Longevity and Health

By Hina Budhwani, MPH
April 8, 2013

pensive old man sitting on bench in parkIt comes as no surprise to anyone that an average lifespan has been steadily increasing across the globe. Extraordinary public health efforts made in disease prevention along with advanced medical care both play a pivotal role in awarding people the benefit of living longer lives. As a result, people are living well into their 80s, 90s, or even beyond 100. However, living longer does not necessarily equate to living a healthy life. In fact, living longer poses new and unique challenges that must be addressed in order to ensure that that people are not only living longer, but also enjoying healthier lives. There are myriad of challenges associated with aging, but I will focus on just a few that I encountered during my academic and professional career and found particularly challenging.

Chronic diseases:
Diseases such as cholera, polio, and typhoid may sound like things of the past, especially in developed countries. However, there is an increased prevalence of chronic and degenerative diseases such as diabetes, cardiovascular diseases, respiratory diseases, neurological diseases, and cancer, which are, presently, the subject of focus in the health industry. Additionally, comorbidities, frailty, falls, and other various forms of physical and mental disabilities are some of, critical, yet inevitable consequences of old age. Ultimately, these diseases are imposing greater demands on individuals, and their family members; changing the dynamics of medical infrastructure; and are affecting our society as a whole.

Although a variety of health promotion and disease prevention programs are available for various age groups and have achieved great success; there is a tremendous need to educate the older population as well. The older population is often neglected because the focus is primarily on curative measures for their age group as opposed to preventive measures. Thus, I believe it is essential that we also educate the elderly so they too can make healthy lifestyle choices, which would result in either preventing the age-related diseases or postpone disabilities.

Long-term care:
As people age, the need for providing long-term care will undoubtedly increase due to inability to function independently. Although many older adults desire to remain at their homes, at some point this option is no longer viable. The reason is that often there is a lack of family support, or impossibility to care for a certain ailment by a family member due to the lack of medical expertise. Ultimately, a decision to opt for a long-term-care then becomes unavoidable. However, financing long-term care has its own challenges, even after implementation of Affordable Care Act, as the CLASS Act (Community Living Assistance Services and Supports) provision was repealed recently. Currently, Medicaid is the only option for financing long-term care, but qualifying process for such a benefit is strictly need-based. On the flip side, Medicaid’s financial ability to handle the increasing numbers of older adult population needing long-term-care will also play a role in determining whether such care will be afforded to them.

Sexuality and sexual health:
Another area I found particularly challenging as I went through my graduate training is a lack of awareness about the importance of sexuality among older adults. The notion that older adults are “asexual beings” seems to persist in society despite the existence of literature evidence, which suggests that maintaining an interest in sexual activity does not decline with age. However, decline in sexual functioning among older adults has been documented, which is attributed to underlying chronic diseases, side effects of medications, and even due to psychological causes such as anxiety and guilt for having a desire to be intimate at their age. In order to further explore the importance of sexuality and its impact on the well being of older adults, I conducted a secondary data analysis using data from National Social Life Health and Aging Project (NSHAP). The NSHAP study is population-based study of health and social factors among community dwelling older adults, which was conducted between 2005 and 2006 on a national scale. Although the data analysis showed an association between lower levels of depression, anxiety, and stress among frequently sexually active, more rigorous studies need to be conducted to further expand on this knowledge.[1]

Just as increasing awareness about sexuality among older adults is important, so is ensuring that sexual health of older adults is maintained. Considering the rising incidence of sexually transmitted diseases such as syphilis, gonorrhea, chlamydia, and even HIV among older adults, public health interventions are crucial. Often healthcare professionals underestimate the risk of development of STDs among older adults because of a belief that older adults are not intimate at their age. However, ultimately, this age-based stereotype leads to under treatment and further transmission of STDs. Hence, it is important that public health interventions are initiated to educate older adults about sexual health, importance of safe sex practices, and ways to seek medical help regarding sexual problems.

In conclusion, the increased aging population will bring many new and unique challenges for public health professionals, which will require advent of new public health interventions. Accordingly, proper avenues have to be emplaced to ensure that as people age; they make wise decisions about their lifestyles. Taken together, although living longer definitely has many benefit, to fully reap the benefits of a long life we must focus on living a healthier life.

Hina Budhwani is a Term 5 medical student at St. George’s University’s School of Medicine. She obtained Master of Public Health with a concentration in behavioral sciences from the University of Texas in 2010.

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