Bridging the Gap between Science and Health Behavior
Landry, Roger, Kahn, Robert L., Aging Today
The Mosterpiece Living Experiment
As in other industrialized countries throughout the world, the United States is an aging society, one where older men and women are becoming an ever-larger proportion of the population. Demographers estimate that almost every seven seconds another American reaches the age of 60. Soon one-fifth of the U.S. population will be over the age of 65.
Those facts are important for the nature and costs of healthcare. In the United States, more than one-third of the national medical bill, already the largest in the world, goes to treat chronic diseases and conditions of aging. If this trend continues, the road ahead looks bumpy indeed. That's the bad news, and it poses some serious questions: Does the Untied States lack basic research on what it takes to age well? Is there a failure of communication between scientists and the public? Do people act on what they know?
KNOWLEDGE IS ROBUST
Let's take those questions one at a time.
Do we lack basic research on what it takes to age well? Not really. Researchers continue to argue about definitions and much about aging is not known, but a great deal, has been learned about ways to postpone, reduce or prevent the illnesses and disabilities that afflict older men and women. The Mac Arthur Foundation Studies on Aging, the Harvard Nurses Study, the Framingham Heart Study, the New England Centenarian Study, the Systolic Hypertension in the Elderly Program and other research provide an increasingly clear picture of what this society can do to maximize people's chances of enjoying a healthy and active old age. Much, of course, remains to be learned; scientific research is a continuous process. But the body of scientific knowledge on aging is robust enough to begin substantive and substantial behavioral change-change far beyond the beginnings that have already been made.
Is there a failure of communication between scientists and the public? Yes, to some extent. Scientists write mainly for each other; scientific journals are not light reading, and scientific writing is often more jargon laden than necessary. There is a flood of advisory, self-help books and articles on aging. Some of them are research based; others are not. Readers must deal with exaggerated claims and contradictory advice: the meat-saturated Atkins diet versus the complex carbohydrates of the food pyramid, for example. However, the health benefits of moderate aerobic exercise, avoidance of being overweight, involvement in stimulating mental activity and maintenance of close personal relationships are dominant themes in the research on healthy aging. Also, for the rapidly growing population of computer-comfortable elders, the Internet offers the research findings of the National Institutes of Health and other legitimate sources. At least a part of the research message has gotten through; people can "talk the talk" of successful aging.
Do people act on what they know? The crucial gap, though, is between "the talk" and "the walk," between what many people already know and what they actually do. How can older Americans bridge the gap between scientific knowledge and health-promoting changes in behavior? This question itself is researchable, but it points toward a kind of research that is not often done. Floyd E. Bloom of the Scripps Institute in La Jolla, Calif., and former editor of the journal Science, put it well: "The puzzles of better health promotion and disease prevention may be approached more rapidly and effectively through intensified social science research, rather than by awaiting the expected evolution of gene-based explanations and interventions of future genetic discoveries."
Bloom is among the authorities calling for social experiments-the equivalent of clinical trials for new drugs-to learn how to create conditions under which people will choose the lifestyle and activity patterns that will maximize their chances for a long and healthy life. …