Public Health England Older People’s work programme AAA Public Health and Active Lifestyles Working Group Elaine Rashbrook National Lead for Older People March 2015

Global ageing population trajectory The number of people today aged 60 and over has doubled since 1980. The number of people aged 80 years will almost quadruple to 395 million between now and 2050. Within the next five years, the number of adults aged 65 and over will outnumber children under the age of 5. Between 2000 and 2050, the proportion of the world’s population over 60 years will double from about 11% to 22%. Since the beginning of recorded history, young children have outnumbered their elders. In about five years’ time, however, the number of people aged 65 or older will outnumber children under age 5. Driven by falling fertility rates and remarkable increases in life expectancy, population aging will continue, even accelerate (Figure 1). The number of people aged 65 or older is projected to grow from an estimated 524 million in 2010 to nearly 1.5 billion in 2050, with most of the increase in developing countries. The remarkable improvements in life expectancy over the past century were part of a shift in the leading causes of disease and death. At the dawn of the 20th century, the major health threats were infectious and parasitic diseases that most often claimed the lives of infants and children. Currently, noncommunicable diseases that more commonly affect adults and older people impose the greatest burden on global health Age Action Alliance Public Health and Active Lifestyles Working Group

The major risk factors are clear The way we live our lives has significant impact on our health. Good diet, exercise and healthy weight would see us living healthier lives Increased blood pressure alone accounted for 9·0% (7·5–10·5) and high body-mass index for 8·6% (7·4–9·8). These risk factors largely increase rates of cardiovascular diseases and cancers. However, the DALYs attributable to each of these risks cannot be simply added together, because some are mediated through each other— eg, fruit consumption has one of its primary effects through lowering blood pressure More individuals are living into the period of life when prevalence of chronic disabling conditions is high; the increase in life expectancy at birth is greater than the increase in HALE (table 1), meaning more years are lived with disability. Despite falling rates of tobacco-attributable burden for both men and women, the UK has a more advanced epidemic than most high-income nations; tobacco remains the leading risk factor in the UK in 2010. Higher incidence rates could be related to factors such as housing and social inequalities; higher case fatality rates in the UK compared with other nations theoretically could be a factor, because lower respiratory outcomes are sensitive to the quality of care Age Action Alliance Public Health and Active Lifestyles Working Group

Tackling these issues requires an integrated approach to Public Health The Health & Social Care Act 2012 introduced wholesale system change across health and social care Key developments included: Refocusing on public health and prevention Localism Focusing on outcomes not targets Added value of PHE: System Leadership: Work transparently, provide government, local government, the NHS, MPs, industry, public health professionals and the public with evidence-based professional, scientific and delivery expertise and advice Protection: Ensure there are effective national and local arrangements for preparing, planning and responding to health protection concerns and emergencies, including the future impact of climate change Local Support: Support local authorities and clinical commissioning groups by providing evidence and knowledge on local health needs, alongside practical and professional advice on what to do to improve health Age Action Alliance Public Health and Active Lifestyles Working Group

PHE is working with partners to improve the national approach …and many more! Age Action Alliance Public Health and Active Lifestyles Working Group

Places and People Older Adults Age 65 – 100 + years Birth – 5yrs Early Years School Aged Children 5--18yrs Young Adults to Established Adults 18 to 64yrs Older Adults 65 to 100 +yrs Home and Family Spaces Leisure & Social Spaces Early Years Settings Education Settings PHE recognises that in order to address the health across the lifecourse we need to recognise that people interact in different spaces at different points of their lives. Workplace Settings Healthcare Settings Age Action Alliance Public Health and Active Lifestyles Working Group

Older People’s work stream Development of employer resources to support employees and employers with common MSK problems eg back pain and osteoarthritis (in collaboration with Work Foundation and ARUK) Carers health and wellbeing – development of resources to support implementation of workplace charter Age Action Alliance Public Health and Active Lifestyles Working Group

One of the seven PHE key priorities Dementia Project Plan One of the seven PHE key priorities Raise people’s awareness and understanding and support them to take actions to reduce their risk of dementia Major new healthy living marketing campaign aimed at 40 to 60-year-olds Work with University College London Partners to develop a new personalised risk assessment calculator for incorporation into the NHS Health Check Work with NHS England and other partners to build dementia risk reduction into care and support for predisposing conditions and raise awareness of inequalities in dementia, supporting people to receive a timely diagnosis and the care and support they need. Work with the Alzheimer’s Society and the Depression Alliance on actions to prevent depression Incorporate dementia risk reduction as a key outcome in health improvement programmes, such as the NHS Health Check Work with Health Education England, the royal colleges and others to increase professionals’ understanding of dementia risk reduction Age Action Alliance Public Health and Active Lifestyles Working Group

Ageing Well Framework In collaboration with NHSE strategic framework on Healthy Ageing/Ageing Well Framework – Dec 2015 Focus on prevention, risk factors and wider determinants Requests from Local Authorities and partners ‘what are the things we should be doing to improve the health and wellbeing of older people?’ As a new team, our initial stakeholder mapping and assessment of the epidemiology shows that there is a need for co-ordinated action on older people’s issues. In producing this plan, we are responding to requests from PHE Centres and Local Authorities who are asking ‘what are the things we should be doing to improve the health of older people?’ The aim of developing a PHE Ageing Well Framework/plan is to focus our resources on an asset based system wide approach to ageing well. The plan will be co-produced and will set out approximately 10 high level actions for the public health system to address and subject to stakeholder feedback, will be supported by a toolkit to inform local action. Age Action Alliance Public Health and Active Lifestyles Working Group

High Impact Areas Age Action Alliance Public Health and Active Lifestyles Working Group

Any questions/comments? THANK YOU Any questions/comments? Contact details: Elaine.Rashbrook@phe.gov.uk Age Action Alliance Public Health and Active Lifestyles Working Group