“When grace is joined with wrinkles, it is adorable. There is an unspeakable dawn in happy old age.”
- Victor Hugo
Here is the good news: most of us are living longer and having fewer babies than our grandparents did. In OECD countries, people who reach age 65 can expect to live an additional 17 to 20 years. This is an extraordinary achievement in human history, reflecting improvements in overall hygiene and sanitation and the advent of modern vaccines and medicines. We can transform infant mortality rates, our ability to fight infectious diseases, and how we treat the great killers such as heart disease and cancer. Still, for too many people, longevity comes at a high price—chronic illnesses that reduce their ability to fully enjoy their longer lifespan and all too often undermine their independence, burden their families, and deplete their economic resources. Most conditions that attenuate productive aging have their roots in social and behavioral antecedents that greatly predate the appearance of diagnosed disease. Over time, these insidious risks deny people the grace of “happy old age.”
Aging well is our new challenge. Achieving it will require us not only to reinvent our health care systems but also to fundamentally change our basic attitudes toward health and well-being throughout our lifetimes. Most individuals think of health as a personal state—“I am healthy” or “I am sick.” What would happen if, instead, we thought about our health in the same way we think about our other assets and resources? What if we regarded health as a personal asset that can be carefully protected and invested over our entire lifetime to ensure long-term benefits—a health retirement account we can draw upon in our older years, in the same way we draw upon our financial retirement accounts? Instead of squandering our health in ways that we know are not really good for us, we could invest in enhancing and sustaining it.
And what if communities assessed their population “healthiness” in the same way they evaluate other natural resources that require thoughtful conservation and proactive management? We have known for a long time that health and prosperity are linked, but have we ever put health in the same framework as we do our water resources or our energy supply? Shouldn’t improving and sustaining a community’s health be at least as important as treating people when they are sick?
Health is truly a precious natural resource, and individuals, communities, businesses, and countries that know this can make better decisions about their health investments. Aging well requires that those investments start even before conception, ensuring that parents can nurture healthy infants, support them through their learning years in schools that foster health and well-being, and then launch them into adulthood. Aging well also requires that adults in all life stages have the information, resources, incentives, and support to invest in protecting their personal health. It is necessary to have health insurance and a competent health care delivery system, but it is not enough. Far more benefit can be achieved by encouraging “health in all policies” and “health in all places” to shape our physical and social environments and thereby motivate and sustain good health behaviors that in the long run enhance our overall “health accounts.”
More good news: there are certainly individuals and communities who are already aging well. As Dan Buettner notes, there are Blue Zones, places in the world where higher percentages of people enjoy remarkably long, full lives (https://www.bluezones.com). What is perhaps most remarkable about these communities is that in most of them, aging well is associated with productivity and activity—something that we need to understand and harness if we hope to compensate for the looming economic consequences of the demographic divide that our aging societies are experiencing. Indeed, creating the opportunity for people to make substantive contributions to their communities and families as they move past the traditional age of “retirement” is critical to our economic viability. Their wisdom, experience, diversity, and skills are treasures that we need to sustain—and honor. Aging well is not just a challenge, it is a global imperative!
About the author
Dr. Julie Gerberding is an Executive Vice President for Merck & Co., Inc., Kenilworth, NJ, USA, known as MSD outside of the US and Canada, and is the former director of the U.S. Centers for Disease Control and Prevention from 2002-2009. She is responsible for the company’s global public policy, corporate responsibility and communications functions, as well as the U.S.-based Merck Foundation and the MSD for Mothers program. Dr. Gerberding joined the company in 2010 as President of the company’s vaccine division and was instrumental in increasing access to vaccines worldwide and making them more affordable for the people who need them most.