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Healthy Ageing in the 21st Century

The best is yet to come

When I was asked to chair this Birmingham University Policy Commission on Healthy Ageing, I thought ‘Where better to host such an important investigation?’. Birmingham is a multicultural city. Its ‘super-diverse’ population provides an ideal opportunity to explore the implications of ageing for ethnically diverse people from across the world. This is a subject area in which there is a paucity of research. The Policy Commission found a need to recognise and accommodate super-diversity and also that cultural sensitivity should be a vital component in the planning of future services for the elderly.

It is, of course, a great success that the proportion of people aged over 60 years is growing faster than any other age group. But, we heard from those giving evidence to the Commission that patterns of ill-health in the older population reflect those in earlier life, with poverty being the most significant causal factor of early death and ill-health in later life. The stark fact is that now, in the 21st Century, people from poorer backgrounds die younger and spend more of their shorter lives with disabilities than those from more affluent backgrounds. Dramatic differences remain between the best off and the worst off in England – an unjust social gradient in health that needs addressing. Healthy ageing should be the life-long goal for individuals, communities and governments. Policies to reduce health inequalities should focus on reducing the social gradient in health by acting on all of the social determinants of health to ensure that people regardless of their socioeconomic status are able to live to a healthier old age.

Increasing numbers of older people flourishing in later life bring with them many opportunities and challenges that require society to adapt in order for the older people to fulfil their potential. A common theme was a desire for more control, independence and security. We heard of numerous examples of older people making huge contributions to their communities including Elders’ Councils influencing policies at local level. But the involvement of older people is not universal. Much more could be achieved if older people had a louder voice at all levels of policy making. This may be made more effective by establishing a Commissioner for Older People who would be charged with the responsibility for encouraging every level of government to listen to the voices of all older people, vulnerable and healthy alike, and with ensuring that their rights and interests are protected and promoted.