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Friday, April 13, 2012

The secret to reinventing a long and happy life

Special to The Japan Times

The secret is out. For thousands of years, man has searched for the secret to along life. And it appears it has been found — at least based on the latest global statistics. We are all living longer, and globally, we have reached the highest ever levels of life expectancy.

Not to spoil the celebrations, but I have another secret to tell. As we marked World Health Day (April 7) and its theme Aging and Health, the secret is no longer about living to a ripe old age but instead about living to a happy old age — free from prejudice, free from chronic illness, and free to take part in the society that values experience and age old wisdom.

The facts are clear. The world is facing an unprecedented demographic shift. 2011 marked the first time the world's population hit 7 billion. At the same time, the global population is aging as never before. Within the next five years, for the first time in history, adults 65 and older will outnumber children younger than 5; by 2050, they will outnumber children younger than 14.

So are we ready? We'd better be. Japan already has the world's oldest population with 23 percent of its citizens over 65 in 2012. This figure is expected to rise to 40 percent in 2050.

Japan is not the only country in this situation. The increases in aging population will be particularly rapid in low- and middle-income countries,where most older people live and where their share of the population is growing fastest. China, South Korea, Thailand, India are all rapidly aging.

Imagine — in 2050, nearly a quarter of the world's population will be over 60.

The implications are enormous. Managing health care costs, long term care needs, retirement benefits, and national economic productivity will require governments, communities and families to devise new innovative and integrated approaches and strategies.

Older persons can remain healthy and contribute to our shared communities, and future generations can equally prepare for "adding life to years." We need to reframe our concept of old age — not as a time of inevitable decline, but one of active, meaningful and positive living. We need to resist stereotypes that discourage older people from fully participating in society and prevent society from fully benefiting from their skills and experience. At the same time, we need to acknowledge the right of old people to enjoy a healthy retirement while maintaining and encouraging their integration into social networks.

The road to healthy aging begins before birth. An unborn child who was undernourished in the womb, or obese teenager, is at increased risk of disease in adult life.

How we age depends to a large degree on how we behave. By watching what we eat, being physically active and avoiding tobacco and the harmful use of alcohol, we can look forward to a healthier old age.

Preventing chronic diseases, such as stroke, diabetes and cancer, is the single best way to prolong healthy lives. Just reducing salt intake and making sure high blood pressure medicines are available can make a very large difference to reduce stroke — as it did in Japan.

The conditions in which we are born, live, work and grow old also crucially influence how well we age and stay healthy. Healthy urban environments are crucial, since more than half of the world population now lives in urban settings.

The right to enjoy the highest attainable standard of health does not diminish with age, and a growing number of people will require age-friendly health systems that meet their needs — be they physical, social and mental. Treatable conditions of old age, such as hearing loss or musculoskeletal disorders, should not be dismissed as a "normal part of aging." As more people than ever reach their 80s and 90s, there will be more people at risk of dementia. Many very old adults will require long-term community, residential or hospital care.

Innovation plays an important role in making available affordable, accessible and acceptable technologies that lead to extending productive lives. There are many such technologies that are useful to older populations and to preserving their freedom and productivity.

All countries must deliver health services, covering all ages, and including disease prevention, treatment, rehabilitation, palliation, long-term care and end-of-life care. Japan has pioneered integrated health and social services, along with universal health care coverage and long term care insurance. However, Japan and all countries must also address rising costs. In the rationing of scarce health resources, equity, not age, should be the determining factor.

Given discrepancies in life expectancy among men and women, health care and social protection policies for older people must take into account the special needs of women, who outlive men on average but have lower rates of education, employment and well-being.

Older people have a lot to offer their communities — through paid or volunteer work, sharing their experience and knowledge, and helping to care for their families. But they can't do that if they're unhealthy.

Let us join hands to reinvent aging, rethink our attitudes, and to support older people's efforts to contribute to society and develop age-friendly health systems, environments and cities.

If we don't, we may find ourselves overwhelmed by the inevitable rise in the number of people with long-term disabilities and diseases that might have been avoided — and that is no secret.

Alex Ross is the director of the World Health Organization's Center for Health Development in Kobe, Japan.

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