Healthy Aging in Canada: Opportunities for Action Centre for Health Promotion Division of Aging and Seniors 25th Annual Spring Research Symposium University of Manitoba Centre on Aging May 5, 2008 Winnipeg, Manitoba

The Vision of Healthy Aging Guiding Principles Dignity • Independence • Participation • Fairness • Security Selected Areas of Focus • Social Connectedness • Physical Activity • Healthy Eating • Falls Prevention • Tobacco Control Supportive Environments Mutual Aid Self Care September 2006: F/P/T Ministers Responsible for Seniors endorse Healthy Aging in Canada: A New Vision, A Vital Investment and From Evidence to Action, providing information and evidence about aging well in Canada. The New Vision document provides a vision of healthy aging that values the contributions of older people; celebrates diversity; reduces inequalities; and provides opportunities for older Canadians to make healthy choices which will enhance independence and quality of life. Three key mechanisms can be used to pursue the New Vision for healthy aging: CLICK 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. We have learned that optimizing health at any age is a key factor to successful and positive aging and is associated with a lowered risk of disease and disease-related disability; high mental and physical function; and active engagement with life. 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. Healthy older adults are more likely to be able to continue to contribute their skills, knowledge and experience to society. Healthy aging is a priority given demographic changes, quality of life issues and the significant economic benefits of a healthier population. These five focus areas and principles are the first to be addressed. Other areas (e.g., elder abuse, income disparities, literacy and lifelong learning) may be addressed later or in other collaborative strategies in advancing healthy aging.

Age-Friendly Community Enables all ages and abilities to age actively: Live in security, enjoy good health, participate in society Building blocks include: Policies and services Physical environment (settings, structures) Social environment Benefits all ages Age-Friendly Community Initiatives PHAC has been involved in two specific age friendly initiatives: The first one was the Global Age Friendly Cities project, done in collaboration with the World Health Organization – PHAC provided significant leadership to the WHO in the development of the WHO Global Age Friendly Cities Guide. It is important to recognize the valuable contributions of the governments of Manitoba and BC – in particular Tessa Graham from BC’s Ministry of Health The other initiative was the Age Friendly Rural and Remote Communities Initiative endorsed by FPT Ministers Responsible for Seniors Physical environment: settings, structures In an age-friendly community, policies, services, settings and structures support and enable people to age actively by: Recognizing the wide range of capacities and resources among older people; Promoting their inclusion and contribution in all areas of community life; Respecting their decisions and lifestyle choices, and Anticipating and responds flexibly to aging-related needs and preferences

of Age-Friendly Cities Essential Features of Age-Friendly Cities Outdoor Spaces & Buildings Transportation Housing Respect & Social Inclusion 5. Social Participation 6. Communication & Information 7. Civic Participation & Employment 8. Community Support & Health Services Discussions within the focus groups centred on the personal experiences of older people, involving them as full partners throughout the process. Focus group questions addressed the eight domains (the domains had been identified within previous research with older people as the characteristics of elder-friendly communities): Transportation Housing Respect and social inclusion Social participation Communication and information Civic participation and employment Community support and health services Outdoor spaces and buildings Participants were asked to comment on the positive and negative aspects, as well as provide suggestions for improvements. Focus group discussions were tape recorded, transcribed and analyzed to identify emerging themes.

Age-Friendly Collaborating Cities Credit: BC Ministry of Health AMERICAS Argentina, La Plata Brazil, Rio de Janeiro Canada, Halifax Canada, Portage La Prairie Canada, Saanich Canada, Sherbrooke Costa Rica, San Jose Jamaica, Kingston Jamaica, Montego Bay Mexico, Cancun Mexico, Mexico City Puerto Rico, Mayaguez Puerto Rico, Ponce USA, New York USA, Portland EUROPE Germany, Ruhr Ireland, Dundalk Italy, Udine Russia, Moscow Russia, Tuymazy Switzerland, Geneva Turkey, Istanbul UK, Edinburgh UK, London SOUTH-EAST ASIA India, New Delhi India, Udaipur AFRICA Kenya, Nairobi WESTERN PACIFIC Australia, Melbourne Australia, Melville China, Shanghai Japan, Himeji Japan, Tokyo 33 cities in 22 countries participated in the Age-Friendly Cities project, as indicated here. Objectives of the WHO’s Age-Friendly Cities Project Identify concrete indicators of an age-friendly city Increase awareness of local needs and good ideas for improvement Produce a practical guide to stimulate and guide based on these indicators to steer advocacy, policy and community development In Canada, Saanich BC, Portage La Prairie MB, Sherbrooke QC and Halifax NS were the participating cities. While most cities in other countries were chosen for their large size, operationally, the research was carried out in smaller, specific neighbourhoods. The eight factors of a supportive environment, as listed on the previous slide, were then measured in each pilot city, and suggestions for improvement were noted. EASTERN MEDITERRANEAN Jordan, Amman Lebanon, Tripoli Pakistan, Islamabad Credit: BC Ministry of Health

The Age-Friendly Canada Rural and Remote Initiative Port Hope Simpson, NL Clarenville, NL Alert Bay, BC High Prairie, AB Alberton, PEI Lumby, BC Guysborough, NS Turtleford, SK Gimli, MB Bonnechere, ON Bonnechere, ON Please forgive the alignment and the failure to show Nunavut on the map! The Age Friendly Rural/Remote project was endorsed by the FPT Ministers Responsible for Seniors in September 2006 – a counterpart to the guide on Age-Friendly Cities. This work, involving 10 small communities in 8 provinces, was collaborative in nature, bringing together researchers, community representatives and government, following a methodology similar to the WHO project. Our working vision for the next few years is to foster sustainable age friendly community initiatives across the country. Concepts similar to those found in the ‘Age-Friendly Cities’ guide may be applied to smaller or more remote communities across the country. It is estimated that nearly 23% of the elderly population lives in a rural or remote area; in some cases this number is rising as seniors retire to rural areas. We must appreciate the fact that seniors in rural areas may have needs which are unique to their area. Challenges and needs vary from region to region, especially in a country as large and diverse as Canada. Canada purposefully selected smaller cities for the WHO Age Friendly Cities Project to better understand small city realities. We also believed that it was important to specifically look at rural/remote communities which the WHO was not considering. The completed Age Friendly Rural Remote Communities Guide was endorsed by FPT Ministers Responsible for Seniors at their November 2007 meeting and gifted to the WHO for international use. These two Practical Guides are available to communities across Canada to assist them in initiating the dialogue on age friendly communities and to help them move forward in undertaking their own approach to building an age friendly community. PHAC is now working with interested P/Ts and other parties to explore opportunities to implement the combined cities and rural remote communities Guides. Source: The Healthy Children, Women & Seniors Branch, BC Ministry of Health.

One Country, Many Identities Recognizing the unique challenges posed by rural or remote areas in comparison to the needs of urban areas is the first step towards initiating an age-friendly movement. Canada is a land of vast distances, with a continental climate which varies from temperate in the south to subarctic and arctic in the north. Because of Canada’s varied topography and climate, communities across Canada, particularly the northern ones, face challenges that are unique and specific to their region. Case in point? This Polar Bear Alert sign from Churchill, Manitoba, one of our most northerly communities and well known as the Polar Bear Capital of the World. CLICK How different will it look in Churchill compared to Toronto when the community engages in the process of becoming more age-friendly? These great differences make it all the more imperative that communities establish their own unique needs in contrast with the needs of other communities.

Older Adults and the 2010 Games

Thank You ! Jim Hamilton Special Advisor, Healthy Aging Public Health Agency of Canada Division of Aging and Seniors email: Jim_O_Hamilton@phac-aspc.gc.ca phone: (204) 789-7410