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Editorial
Today, for the first time in history, most people can expect to To progress action in this area, the World Health
live into their 60s and beyond (United Nations Department Organization (WHO) recently released the first World report
of Economic and Social Affairs [UNDESA], 2007). And those on ageing and health (WHO, 2015). Nearly 200 people con-
who reach 60 years of age can expect to live longer than ever tributed directly to the report, including authors of a series
before. When combined with marked falls in fertility rates, of background articles, many of which have been refined for
these increases in life expectancy are leading to the rapid age- academic publication in this supplement. Given the great
ing of populations around the world. These changes are dra- diversity of issues that are relevant to ageing and health, it is
matic, and they have profound implications for each of us as not surprising that the scope of these articles is broad.
individuals, as well as for society more broadly. The report outlines a public health framework for
Longer lives present many opportunities, and the arti- action on Healthy Ageing that is built around the concept
cle by Fried (2016) in this supplement makes a strong of functional ability. This is defined by the report as “the
case that appropriate social investment can create a “third health related attributes that enable people to be and to do
demographic dividend” for society. Yet, the extent of the what they have reason to value”. The report emphasizes
opportunities that arise from increased longevity will that this ability is determined by both the intrinsic capac-
depend heavily on one key factor: health. If people are ity of the individual and the influence of the environments
experiencing these extra years of life with good physical they inhabit. This builds on capabilities-based approaches
and mental capacity, and if they live in enabling environ- used in other fields (Anand, 2005). The report approaches
ments, their ability to do the things they value may have the changes associated with ageing in the context of the
few limits. If these added years are instead dominated by entire life course, yet focuses on the second half of life. It
declines in capacity and disabling environments, the impli- describes some of the important underlying physiologic
cations for older people and for society are much more neg- changes that can occur with age (for example, those out-
ative. Staudinger, Finkelstein, Calvo, and Sivaramakrishnan lined in the article by Blume-Peytavi et al. (2016) on skin)
(2016) take up this issue and look specifically at the effects but also considers the disorders that become more frequent
of work on health in later life. in older age and that can impact on functioning. These are
Unfortunately, there is only limited information to sug- largely chronic conditions, particularly noncommunicable
gest that older people today are experiencing these extra diseases, hearing loss, and musculoskeletal disorders as dis-
years in better health than previous generations (Chatterji, cussed by Davis and colleagues (2016) and Briggs and col-
Byles, Cutler, Seeman, & Verdes, 2015). Moreover, in many leagues (2016), respectively.
places, neither the policies nor the infrastructure is in place Many of these can be prevented or delayed by engaging
to ensure that the opportunities that arise from popula- in healthy behaviors across the life course, and the ben-
tion aging can be realized. Public health action on ageing efits of these behaviors continue into later life (Hrobonova,
is therefore urgently needed. Yet debate on what this might Breeze, & Fletcher, 2011). The article by Bauman, Merom,
comprise has been remarkably limited (Lloyd-Sherlock Bull, Buchner, and Singh (2016) highlights the importance
et al., 2012) of these ongoing influences, making a robust case for
© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. S163
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S164 The Gerontologist, 2016, Vol. 56, No. S2
promoting physical activity among older adults. However, we measure it, and how might we foster it. The reconcep-
Bauman and colleagues also show how ageing influences tualization of Healthy Ageing provided by the report draws
the relationship of these behaviors to health and the impor- on many years of gerontological and geriatric research and
tance of considering this when developing interventions to debate to start to answer these challenging queries.
foster capacity and ability. Their article highlights how, for In building this public health framework for action,
physical activity, this may lead to a shift in focus that gives WHO looked to challenge many pervasive misconceptions.
priority to interventions that can help the retention of mus- In particular, the report seeks
cle mass and balance. Subtle shifts in messaging across the
•• to emphasize that action is urgent;
life course may also be required if these interventions are to
•• to acknowledge the great diversity of health and experi-
succeed (Notthoff & Carstensen, 2014).
ence in older age and the need for policy responses to
“In the 21st Century, no country can afford not to have context and rationale for action in Chapter 1 is followed
an integrated system of long term care.” Population and by the development and explanation of a Public Health
social trends mean it is no longer feasible, sustainable, or Framework for Action in Chapter 2. Chapter 3 provides a
equitable for governments to leave this to families alone. comprehensive, stand-alone update of current knowledge
This does not mean that this role should instead fall solely on health in older age. It includes a review of demographic
to governments, but if families are to provide adequate care and epidemiological change; the characteristics of health
and not be unreasonably burdened, at a minimum they need in older age, including underlying changes as well as the
information that can allow them to fill this role, and have health conditions of older people; changes in intrinsic
access to support such as respite care. Governments also capacity and functional ability; behaviors that influence
need to put in place mechanisms to ensure the quality of Healthy Ageing; and key environmental risks. Chapters 4,
Davis, A., McMahon, C. M., Pichora-Fuller, K. M., Russ, S., Lin, F., ageing and health. The Lancet, 379, 1295–1296. doi:10.1016/
Olusanya, B. O., … Tremblay, K. L. (2016). Aging and hearing s0140-6736(12)60519-4
health: the life-course approach. The Gerontologist, 56, S256– Notthoff, N., & Carstensen, L. L. (2014). Positive messaging pro-
S267. doi:10.1093/geront/gnw033 motes walking in older adults. Psychology and Aging, 29, 329–
Foebel, A. D., & Pedersen, N. L. (2016). Genetic influences on func- 341. doi:10.1037/a0036748
tional capacities in aging. The Gerontologist, 56, S218–S229. Pillemer, K., Burnes, D., Riffin, C., & Lachs, M. S. (2016). Elder
doi:10.1093/geront/gnw006 abuse: global situation, risk factors, and prevention strategies.
Fried, L. P. (2016). Investing in health to create a third demographic The Gerontologist, 56, S194–S205. doi:10.1093/geront/gnw004
dividend. The Gerontologist, 56, S166–S177. doi:10.1093/ Sadana, R., Blas, E., Budhwani, S., Koller, T., & Paraje, G. (2016).
geront/gnw035 Healthy ageing: raising awareness of inequalities, determi-
Garçon, L., Khasnabis, C., Walker, L., Nakatani, Y., Lapitan, J., Borg, nants, and what could be done to improve health equity. The