Planning for Aging Societies

Older adults represent a significant and growing share of the global population. People aged 60 and over already account for more than one billion of the world’s population; this age group is expected to double—to over two billion—by 2050. Amid these major global trends, the United Nations Decade of Healthy Ageing (2021–2030) aims to improve the lives of older people—as well as their families and communities—through a global multi-sectoral, multi-stakeholder approach. Fostering a more holistic approach to healthy aging throughout life is vital for the well-being and strength of individuals, societies, and economies around the world.

In alignment with the U.N. Decade of Healthy Ageing, FP Analytics has partnered with AARP to identify groundbreaking and integrated approaches to healthy aging to help inform policymaking, catalyze program implementation, and stimulate innovations in the marketplace. Through a meta-analysis of leading research, a series of closed-door roundtables, expert surveys, and one-on-one interviews, FP Analytics has produced an in-depth analysis and an online toolkit highlighting innovative policies and human-centered practices from around the world. These resources are intended to support policymakers, practitioners, and leaders in private industry working in this space. Throughout the course of the research, several key insights and areas for action emerged:

A more integrated and holistic approach to healthy aging is needed to close service delivery gaps: The COVID-19 pandemic has focused global attention on the health and well-being of older adults, presenting an opportunity for innovation and policy action to address chronic gaps in health care access and service delivery and more effectively support older adults to maximize their potential in society. Critical barriers to healthy aging persist, particularly in relation to the affordability, availability, accessibility, suitability, and quality of support for older persons.

Cross-country learning can help inform and catalyze national action plans. As governments increasingly link healthy aging to a range of security, economic development, and environmental agendas, there is a growing interest in exploring intersectional and collaborative approaches to proactively support healthy aging and protect the human rights of older adults. National plans, strategies, and policies around healthy aging play pivotal roles in defining a country’s priorities for maintaining and improving the well-being of older adults, with innovative programs having the potential to inform national strategies currently under development. Important components of more holistic policymaking include taking a life-course and rights-based approach to aging, monitoring and evaluation guidelines, appointing department and agency leads to address aging, establishing implementation timelines, allocating budgets, and targeting financial and non-financial resources to help ensure program viability and sustainability. Mainstreaming aging issues across government departments, implementation agencies, and private industry will help ensure that intersectional needs of older adults (such as transportation and housing) are addressed and budgeted.

Implementing multi-sectoral approaches to healthy aging that engage relevant stakeholders and are informed by older adults is vital: Governments, civil society actors, the private sector, and health service providers are particularly key to the promotion of healthy aging, demonstrating the need for a collaborative, multi-sectoral approach. These four contingents play critical roles in providing leadership and setting norms, incorporating and amplifying the voices and demands of older adults, driving innovation through funding and experimental approaches, and ensuring high-quality service delivery.

Cross-cutting principles and recommendations to support healthy aging

The analysis illuminates seven attributes of innovative and holistic approaches to healthy aging that actors across stakeholder groups can apply to the development and strengthening of healthy aging policies and initiatives.

Principles for Innovations in Healthy Aging:

1. Participatory Processes and Co-design: Taking inspiration from the disability rights slogan “Nothing about us without us,” public-and private-sector actors can ensure that new programs and products reflect the needs and priorities of older adults through an iterative co-design process.
2. Equity and Inclusion: Systemic and individual interventions to support healthy aging benefit from a culturally sensitive and adaptive approach that can evolve as the population’s needs do and acknowledges the diversity of the older population.
3. Focus on Dignity: Pervasive ageism still exists across the world, eroding the rights, quality of life, and quality of care of older adults. Protecting the inherent dignity and rights of all people—including older people—is essential to the promotion of healthy aging and health at all ages.
4. Life-Course Approach: Aging begins at birth. Interventions to support healthy aging should therefore begin early in one’s lifetime, through a life-course approach that promotes mental and physical health at every age.
5. Whole-of-Society Approach: A whole-of-society approach acknowledges that healthy aging is influenced by a range of factors within our societies and economic structures and seeks to develop integrated strategies to support older adults through collaboration with public, private, non-profit, and civil society groups.
6. Commitment to Monitoring and Evaluation: Careful monitoring, data collection, and evaluation practices will benefit existing and developing healthy aging interventions. Systematically collected information and transparent reporting are critical to refining existing programs and to helping to inform the expansion, replication, and adaptation of the initiatives in other contexts.  
7. Support for Caregivers: Supporting and growing the care economy, with specific attention to the needs of paid direct care workers as well as unpaid family caregivers, is vital to the success of healthy aging work, as caregivers are responsible for monitoring and maintaining physical and mental health—and are often older adults themselves.

Recommendations:
The promotion of healthy aging across society will necessitate actions by national and local governments, civil society organizations, the private sector, and health care service providers—with ongoing input from older adults in order to attain healthy aging goals and meet the needs of this growing cohort. With the seven principles for innovation in mind, the following actions explored in the report could be taken to accelerate progress.

National Governments:
Governments are central to the implementation and promotion of healthy aging agendas, and to providing the services and resources to support them, including by allocating funding. Recommendations for governments include:

• Invest in the care economy to encourage more people to enter the care workforce;
• Support unpaid family caregivers to provide safe, high-quality care through publicly-funded programs and incentives; and
• Adopt a rights-based approach to confront ageism and encourage older adults’ active participation in daily life.

Civil Society Organizations:
Civil society organizations play a major role in advocating for and on behalf of older adults, facilitating healthy aging agendas, and convincing policymakers to commit resources to healthy aging agendas and older persons’ needs. Recommendations for civil society organizations include:

• Engaging directly with older adults and empowering them to tell their own stories and inform policymaking and program development;
• Amplify the voices of older people on the national and global stages;
• Tackle ageism by encouraging meaningful engagement between older persons and their communities; and
• Act as a watchdog for government policies on healthy aging.

The Private Sector:
Private sector firms of various sizes and scales are often integral to the promotion of healthy aging around the world, including through delivery of care, and can support and expand the work of other major actors. Recommendations for the private sector include:

• Invest in and/or co-fund innovative research into healthy aging products and services, including through public-private partnerships;
• Support older adults seeking to remain in the labor force; and
• Share anonymized data collected via service delivery and product use.

Health and Social Service Providers: 
Health and social service providers are key to the implementation and enforcement of healthy aging agendas at the national and international levels and can be on the cutting edge of health and healthy aging innovation. Recommendations for private and nonprofit health service providers include:

• Professionalize the care workforce through investment in human capital, and support unpaid family caregivers with formal respite service provision;
• Address health disparities exacerbated by race, ethnicity, gender, and sexuality; and
• Shift to an integrated care approach that treats all aspects of health in harmony.

Older adults, both now and in the future, have a right to high-quality, integrated care that allows them to maintain their dignity and autonomy, and supports meaningful connections to their communities. As Paul Irving, chairman of the Milken Institute Center for the Future of Aging, noted optimistically during an interview, “If societies can keep their aging populations healthy and engaged, think of how exciting those future years might be.” This report and the corresponding toolkit seek to contribute to this effort and provide a resource for policymakers and practitioners as we collectively work toward these common goals.