HEALTH, WELL-BEING, AND AGING AN INESCAPBLE CHALLENGE Dr. Enrique Vega PAHO/WHO Regional adviser on Aging and Health vegaenri@paho.org

AGING OF THE REGION STILL A WINDOW OF OPPORTUNITY Millions http://public.tableausoftware.com/views/EnvSal_IndiceEnvejecimiento_viz1/Dashboard1?:embed=yes&:toolbar=yes 2 Source: United Nation Population Projections, 2006 2

THEY ARE LIVING LONGER Life expectancy at birth in the region is more than 70, and it has increased by 17 years in the last 25 years 75% of persons born today in the LAC region will be older adults and 40% will live past 80 Life expectancy at age 60 in 2006, is 17 years for men and 21 for women. In developed areas the figures are 19 and 23 years 3

Barriers remain; needs are growing In LAC 50% said they do not have enough resources to meet their daily needs 33% of the older persons in urban areas and 50% in rural areas are in poverty. One-third of the older persons do not have an annuity, pension, or paying job Illiteracy rates are very high; in some countries as high as 80% in the rural zones 4

Barriers remain; needs are growing In the United States 22.7% of older persons said they had fair or poor health. In LAC the figure was 58% for women and 51% for men Two of every three older persons in LAC reported at least one of the most frequent chronic illnesses 30% had fallen within the past year, 20% experienced cognitive loss, and 18% depression 61% was overweight, three of every four did no physical activity, one in four men smoked 5

OLDER PERSONS REPORTING AT LEAST ONE DISABILITY Source: SABE/2000 – PAHO 6 6

WHO CARES FOR THE ELDERLY? Barriers remain; needs are growing Family caregivers with no community support Community health workers lacking adequate tools Health professionals with no training in these subjects 7

Barriers remain; needs are growing In LAC most caregivers of elderly persons are the families, the women (90%) Caregivers are generally over the age of 50, subjected to high stress levels; 60% say they “can’t take it any more” A little more than 80% say they have problems “meeting expenses” Support programs for these persons are rare or nonexistent in the countries 8

Barriers remain; needs are growing 40% of the hypertense persons surveyed by SABE had not had a primary care doctor visit in the last 12 months 80% of those surveyed reported unmet dental needs Only 2% of the countries have health promotion goals for persons above the age of 60 Only 5% of the depressed persons in the sample had anti-depression treatment 9

HUMAN RESOURCES PREPARATION First-line human resources still have major knowledge gaps with respect to aging and older persons There are insufficient human resources specialized in gerontology and geriatrics Motivational and ethical aspects highlight older persons’ rights and opportunities to obtain positive results in improving their health. 10

A RACE AGAINST TIME

BUILDING A VISION OF HEALTH FOR OLDER PERSONS Resolution CSP26.R20 on Aging and Health of the 26th Pan-American Sanitary Conference (2002) International Plan of Action on Aging. World Assembly on Aging (2002) Regional strategy for implementation in Latin America and the Caribbean (2003) Declaration of Brasilia (2007) Declaration on Primary Health Care(2006) Health Agenda of the Americas 2008-2017 (2007) 12

PUBLIC HEALTH AND AGING “Maintaining the quality of life of elderly people should be part of health programs geared specifically to this age group. Combining economic and food subsidies to accompany these health interventions is key to ensuring that older adults participate in health programs. Educating health workers about elderly care technologies should be a priority and the focus of specific health care training programs.” Health Agenda of the Americas 2008-2017 Approved by Ministers of Health of the Americas Panama City, June 2007

STRATEGIC APPROACH AND PLAN OF ACTION 2009-2018 Response to health needs of older persons Older persons should have access to health care to help them to maintain or regain the optimum level of physical, mental, and emotional well-being and to prevent or delay the onset of illness Older persons should be able to enjoy human rights and fundamental freedoms when residing in any shelter, care or treatment facility, including full respect for their dignity, beliefs, needs and privacy and for the right to make decisions about their care and the quality of their lives UNITED NATIONS PRINCIPLES FOR OLDER PERSONS Resolution 46/91

STRATEGY AND PLAN OF ACTION 2009-2018 Response to health needs of older persons Based on the United Nations Principles for Older Persons; Recognizes that no country or agency can by itself take on the entire challenge of health and aging; Demands a major reorganization of international cooperation to tackle the new challenges of aging and the health of older persons APPROVED 15 15

BASIC STRATEGIES: STRATEGIC AREA I: HEALTH OF OLDER PERSONS IN PUBLIC POLICY AND ITS ADAPTATION TO INTERNATIONAL INSTRUMENTS STRATEGIC AREA II: ADAPT HEALTH SYSTEMS TO THE CHALLENGES ASSOCIATED WITH THE AGING OF THE POPULATION AND THE HEALTH NEEDS OF OLDER PERSONS STRATEGIC AREA III: TRAINING OF THE HUMAN RESOURCES NECESSARY FOR MEETING THE HEALTH NEEDS OF OLDER PERSONS STRATEGIC AREA IV: STRENGTHEN THE CAPACITY TO GENERATE THE NECESSARY INFORMATION FOR EXECUTING AND EVALUATING ACTIVITIES TO IMPROVE THE HEALTH OF THE ELDERLY POPULATION

RESOLUTION: URGES THE MEMBER STATES To consider the Principles of the United Nations for Older Persons as the foundation for public policies on aging and the promotion and protection of human rights and basic freedoms of older persons who receive long-term care Promote an internal dialogue among public sector institutions and between them and the private sector and civil society, with a view to building a national consensus on the issue of the health of older persons Conduct an internal review and analysis of the relevance and viability of this strategy in the national context 17

FROM APPROVAL TO IMPLEMENTATION THE REAL CHALLENGE Desde su aparición como especie los humanos incrementaron muy lentamente la duración de la vida. El efecto de una vida socialmente protegida comenzó a hacer la diferencia con la selección natural de la vida salvaje; pero el impacto en la expansión fue sólo de unos veinte años en veinte siglos: (de 23 años en la época del Imperio Romano a 44 años en los inicios del Siglo XX). Durante el siglo pasado la expansión de la vida alcanzó niveles sin precedentes, sólo desde 1950 hasta la fecha, el promedio de vida se incrementó en casi 20 años, desde los 46.5 años hasta los 66 años. En los últimos 25 años la esperanza de vida de latinoamericanos y caribeños se incrementó en 17 años. (1) 18 18

In the next 40 years the region’s demographic situation will offer a window of opportunity, in which the active working sector will grow faster than the dependent sectors. Only with adequate social and health investments based on a concept of a right will it be possible to democratize healthy and active longevity and enable our countries to convert it to a real social accomplishment rather than a future economic burden 19

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