Executive Summary

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Each of us is aging. And as a population, Canada is aging faster than ever before. Today, people aged 65 and over make up some 13 percent of the Canadian population. By 2031, there will be approximately 9 million seniors, and they will account for 25 percent of the total population (Statistics Canada, 2005).

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. A focus on the latter is needed in order to help people maintain optimal health and quality of life. Doing so is also one way to manage health system pressures.

If we are to reap the benefits of the many contributions that seniors make to their families, communities and nation, and to curb health care costs associated with chronic disease, healthy aging must move to the forefront of the social policy agenda. If left unaddressed, the aging of the population will have far-reaching social, economic and political impacts (Statistics Canada, 2005) that will far outweigh the cost of investing in healthy aging now.

A Vital Investment

In addition to the demographic and political imperatives of an aging population, there are several key reasons to invest in healthy aging:

1. Seniors make a significant contribution to the richness of Canadian life and to the economy. Older people provide a wealth of experience, knowledge, continuity, support and love to younger generations. The unpaid work of seniors makes a major contribution to their families and communities. Some 69 percent of older Canadians provide one or more types of assistance to spouses, children, grandchildren, friends and neighbours (National Advisory Council on Aging (NACA), 2001). Older Canadians make an important contribution to the voluntary sector and to the paid economy. More than 300,000 Canadians 65 or older were in the labour force in 2001 (Statistics Canada, 2001). Working longer requires good health.

2. Healthy aging can delay and minimize the severity of chronic diseases and disabilities in later life, thus saving health care costs and reducing long-term care needs (Laditka, 2001). Chronic diseases account for an enormous human and economic burden in Canada. The prevalence increases with age and is highest among older people in vulnerable communities (e.g., Aboriginal and economically disadvantaged groups) (Public Health Agency of Canada (PHAC), 2005a). Chronic diseases are responsible for 67 percent of total direct costs in healthcare and 60 percent of total indirect costs ($52 billion) as a result of early death, loss of productivity and foregone income (PHAC, 2005a).

3. The evidence compels us to build on existing opportunities, to put in place interventions that are known to be effective, and to show leadership by supporting innovative approaches. Experience provides us with some models and successful interventions that can be replicated in different settings. In addition, there are opportunities to build on existing strategies in aging and healthy living that are already underway in most provincial/territorial, federal and local jurisdictions.

4. Canadians of all ages believe that efforts to enable seniors to remain healthy and independent are "the right thing to do". Established values such as independence and interdependence, social justice and respect for families with multiple generations help to define Canadian society.

A New Vision

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.

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.

Three key mechanisms can be used to pursue the new vision for healthy aging:

1. Supportive environments refers to creating policies, services, programs and surroundings that enable healthy aging in the settings where older Canadians live, work, learn, love, recreate and worship.

2. Mutual aid refers to the actions people take to support each other emotionally and physically, and by sharing ideas, information, resources and experiences. Encouraging mutual aid means recognizing and supporting seniors' efforts in volunteerism, self-help groups, caregiving and the informal support family members provide to each other.

3. Self-care refers to the choices and actions individuals take in the interest of their own health; for example, an older person choosing to get active, to join a community organization or to safety-proof his or her home.

Five Key Focus Areas

While recognizing that healthy aging depends on all of the broad determinants of health (including income, housing, protection from abuse etc.), in 2005, the F/P/T Ministers Responsible for Seniors endorsed the need for action on five key issues, based on their impact on seniors health, the availability and effectiveness of interventions, the costs associated with treatment for health problems associated with these factors and their potential to reduce health inequities. These areas of focus are social connectedness, physical activity, healthy eating, falls prevention and tobacco control.

Part II of this paper addresses each of these focus areas: what we know and don't know, promising practices, and directions for policy and practice.

Moving Ahead

Investing in healthy aging is not an "either-or proposition" that sets up competition for resources between the young and old. Rather, it is part of a life course that makes strategic investments at different transitions related to age and fosters intergenerational support and solidarity. The final chapter in this report provides some suggestions for moving ahead. It is hoped that a variety of stakeholders in various jurisdictions will consider these opportunities and others, and put plans in place to work toward the new vision for healthy aging.

Through a combination of political will, public support and personal effort, healthy aging with dignity and vitality is within reach of all Canadians.

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