KEY CONCEPTS PAGE
Public health and aging 224
Demographics of an aging society 224
Theories of aging 225
Preventive gerontology 225
Health disparities in aging populations 226
Multiple jeopardy 226
Ethnicity as compensation 226
Impact of dementia 230
Organizing for an aging society 233
Compression of morbidity 236
Quality of life 236
Key concepts – Definitions Page
Public health and aging: Public health can vastly improve the late life 224
experience to the benefit of all generations by responding to rising
numbers of elders in two ways: 1) address the health needs of elders
living today, and 2) prepare the younger generations for a healthier late
Demographics of an aging society: The total number of Americans over 224
age 65 is 35 million at present and is on the rise. This number will more
than double to over 70 million in only forty years, and the age group 85
and older will triple in the same time period. Huge differences between
racial and ethnic groups exist with minority groups having shorter life
spans at birth. A demographic cross over effect also exists in which
minority older adults who have survived to age 85 are as or more likely to
live into their 9th decade as their white counterparts. Demographics
within racial and ethnic groups as a whole are also changing, and
minorities are starting to make up greater percentages of the older adult
population as the world ages.
Theories of aging: There are multiple theories regarding the aging 225
process including intrinsic, biologic clock, programmed theories in which
the maturation of the human being is programmed regarding
developmental milestones including the aging process, and wear and
tear, stochastic, extrinsic theories that address accumulated damage to
organ systems until some failure point is reached.
Preventive gerontology: From this perspective, aging is viewed as a life 225
long event, not one that “begins” at age 65. More research is showing
that intrauterine, childhood, and adult health, disease, and injury events
are connected to late life functional status and morbidity.
Health disparities in aging populations: In spite of an increase in life 226
expectancy in the United States, disparities exist across groups in terms of
healthy life expectancy. Female gender has also been included as an
additional layer of vulnerability because single, older, minority women
are the most impoverished across populations.
Multiple jeopardy: Experienced by many minority elders; refers to risk 226
and vulnerability of being not only old in an ageist society, but minority as
Ethnicity as compensation: The idea that being a member of a close-knit 226
ethnic group may serve to mitigate the exigencies of old age. This is not
always the case.
The impact of dementia: Prevalence of AD is currently 4.5 million known 230
cases, but will rise to 13.2 million cases by 2050. AD strikes at the core of
individuality by taking people’s ability to think for themselves. Memory
loss is one key symptom of AD, but judgment, planning, calculation, and
decision-making are also impaired and constantly worsen over two to
twenty years and it has huge emotional impacts for patients and their
families. Consequently, it is the quintessential condition of aging in terms
of triggering need for all the financial and personal resources available,
from family to physician to community resources to nursing home.
Organizing for an aging society: As the country ages, Public Health is in a 233
key position to stimulate much needed organization for an aging society.
Issues such as the Economics of Aging (funding of programs such as
health, Medicare, Medicaid and long term care) Political Advocacy
(ensuring seniors have a voice in influencing the political landscape
through efforts like those of the American Association of Retired Persons,
Gray Panthers, and Silver Lining), Research (to improve the health and
well being of older adults), and Geriatric education (specialized training of
health professionals and others around the needs of an elder population)
will need to be adequately addressed.
Compression of morbidity: Minimizing the length of time in a dependent 236
state due to disease or disability is the basis of the concept “compression
of morbidity,” or “rectangularization of the morbidity curve.” In this
scenario, the continued increase of the age at which continuing
dependency begins would result in fewer years of dependency prior to
death. If one can live with health and high function most of their life, with
most dependency due to chronic sickness compressed into a smaller
period of time the outcome would be not only a higher quality of life for
most, but also a more economically feasible late life experience.
Quality of life: Health-related quality of life is a health status assessment 236
that measures disease impact on the individual. It consists of patient
reports of functional status, mental health, affective status, emotional
well-being, social engagement, and symptom states, to include items
such as shortness of breath, visual problems, hearing problems, and
fatigue. It is most valuable for public health interventions.