Public Health Agency of Canada
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3. A Vision for Healthy Aging
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Each of us is aging. And as a population, Canada is aging faster than ever before. Today, there is a more informed recognition of the important contribution that older people make to their families, communities and nation. There is also a growing understanding of the diversity of Canadian seniors in terms of age groupings, levels of independence and ethnocultural backgrounds.
Today, older Canadians are living longer and with fewer disabilities than the generations before them. At the same time, the majority of seniors have at least one chronic disease or condition.
Our health care system primarily focuses on cure rather than health promotion and disease prevention. Redirecting attention to the latter is required in order to enable older Canadians to maintain optimal health and quality of life. It will also help to manage health system pressures.
The evidence is clear. Older adults can live longer, healthier lives by staying socially connected, increasing their levels of physical activity, eating in a healthy way, taking steps to minimize their risks for falls, and refraining from smoking. But there are real environmental, systemic and social barriers to adopting these healthy behaviours. Some relate to inequities as a result of gender, culture, ability, income, geography, ageism and living situations. These barriers and inequities need to be and can be addressed now. Through a combination of political will, public support and personal effort, healthy aging with dignity and vitality is within reach of all Canadians.
Ageism and Healthy Living
Ageism-discrimination based on age, especially prejudice against older people-is common in all societies. Ageism occurs when people believe that enabling and promoting healthy living among seniors is unimportant or too late to make a difference. For example, it is widely recognized that promoting activity is important for children and youth. There are many initiatives designed to do just that. But there is a prevailing attitude that it is not as important to be physically active in later life- that it may be too late, that the cost is prohibitive, and that the benefits aren't as great at this stage of life. This prejudice reflects our minimized expectations of older adulthood and misconceptions about seniors' ongoing and future participation and roles in society.
A New Vision
It is time for a new vision on healthy aging-a vision that:
- values and supports the contributions of older people;
- celebrates diversity, refutes ageism and reduces inequities; and
- provides age-friendly environments and opportunities for older Canadians to make healthy choices, which will enhance their independence and quality of life.
Building on a Solid Foundation
This vision for healthy aging builds on several key concepts and plans previously endorsed by the Ministers Responsible for Seniors:
The National Framework on Aging sets out an overall vision: "Canada, a society for all ages, promotes the well-being and contributions of older people in all aspects of life" (Health Canada, 1998). The vision for healthy aging seeks to further specify how this will play out by providing age-friendly environments and opportunities for older Canadians to make healthy choices, which will enhance their independence and quality of life.
Five principles identified by the National Framework on Aging underpin this vision: dignity, independence, participation, fairness and security (Health Canada, 1998). These principles provide a common set of values for all jurisdictions that are consistent with the United Nations principles for older persons (United Nations General Assembly, 1991).
Planning for Canada's Aging Population: A Framework was developed by the F/P/T Committee of Officials (Seniors) to guide governments across Canada as they develop policies and programs for their aging populations. It outlines three pillars for action: health, wellness and security; continuous learning, work and participation in society; and supporting and caring in the community. The vision and framework for action presented in this document builds specifically on the pillar related to "health, wellness and security".
Reducing Inequities
Achieving this vision of healthy aging will require strategies to address the needs of all older Canadians, as well as explicit efforts to reduce inequities in health and wellbeing.
An important step in reducing inequities in health is to decrease socioeconomic disparities. Providing all seniors with incentives to make healthy choices, and making low- or no-cost programs and services available to those who have low levels of education and low income levels will enable greater access to and involvement in healthy aging initiatives.
A recent report from the National Advisory Council on Aging (NACA, 2005) makes a number of recommendations for policies related to taxation, income support, lifelong learning, housing and long-term care that aim to alleviate poverty and socioeconomic disparities among seniors. Implementing these reforms is part of a comprehensive strategy to enhance healthy aging.
The average life expectancy of Aboriginal people remains significantly lower than the Canadian average. Also, among Aboriginal seniors, the prevalence of certain chronic conditions such as heart problems, hypertension, diabetes and arthritis is often double or triple the rate reported by Canadian seniors overall (Government of Canada, 2002). As a result, Aboriginal people are often seen to age earlier than non- Aboriginal people and considered to be "seniors" earlier than age 65.
Premature aging, high rates of chronic diseases and low levels of life expectancy among older Aboriginal people represent a particular challenge that must be dealt with through culturally-sensitive policies and interventions. These should be spearheaded by Aboriginal peoples themselves, and supported by policymakers and service providers.
In the past, most immigrants came from the UK and other European countries. Today, many older immigrants and refugees come from regions such as East and West Asia, South America and Africa. These newcomers may not speak English or French, and may be vulnerable to isolation. For example, older women who come to Canada to take care of grandchildren are one of Canada's most isolated groups, placing them at greater risk for depression and loneliness (Taylor et al, 2003; Kobayashi, 2003). Some ethnic groups are at higher risk for certain chronic diseases and for mental health concerns related to displacement and experiences in their homeland. In 2005, 7.2 percent of seniors were members of a visible minority. They may be particularly vulnerable to social exclusion based on racism as well as ageism and may have different social and health needs than those who grew old in Canada (NACA, 2005a; Government of Canada, 2002; Durst, 2005).
Inequities Among Seniors: Some Facts and Figures
- In 1999, 30 percent of seniors with household incomes of less than $20,000 saw themselves as being in "fair" to "poor" health and 69 percent were physically inactive. In comparison, only 20 percent of seniors with incomes over $20,000 rated themselves in poor health and 58 percent were inactive (NACA, 2001)
- Seniors with low incomes have increased odds of institutionalization in longterm health care facilities (Trottier et al, 2000).
- Among seniors with disabilities, those with low incomes are more functionally incapacitated than those with higher incomes (Raina and Wong, 2002).
- Almost one in five seniors lives near the poverty line. Poverty is most common among seniors living alone (especially women who are divorced or separated), women over the age of 80, visible minorities and immigrants (NACA, 2005 and 2005a).
- Older women are more vulnerable to poverty and older women's health appears to be more vulnerable to the effects of poverty than is men's health (Plouffe, 2003).
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