A Public Health Approach to the Challenges of an Aging Society

Abstract

Public Health for an Aging Society is the successor to Public Health and Aging, published in 1997. In brief, this 456-page volume offers readers an overview of key aging-related topics and the steps that public health can, does, and should take to address the challenges of our aging population. The volume is divided into five sections: Fundamentals, Social and Behavioral Factors, Societal Applications, Public Health Infrastructure for an Aging Society, and Emerging Issues. In the opening chapter of Fundamentals, Wetle and Sherwin introduce readers to public health and some of the major issues facing the field. In Chapter 2, Fried discusses population aging and the societal implications of the growth of the older population. One of the things that I appreciate about this chapter is that Fried reminds readers that the rising tide of older adults—if encouraged and supported—has the potential to be a valuable resource for addressing the problems that we face as a nation (as opposed to simply being a “problem”). In Chapter 3, Stone and Benson provide a very accessible introduction to Medicare and Medicaid and the role these public programs play in financing health and long-term care for older adults. They also discuss the state of long-term care funding in the United States and relevant elements of the Affordable Care Act. Furner and Anderson (Chapter 4) round out this section with a discussion of health and quality of life. They offer definitions of these concepts, discuss their measurement, and explain how population health is assessed and monitored. In Social and Behavioral Factors, Wallace (Chapter 5) introduces readers to the concepts of social determinants, health inequities, race, and class. He discusses health inequities among older adults—most notably those that exist by socioeconomic status—and ends what I found to be a motivating chapter by encouraging readers to “[make] real” Dan Beauchamp’s assertion that “public health is social justice” (p. 114). In Chapter 6, Branch, Meng, and Guralnik discuss disability. Strengths of this chapter include their discussion of measurement-related issues as well as their discussion of primary, secondary, and tertiary prevention of disability. In the final chapter of this section, Hughes, Ory, and Seymour provide an overview of several key health behaviors and the state of older adults’ engagement in those behaviors. They also highlight a number of issues to consider when designing interventions to encourage engagement in health-promoting behaviors. Societal Applications is the focus of the third section of the book. Prohaska, Smith-Ray, and Glasgow open the section with a chapter on translation of health promotion interventions. They inform readers that “there are relatively few feasible, generalizable, effective, and sustainable health promotion interventions for use in applied health and community settings” (p. 162), commentary that should serve as a motivating force. They go on to describe factors that would help remedy the situation as well as offer guidance on how to increase the impact of interventions on the public’s health. In Chapter 9, Gitlin and Schulz deliver a very thoughtful chapter on family caregiving. In addition to providing descriptive information on caregiving (e.g., caregiver characteristics), they