Health Promotion for Older Persons

Dra. Magaly OjedaVida Senior CenterWashington DC. USAmagaly66@gmail.com

ARE THERE MODERN STRATEGIES FOR HEALTH PROMOTION?

Key Points:

The evolution of health promotion has become an increasingly powerful tool in the hands of society.

The political framework of active aging is a health promotion strategy.

Advances in health promotion strategies should be approved for the promotion of active aging.

Turning Plans into Action

PROMOTION

EQUITY

Determinants of health

OPPORTUNITY

SOCIAL CAPITAL

Community Participation

The Concept of Promotion

Health promotion consists of providing communities the means to improve their health and exercise greater control over it. To reach a state of complete physical, mental and social wellbeing, an individual or group must be able to identify and realize aspirations to satisfy their needs and to change or adapt to the environment. The objective is not to create a perceived health, but rather to enrich everyday life.

Ottawa letter for the promotion of healthOMS. Ottawa, 1986

Evolution of a Strategy

First Conference: Ottawa, Canada, 1986 Main message: New definitions of health

Second Conference: Adelaide, Australia 1988Main message: Public policies for health

Third Conference: Sundsvall, Sweden, 1991Main message: Environments for health

Fourth Conference: Jakarta, Indonesia, 1997Main message: Determinants of health: New challenges

Fifth Conference: Mexico City, Mexico, 2000Main message: Decreasing the equity gap.

Evolution of a Strategy

Sixth Conference: Bangkok, Thailand, 2005 Main Message: Determinants of health and globalization

Seventh Conference: Nairobi, Kenya, 2009 Main message: Promotion of health in the policial development agenda.

World Conference on Social Determinants of Health: Río, Brasil, 2011Main message: Governance in favor of health and development

Eighth Conference: Finland, 2013 Main message: Health in politics.

The world has changed

An unprescedented speed

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1700 1750 1800 1850 1900 1950 2000 2050 2100

% p

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France Mexico

Increase in the older adult population over 56 years in France and Mexico

Barbados is part of this process

The challenge of aging and health

The aging population is one of the greatest triumphs and also one of the biggest challenges facing humanity. Health is part of this challenge.

Making the result of this process positive will depend on the coherent and integrated action in all sectors.

The public health sector should assume conceptual advances in health promotion to understand and face this challenge.

Active aging as a health promotion strategy

Active aging is the process of optimizing opportunities for health, participation and secuirty in order to improve the quality of life as people age.

Conceptual Framework

World Health Organization, 1999

Active Aging

ActiveHealthy

Functional

Colin A. Depp, Ph.D., and Dilip V. Jeste, M.D. Definitions and Predictors of Successful Aging: A Comprehensive Review of Larger Quantitative Studies. Am J Geriatr Psychiatry

14:6-20, January 2006

ACTIVE AGING

Physicalenvironment

Personaldeterminants

Behavioraldeterminants

Social determinants

Economic determinants

Health and social services

culture

sex

Determinants of Active Aging

Functional capacity and the life course

Help people to continue living independent and active lives.

Strengthen promotion and health prevention. Increase the quality of life. Avoid the breakdown of health and social systems. Balance the care of persons who need assistance

between the family and the state. Recognize and support the important role of taking

care of others.

To ensure active aging:

Pillars of Active Aging

Active aging should grow as a strategy

Inserting aging in health promotion strategies

What do we have for 2014?

Public Policy

United Nations Declaration on the Rights of Older Persons (1999)

International Plan of Action on Aging (2002), Chile International Agreement (2003), the Brazil Declaration (2007) and the San Jose Letter (2012)

The Regional Strategy and Plan of Action on Aging and Health 2009-2018 (2009)

World Health Day (2012) Advancement toward the Convention on the Rights of

Older Persons

Other Tools

Promoting the creation of age-friendly environments

Promoting the creation of favorable environments

Strengthening Community Action

Essential components to healthy aging:Physical activityMental activitySocial activitySocial Commitment: Productive and significant

roles in society

Only in the community and with the community can we achieve this

The reorganization of health services. (The problem)

Health systems were not constructed for the management of chronic disease.

Chronic diseases last for many years and are long-term problems..

The most significant diseases are affected by our personal context and behavior, which the system cannot entirely support.

Older persons oftentimes have multiple complex needs, complicated by the influence of health determinants.

The reorientation of health services (How to solve the problem)

Design health services that satisfy the needs of persons with chronic diseases.

Planned and integrated care. Patients who are conscious of the management of

their disease. Continuous attention to the promotion of health and

quality of life. Access to medicine and appropriate technologies.

Other Tools

Developing personal skills (The problem?)

Health behavior is the cause of many premature deaths. People need to be educated on health material and have

support from other people, programs, institutions and specific tools in overcoming their difficulties.

It is difficult for people to start changing their habits and even harder to keep these long-term changes.

It is not enough to simply tell someone to stop their bad habits.

Patients must make their own decisions regarding their behavior and habits.

Developing personal skills (How do we resolve the issue?)

Education on the basic principles of health behavior. This education should be given by those who can relate and should include practical advice, suggestions and ideas.

Understand that different patients have difference needs. Each case is unique.

People go through different stages of change: some are willing to change now, while others may not be ready yet.

Interventions should be based on individual needs and their social and cultural environment.

Developing personal skills (With what?)

We have evidence-based programs (Taking Control of Your Health, etc.) that should:

Offer motivation and confidence en the management of a person’s condition.

Establish goals, plans of action and support from their partners.

Achieve behavior changes that are significant in reaching healthier results – specific, measurable and realistic.

Resolution of problems, review and feedback.

World Health Day 2012

Participation VS Compromise

Provide education and training opportunities throughout the WHOLE life cycle.

Recognize and allow the GUARANTEE of the active participation of people in economic development activities, formal and informal work and volunteer activities as they age, according to their needs, preferences and individual capacities.

Encourage people to participate fully in family and community as they age.

Security

Ensure the protection, security and dignity of older persons while addressing the social security rights and needs of people who are aging.

Reduce inequalities in the security rights and needs of older women.

Convention on the Rights of Older Persons

Measures in various sectors other than health and social, such as education, employment and labor, the economy, social security, housing, transport, justice and rurarl and urban development.

These measures support the goals of improving health through intersectoral action.

This approach emphasizes the importance of the many different public health partners and strengthens teh role of the health sector as a catalyst for action.

Intersectoral action