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11

October

By Angelique Mavrodaris, Public Health Consultant Lead for Ageing Well at the Cambridge Institute for Public Health

For the first time in history it is estimated that the number of people aged 65 and over will outnumber children aged 5 and under by 2050. Population ageing implies impacts on health and wellbeing, housing and the environment, work and retirement, movement and autonomy. The experiences of ageing are diverse and dynamic, reacting to ageism or responding to value and purpose. Clearly ageing presents a global population health challenge on a number of fronts and begs the question – where do we start?

At a Policy Institute seminar on ageing earlier this year, researchers, policymakers and practitioners from across sectors came together to explore key issues faced by ageing populations today. These are complex issues with no easy solutions, yet the will and commitment to address them is mounting. In November last year, the UK government published the its industrial strategy, which highlights ‘meeting the needs of an ageing society’ as one of four ‘grand challenges’ – or priority areas and industries – of the future.

While we all aim to address these issues from our own sectors and fields, one feature that needs to be embedded across approaches is sustainability. For too long economic prosperity, health and urbanisation have advanced at the expense of unchecked resource consumption, energy use and disturbance of natural ecosystems and resulted in anthropogenic climate change and environmental depletion.

Environmental changes will have particular impacts for ageing populations which are already vulnerable. More than 60% of the world’s population aged over 60 years are currently living in low- and middle-income countries, challenged not only by impacts on health and wellbeing, but also facing inequality and stigma. How we design and apply global sustainable solutions in response to these issues is critical. What is fundamental for health is the recognition of the widespread interactions and synergies that exist between sustainability threats, in the context of population growth and ageing:

Potential effects of environmental issues and pressures on the health of ageing populations

Disturbances in ecosystems and climate will have direct and indirect effects on human health. Directly, from extreme weather events such as flooding, heatwaves and severe storms, and indirectly through altered vector-borne disease transmission due to increased temperatures; inability to grow and produce nutritious food due to drought or damage of land; water restrictions and compromised water safety. In addition, the insecurity these threats will create may result in the destruction of environments and communities, as well as conflicts that in turn lead to migration, displacement and isolation of those too weak or unable to move. Each of these effects will be felt even more by older populations as the socioeconomic determinants of health are further compromised.

Synergy between what promotes healthy ageing and what sustains the environment

But in the face of these complex challenges, there are a range of opportunities that promote ageing well in alignment with sustainability.  To quote the BMA: ‘What’s good for health is good for the environment.

For example, a recent study demonstrated that active travel cut the risk of mortality from heart disease and stroke by up to a third. Reducing car use and engaging in more physical activity through active travel options improves health and reduces air pollution. Similar alignments can be made for designing more sustainable, insulated and connected homes and communities. as well as for healthier dietary patterns and food production.

Unique contribution and collective wisdom of ageing generations 

Understanding these challenges is critical but we need to go further, re-inventing the way we do things and inspiring change at community levels. We have much to celebrate and preserve from the positive aspects of increased life expectancy and much to learn about what contributes to a good and sustainable quality of life, for older people and generations to come. Our ageing populations carry with them wisdom, skills and an understanding of what it really means to age successfully. The contributions they have to offer are not only an asset but are key to preserving purpose and community cohesion across generations.  We have much to share and learn from each other at what is a critical time for both ageing populations and the planet.

Work is currently underway to develop a framework for action that will empower ageing populations and protect the planet by ensuring equitable, cross-sectoral and sustainable approaches are adopted across the life course. This cannot be done in isolation and will depend on ingenuity and consistent commitment from us all; to bring to life a shared vision of what kind planet we all want to thrive and grow old in.