health problems attend together.

Workshops are facilitated by two trained certified leaders, one or both of whom are not health professionals. Subjects covered include: techniques to deal with problems such as frustration, fatigue, pain and isolation; appropriate exercise for maintaining and improving strength, flexibility and endurance; appropriate use of medications; communicating effectively with family, friends and health professionals; nutrition; decision making and how to evaluate new treatments. 

The Tennessee Department of Health’s Diabetes Self-Management Program is a chronic disease self-management program that specifically targets diabetics and their needs.  

Why focus on adults aged 50-64 for clinical preventive services?

The Department of Health and Human Services’ National Adult Immunization Plan provides an overview of actions needed to be undertaken by federal and nonfederal partners to protect public health and achieve optimal prevention of infectious diseases and their consequences through vaccination of adults. The plan establishes four key goals: (1) strengthen the public health and health care systems involved in adult immunization, (2) improve access to adult vaccines, (3) increase awareness of adult vaccine recommendations and use of recommended vaccines and (4) foster innovations in adult vaccines, including new vaccines and new ways to provide them.

As noted in one section of the report, Why This Matters, the impact of the issue on adults aged 50 to 64 and at-risk or vulnerable populations, the value of the preventive service, and cost implications are highlighted:

Breast Cancer Screening

• Breast cancer is the second leading cause of cancer death among women in the U.S. and the most commonly diagnosed non-skin cancer.
• One of every four dollars spent on cancer in the U.S. goes toward the cost of treating breast cancer.  Early detection can save up to 35 percent of the net cost of this care.

Cervical Cancer Screening

• Poor women between 45 and 64 years of age are 25 percent less likely to have received a Pap test in the past three years compared with high-income adults.
• Early detection of cervical cancer through population-wide screening with the Pap test every 3 years can reduce the rate of invasive cervical cancer by 91 percent.

Colorectal Cancer Screening

• The cost of treatment for colorectal cancer is often lowest when the tumor is detected in an early stage.
• In 2005, an estimated 141,405 Americans were diagnosed with colorectal cancer, making it the third most common cancer in both men and women.

Cholesterol Screening

• Periodic cholesterol screening for early detection and treatment can decrease hospital and ambulatory services, prevent premature mortality from coronary heart disease, and avoid considerable disability, distress and pain.
• Adults aged 45 to 64 with low incomes are 15 percent less likely to have received a cholesterol screening in the past 5 years compared with high-income adults.

Influenza Vaccination

• Influenza infection can exacerbate other underlying medical conditions and lead to hospitalization or even death.
• Healthy, working adults who receive influenza vaccines experience significantly fewer days of influenza-like illness, make fewer doctor visits for such illnesses, and miss fewer days of work than non-vaccinated workers.

Pneumococcal Vaccination

• On average, costs to employers are approximately five times higher for workers who had pneumonia than for the overall population of workers.

Shingles Vaccination

• The same virus that causes chicken pox in childhood can painfully reemerge as shingles later in life.  CDC recommends adults age 60 and older get vaccinated for shingles.

Who advocates for older Tennesseans?

The Tennessee Commission on Aging and Disability's Information and Assistance program was established by the Older Americans Act.  Area Agencies on Aging and Disability plan and provide programs and services for older Tennesseans, as well as those with disabilities. 

Government partners

Tennessee Commission on Aging and Disability (TCAD)
www.tn.gov/aging.html

Centers for Disease Control and Prevention (CDC)
National Center for Injury Control and Prevention
www.cdc.gov/injury/index.html

Stopping Elderly Accidents, Deaths and Injuries
www.cdc.gov/steadi/index.html

Department of Health and Human Services (HHS)
National Prevention Council
www.surgeongeneral.gov/priorities/prevention/about/index.html

Additional resources

American Association of Retired Persons (AARP) 
Livable Communities
www.aarp.org/livable-communities

Where We Live: Communities for All Ages
www.aarp.org/livable-communities/tool-kits-resources/info-2016/where-we-live-communities-for-all-ages.html

National Aging in Place Council 
Age in Place
www.ageinplace.org

NPT’s main page for Aging Matters
www.wnpt.org/agingmatters/about/

Honoring Choices
Honoring Choices® Tennessee provides educational resources to assist individuals and families plan for the future and make difficult decisions.
www.honoringchoicestn.org

Helpful documents

Robert Wood Johnson Foundation
A State-by-State Look at Adult Health
www.commissiononhealth.org/Documents/AdultHealthChartbookFullReport.pdf

American Association of Retired Persons (AARP)
Growing Smarter, Living Healthier: A Guide to Smart Growth and Active Aging 
www.aarp.org/content/dam/aarp/livable-communities/act/planning/growing-smarter-living-healthier-a-guide-to-smart-growth-active-aging-aarp.pdf (PDF)

Tennessee Department of Health
Tennessee State Plan on Aging
www.tn.gov/content/dam/tn/aging/documents/State_Plan_2014-2018.pdf (PDF)