Healthy Ageing and Health Equity.
IFA – WHO Invited Symposium Healthy Ageing Health Equity
The World Report on Ageing and Health defines Healthy Ageing as the process of developing and maintaining the functional ability that enables wellbeing in older age (WHO 2015). Functional ability is “all the health-related attributes that enable people to be and to do what they have reason to value, ” and is in turn determined by: (i) an individual’s intrinsic capacity (i.e., the composite of all the physical and mental capacities of an individual (i.e. comprehensive, person centered “within the skin” capacities), (ii) the environment (i.e., all the factors in the extrinsic world that form the context of an individual’s life), and (iii) the interactions between the two. The Report also proposes a framework for action that draws on a variety of sectors, to support ensure older adults maintain high and stable intrinsic capacities, as well as ensure that the needs and rights of older adults with declining, or a significant loss of capacity, can continue to optimize functional ability in the context of where they live.
Existing evidence on broader determinants of health relevant to healthy ageing, points out that much of the disparity, or total inequality, in how older adults experience health and illness — not only disease and death — is due to the extent to which an individual, household or group, has lived in a society where investments in a safe and healthful environment enables all people over their lives irrespective of their gender, social or economic position, to engage in healthy lifestyles, to enable positive psycho-social interactions, and get effective health and social services based on need and right, rather than pocket book or charity. Within each group, there might be as much variation in experience, as there is across groups: for example, average differences between older women and men, mask variation in women’s or men’s experience. When differences exist that can be avoided and are considered unfair, these differences should be labelled as health inequities. Health equity implies that ideally everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged from achieving this potential.
A model of the healthy ageing process requires a person-centered, dynamic approach, recognizing multilevel determinants and pathways. It should also help explain individual, group and overall differences, whether within countries or across countries, and identify entry points for action. Actions should have impacts so that on average, older adults optimize functional ability, and across and within countries and communities, intrinsic capacities. Actions should also mitigate past inequities, and pro-actively aim to enhance equity. A sign of improving equity is that differences measured by relevant characteristics are narrowed, and the average is lifted towards the frontier levels. This will also reduce total inequality.
Actions may therefore be targeted at different determinants of health, social processes, institutional mechanisms, community governance, etc., in addition to those addressing health and social care; and depending on each context, be universal of nature, or targeted to specific population sub-groups without stigmatizing a particular group. Information and evidence can inform what can be done, and whether actions have intended impacts to optimize functional ability. Monitoring capacities and ability, and other health outcomes of interest, disaggregated by sub-groups, is a key step for stakeholders to document inequalities and discuss what can be done to improve health equity inclusive of older adults. This is important at all levels of policy and action, whether in communities, provinces, national or global.
This Invited Symposium – 10 August, 2.00pm – 3.30pm, Chelsea Hotel, Rosetti B
An interactive symposium where panelists, delegates and other participants will exchange learning on ways to advance research, evidence synthesis, actions, and measure impacts that optimize health outcome important to older adults, including functional ability, and enhance equity. Questions discussed and collected from participants will improve a WHO – IFA – HelpAge International policy brief on healthy ageing and health equity (An penultimate version will circulated to all conference participants, will be finalized with inputs from the conference, and is planned to be released on 1 October 2018, International Day of Older Persons).
Panel introductory remarks (5 minutes each, maximum 3 slides)
- Introduction to optimizing Healthy Ageing and Health Equity, reflecting on background and introduction to healthy ageing and health equity process – Ritu Sadana, WHO (each of the subsequent panelists highlight a key ingredient)
- Political commitment and strategy: to be confirmed. Learning from countries – approach to commitment at diverse levels, making and implementing the case for health promotion and broader determinants approach to support and engage older adults.
- Learning from communities – what can be done with partnerships –community based efforts to include older adults in Universal Health Care schemes and reduce health inequities – Justin Derbyshire, CEO, HelpAge International
Q & A – 10 minutes + collection of questions
- Learning from existing data: re-analysis of Health and Retirement longitudinal studies (selection of 20 countries) and the evolution of gender inequalities in late life health with a special look at the range of abilities across the life course and how they relate to inequalities in reproductive health, empowerment, and economics. Drystan Phillips, University of Southern California
- Documenting evidence gaps & encouraging new research – results from evidence mapping and gaps analysis to optimize older adults’ functional ability – Vivian Welch, Campbell and Cochrane Global Ageing
Q & A – 10 minutes + collection of questions
Moderated Discussion – with panel, including from question cards – 30 minutes
Closure & Next Steps