THERE is no ‘typical’ older person. Some 80-year-olds have physical and mental capacities similar to many 20-year-olds. Other people experience significant declines in physical and mental capacities at much younger ages. A comprehensive public health response must address this wide range of older people’s experiences and needs, according to the World Health Organization (WHO).

Health inequities

However, the diversity seen in older age is not random. A large part arises from people’s physical and social environments and the impact of these environments on their opportunities and health behaviour. The relationship we have with our environments is skewed by personal characteristics such as the family we were born into, our sex and our ethnicity, leading to inequalities in health. A significant proportion of the diversity in older age is due to the cumulative impact of these health inequities across the life course. Public health policy must be crafted to reduce, rather than reinforce, these inequities.

Outdated and ageist stereotypes

Older people are often assumed to be frail or dependent, and a burden to society. Public health, and society as a whole, need to address these and other ageist attitudes, which can lead to discrimination, affect the way policies are developed and the opportunities older people have to experience healthy ageing.

A rapidly changing world

Globalisation, technological developments (eg in transport and communication), urbanisation, migration and changing gender norms are influencing the lives of older people in direct and indirect ways. For example, although the number of surviving generations in a family has increased, today these generations are more likely than in the past to live separately. A public health response must take stock of these current and projected trends, and frame policies accordingly.

WHO’s response

In accordance with a recent World Health Resolution (67/13), a comprehensive Global Strategy and Action Plan on Ageing and Health is being developed by WHO in consultation with member states and other partners. The strategy and action plan draws on the evidence of the world report on ageing and health and builds on existing activities to address five priority areas for action.

Aligning health systems with the needs of older populations

Health systems need to be better organised around older people’s needs and preferences, designed to enhance older peoples intrinsic capacity, and integrated across settings and care providers. Actions in this area are closely aligned with other work across the organisation to strengthen universal health care and people-centred and integrated health services.

Developing systems for providing long-term care

Systems of long-term care are needed in all countries to meet the needs of older people. This requires developing, sometimes from nothing, governance systems, infrastructure and workforce capacity. WHO’s work on long-term care (including palliative care) aligns closely with efforts to enhance universal health coverage, address non-communicable diseases, and develop people-centred and integrated health services.

Creating age-friendly environments.

This will require actions to combat ageism, enable autonomy and support healthy ageing in all policies and at all levels of Government. These activities build on and complement WHO’s work during the past decade to develop age-friendly cities and communities including the development of the Global Network of Age Friendly Cities and Communities and an interactive information sharing platform age-friendly world.

Improving measurement, monitoring and understanding

Focused research, new metrics and analytical methods are needed for a wide range of ageing issues. This work builds on the extensive work WHO has done in improving health statistics and information, for example, through the WHO study on global ageing and adult health.