HABERAGINGPPT_Ch01.pptx

CHAPTER 1
Introduction to Health Promotion
and Aging

POWERPOINTS TO ACCOMPANY

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Surgeon General 1979 report
Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention
U.S. Public Health Service 1980 report
Promoting Health/Preventing Disease: Objectives for the Nation
U.S. Public Health Service 1990 report
Healthy People 2000

Healthy People Initiatives

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Documenting baselines, setting objectives, and monitoring progress. 2030 objectives are now being established
Health oriented, not disease oriented
Politics of healthcare
Conservatives and libertarians
Liberals and paternalists
Libertarian paternalism: A compromise opting out versus opting in

Healthy People Initiatives—cont’d

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What aging Americans have in common
Intensified demand for medical care (healthcare)
Ongoing escalation of medical costs
Health promotion, disease prevention, and chronic disease management
Screening, education, and intervention costs
Social Security and Medicare support extends lives and service needs

Aging, Health, Social, and Medical Trends

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Percentage of older adults has increased dramatically over the past century
And will continue in the future: 2020–2060
More than sixfold increase in those 65+
2030
65+ population projected to reach 20%
Age pyramid versus age rectangle
U.S. Population Growth Over Age 65

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Born in the United States between 1946 and 1964 (76 million)
Retirement
History of advocacy and future influence on society
Impact on Social Security and Medicare programs
Health and long-term care alternatives will continue to evolve to meet the needs of the boomers
Baby Boomers

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Age 85+ is the fastest growing age group
Increasingly a common stage of life
Significantly reduced ability to function fully
Service needs increase accordingly
Disability and chronic conditions
Difficulty with hearing, vision, cognition, ambulation, self-care, or independent living

The Older Old

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Centenarians
2015 Census: 77,000 people were 100 years or older
More than doubled from 1980
Census projections: 8 times more by 2050
Supercentenarians: 110 years or older
Biogerontology
Centenarians

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2014—78.9 years; 2017—78.6 years
Rising since 1900—Why a dip?
Contributing factors
Threats
U.S. ranking
Trails 49 other countries in life expectancy
Life Expectancy

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Closing gender gap
Men: 76.1 years
Women: 81.1 years
Decreasing disparity between Blacks and Whites
Top three causes of death
Heart disease
Cancer
Chronic lower respiratory diseases
Life Expectancy—cont’d

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Fastest-rising causes of death
Diabetes (lifestyle/obesity)
Alzheimer’s disease (advanced age)
Life Expectancy—cont’d

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Declining hospital stays for age 65+
Increasing medication costs among Medicare enrollees
Advertising of expensive brand-name drugs
Generic drug cost increase
Medicare Part D—Ban on the government negotiating lower medication costs

Hospital Stays and Medication Use

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Slightly better health habits than younger adults
Tendency of older men to be married, not widowed
Increased percentage in workforce
Education: Increased percentage with degrees
Decreased poverty
Voting clout protects Medicare and Social Security

General Health Habits in Older Adults

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Public Health Service components
Disease prevention
Health protection
Health promotion
Prevention categories
Primary
Secondary
Tertiary
Healthy Aging

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Wellness
Alternative activities
Seven dimensions of wellness
Antiaging versus proaging movement
Compression of morbidity
Is it increasing or decreasing?
Healthy Aging—cont’d

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Health expectancy versus life expectancy
Reciprocal relationship between physical and emotional health aspects
Leading-edge boomers
Trailing-edge boomers
Intergenerational conflict

Health Perspectives and Aging

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Medicare
Helps persons age 65+ pay for medical care
Medicare Part A
Medicare Part B
Medicare Part C
Medicare Part D
Medicaid
Covers 60% of nursing home care costs
Approximately one-third of each state’s budget

Legislation

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Medicaid differs from Medicare
Not focused primarily on older adults
State-run
Funded jointly by states and federal government
Largest funding source for medical and health services for people with a limited income
Not entitlement (“welfare”)
Legislation—cont’d

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Social Security
Federal program
Partial protection from loss of earnings
An entitlement
85-year-old program (in 2020)

Legislation—cont’d

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Growth of U.S. healthcare spending
United States: 18% of GDP
Other developed countries: between 9% and 11%
WHO ranking of U.S. healthcare versus other countries
Quality: 37th
Life expectancy: 50th
Affordable Care Act reduced percent uninsured

Healthcare and Medical Care

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Healthcare
60% of early deaths due to behavioral, social, and environmental circumstances
10% of early deaths due to shortfalls in medical care
3% of expenditures targeted toward health promotion and disease prevention
Less than 1% spent on helping individuals to change unhealthy behaviors

Healthcare and Medical Care—cont’d

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