An Aging Population Why This Matters to Public Health. Health Data On the Older Adult Population. Opportunities For Public Health

Transcription

1 Healthy Aging in Oregon Kirsten Aird, MPH Cross Agency Systems Manager Public Health Division Presentation Overview 1 An Aging Population Why This Matters to Public Health 2 Health Data On the Older Adult Population 3 Opportunities For Public Health 1 An Aging Population Why This Matters To Public Health 1

2 Oregon s Aging Population Population Pyramids: Percent of total Oregon population by age A success story longer lifespans and lower birth rates A permanent change A worldwide change Source: U.S. Population Increase: 2012, 2030, 2050 Source: An Aging Nation: The older population in the United States. Current population reports, Orfman, Velkoff, Hogan. Issued May 2014, P U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. More Than Just An Increase In Number Growing diversity among older adults Increasing diversity in race/ethnicity Increasing diversity in health and functional ability Greater older adult population increases in rural areas 2

3 Why is this relevant to public health? Increase in aging population is a public health success story! Older adults are part of every community Less than 5% of older Oregonians live in any kind of longterm care setting An expanding community resource A population-focus includes the full life span Older adults are a growing segment of our population An equity issue National Conversations AARP Age Friendly Communities: An age-friendly world enables people of all ages to actively participate in community activities and treats everyone with respect, regardless of their age. It is a place that makes it easy for older people to stay connected to people that are important to them. It helps people stay healthy and active even at the oldest ages and provides appropriate support to those who can no longer look after themselves. National Conversations ASTHO President s Challenge (2015): Promote the health of older adults by collaborating across sectors Implement evidence-based strategies for increasing the number of older adults who are living well in our communities Use data to understand each state s older adult population and drive action Trust for America s Health: Framework for an Age-Friendly Public Health System Promote health, prevent injury and manage chronic conditions Optimize physical, cognitive and mental health Facilitate social engagement 3

4 Oregon s Goals Elevate healthy aging in the civic discussion Bring together stakeholders that represent older adults and caregivers to inform state and community health improvement plans Identify the public health role in the moving the work forward 2 Health Data On the Older Adult Population 2018 U.S. Senior Health Rankings Lighter colors indicate better health ranking. Source: America s Health Rankings Senior Report

5 Data on Oregon s Older Adult Population Health Older Oregonians are doing well in many ways: 12 th in a national ranking in 2017 Positives: Low percentage of ICU use High SNAP enrollment Low preventable hospitalization rate Low smoking rate Concerns: Low flu vaccination Low prevalence of pain management High falls High excessive drinking 15 th in a national ranking in 2018 Positives: Low prevalence of physical inactivity Dental Visits went Low preventable hospitalization rate Low smoking rate Concerns: Low flu vaccination Low prevalence of pain management High falls- increased from 2017 Suicide increasing over the last 4 years *Source: America s Health Rankings Senior Report 2018 Questions for the Viewer? Does your agency get data on seniors from (check all that apply): A. Local sources B. State sources C. Federal sources D. Other (type in chat box) Cognitive Decline Data Definition 187,000 Those aged 45+ who have experienced confusion or memory loss (CML) that is happening more often or getting worse within the past year Number of those reporting CML in Oregon (11% of adults aged 45+) Demographics Average age of 62 Has lower education Has lower socioeconomic status (SES) Not in workforce Source: Oregon Behavioral Risk Factor Surveillance System () 5

6 Health Impacts of Cognitive Decline Those with confusion or memory loss are more affected by health risk factors and poor health status: Poor/fair health status With confusion or memory loss Without 18% 57% Limited by poor health 13% 43% Obesity 30% 37% Food insecurity 11% 34% Current tobacco user 15% 25% Source: Oregon Behavioral Risk Factor Surveillance System () Demographics of Caregiving Time spent Over 60% have been providing care for 2+ years 1 in 2 provide care 8 hours per week 1 in 5 provide care 40+ hours per week Age of recipient 1 in 5 under age 50 2 in 5 age 75 or older Relationship to recipient Parent or grandparent (48%) Non-relative (21%) Spouse (14%) Child or grandchild (9%) Source: Oregon Health Impacts on Caregivers Caregivers are more likely to have health risk factors and poor health status: Food insecurity Caregiver Non-caregiver 19% 37% Obesity 26% 33% Current tobacco user 20% 29% Poor/fair health status 16% 21% Limited by poor health 13% 17% Source: Oregon 6

7 3 Opportunities For Public Health 1. Connecting and convening multiple sectors and professions that provide the supports, services, and infrastructure to promote healthy aging Framework for an Age-Friendly Public Health System 2. Coordinating existing supports and services to avoid duplication of efforts, identify gaps and increase access to services and supports 3. Collecting data to assess community health status (including inequities) and aging population needs to inform the development of interventions 4. Conducting, communicating, and disseminating research findings and best practices to support healthy aging Source: Trust for America s Health 5. Complementing and supplementing existing supports and services, particularly in terms of integrating clinical and population health approaches. Major opportunities Data Partnerships Part of Public Health Network 7

8 Opportunities: Data Need further breakdown of data for those age 60+ (e.g., 60-74; 75+; potentially 85+) State-funded cognitive decline and caregiver modules Healthy Aging Index Development of short list of key public health indicators that can be tracked over time Opportunities: Data Categories Measure Data source Oregon Healthy Aging Indicators June 2018 = Behavioral Risk Factor Surveillance System HDD= Hospital Discharge Data Functional health Status Disability 5-item measure Causes of death 60+ Death certificates Causes of death 75+ Death certificates Physical health overall Falls hospitalization HDD Oral health: dental visit Tobacco Obesity/Body Mass Index Physical health: risk factors Physical activity Physical health: chronic conditions Heavy drinking Chronic disease prevalence Arthritis Diabetes Heart disease Stroke Asthma All cancers incidence Oregon Cancer Registry Preventive services Influenza immunization Psychosocial 14+ poor mental health days in past 30 days Suicide deaths Death certificates Cognition Alzheimer s deaths Cognitive decline Death certificates Social determinants Food insecurity Caregiver health Caregiver responsibilities one month or more Opportunities: Partnerships Convening Partners: A traditional strength of PH Recognizing the many existing partners already involved in aging Bringing people together to look at data, population-level approaches, and environment/systems/policy approaches 8

9 Opportunities: Partnerships Federal Civic Leaders: Oregon s Congressional Delegation and Senators Centers for Disease Control Administration on Community Living State & Local Department of Human Services-State Unit on Aging Governor s Commission on Senior Services Oregon Health Policy Board/Public Health Advisory Board AARP Alzheimer s Association Civic Leaders: state executive leadership, state legislators, city/county officials Community Oregon Health and Sciences University Portland State University, Institute on Aging Oregon State University-Center for Healthy Aging Research Area Agencies on Aging Aging and Disability Resource Centers Local Public Health Departments IRCO, Asian Family Center Health Care & Treatment Home Care Commission Coordinated Care Organizations-Long Term Care Innovator Agents EHRs adapted for STEADI Community Health Workers Questions for the Viewer? What senior-specific partnerships does your agency participate in? What additional partnerships can you look for in your community? Please type responses in the chat box. Opportunities: Public Health Network Ensuring that public health addresses all ages: Ensuring older adult population is part of programs and policies Older adults, people with disabilities, and aging services providers involved in planning Older adults and people with disabilities included in potential target populations for public health efforts Brain health as part of heart health messaging Focus on communities for all ages Age-friendly communities, dementia-friendly communities, age and disability considerations for SMART design Collaboration with aging partners 9

10 Recent Accomplishments Raising the civic conversation in Oregon using Public Health's communication infrastructure: Place Matters Oregon Published the Health Within Reach Blog and Data Within Reach Webinar Convening partners outside of public health to enhance civic dialogue about healthy aging Staff Training Lessons Learned Aging-related programs and activities have been happening for a long time in Oregon: Legislative long term care task force : cognitive impairment and caregivers Oregon Senior Falls Prevention project While conversations are happening across many sectors, a population perspective is lacking Opportunities to establish a clear role for public health, highlight the work of partners, and elevate the need for collective, cross-sector action 10

11 Responding to Funding Challenges Healthy aging is part of what Public Health does! Use a public health modernization lens: Additional Programs Public Health Modernization Foundational Programs Foundational Capabilities Communicable Disease Control Prevention & Health Promotion Leadership & Organizational Competencies Health Equity & Cultural Responsiveness Community Partnership Development Environmental Health Access to Services Assessment & Epidemiology Policy & Planning Communications Emergency Preparedness & Response Work to make foundational programs & capabilities present in every health department Key Takeaways Do what we do well in public health: Data Convene partners Promote health Start with what and who you know Don t turn this into a program Use the Framework for an Age-Friendly Public Health System 1. Connecting and convening multiple sectors and professions that provide the supports, services, and infrastructure to promote healthy aging Framework for an Age-Friendly Public Health System 2. Coordinating existing supports and services to avoid duplication of efforts, identify gaps and increase access to services and supports 3. Collecting data to assess community health status (including inequities) and aging population needs to inform the development of interventions 4. Conducting, communicating, and disseminating research findings and best practices to support healthy aging 5. Complementing and supplementing existing supports and services, particularly in terms of integrating clinical and population health approaches. 11

12 Questions for the Viewer? What health assessment and planning efforts, from either state or local levels, would be useful? Please type responses in the chat box. Questions? 12