State Health Departments (SHDs) and State Units on Aging (SUAs) constitute a vital network for healthy aging, yet a new report reveals significant gaps between these agencies' funding approaches and operating philosophies-gaps that impede thei ability to coordinate efforts to improve health status and quality of life for older Americans.
The study, The Aging States Project: Promoting Opportunities for Collaboration Between the Public Health and Aging Networks, states, "The new challenge for public health is to develop a focus on healthy aging to assure that older adults maintain optimal health status and quality of life in their later years." Previously, public-health initiatives have focused mainly on infectious-disease control, immunization provision and chronic-disease prevention.
According to the study, although states play an increasingly crucial role in protecting and enhancing the health status of older Americans, "most states have a fragmented or limited approach to addressing the health needs of older adults." The report continues, "Inadequate resources and attention are focused on health promotion and prevention of disease or secondary disability for older adults, the very population that experiences the highest rates of chronic disease and disability. A key cause of this fragmentation is the lack of collaboration between state agencies that are responsible for assuring healthy residents, and those that are responsible for aging residents."
The Aging States Project was a collaborative effort of the Association of State and Territorial Chronic Disease Program Directors and the National Association of State Units on Aging, with support from the Centers for Disease Control and Prevention (CDC) and the Administration on Aging (AoA). The research team conducted an online needs-assessment survey of SUA and SHD directors using Zoomerang Web-based technology. A total of 38 SUAs and 43 SHDs responded. Headed by Ruth Palombo, elder health director at the Massachusetts Department of Public Health, the project team aimed to create an overview of current health-promotion and disease-prevention efforts for older adults and identify barners, program support needs and the status of collaborations between SUAs and SHDs across the United States.
In general, the authors of the report observed that few SHDs have programs targeted toward older adults, even though elders are at high risk for chronic disease, injury and disability. The authors commented, "There is some irony in the fact that, while the graying of America has been largely a product of a century of public-health successes in extending life expectancy, SHDs still do not have a clearly defined role in health promotion and disease prevention for older adults."
ISSUES NOT RECOGNIZED
One significant finding of the study was that "SUAs identified several issues that may be key to health promotion but were not widely recognized by SHDs." For instance, SUAs, which are primarily funded by the federal Older Americans Act and focus on community-based direct services, saw transportation as a major concern and service barrier for elders. However, SHD directors rarely identified transportation as a priority issue in their survey responses. The report says that SHDs rely chiefly on CDC funding that is awarded on a competitive and often disease-specific basis to a limited number of states; thus, they tend to focus on issues directly affecting disease prevention. Alternatively, the study says that although SUAs have substantial knowledge of and involvement with the service and support needs of older adults, "most do not have broad expertise in public health or preventive strategies."
Overall, the researchers concluded, "Developing an integrated system of health-promotion and disease-prevention services for older adults will require stronger collaboration and cooperation between these two essential networks. …