WHAT WE'RE LEARNING

Dear Colleagues—

What does it mean for public health to be age-friendly? Imagine an older woman living alone and managing her many health conditions while raising three grandchildren. She falls and winds up in the hospital. Now, imagine you are a county public health official charged with developing health strategies for your county. You learn about this woman’s situation and review local population health data for related trends—finding surprisingly high numbers of older adults with complex health needs in your county. Seeing this bigger picture helps you plan fall prevention and chronic disease management programs and explore how to design county programs for children that incorporate support for aging grandparents. Leveraging data is a powerful way for public health to become age-friendly.

Public health departments are vital. They protect us from disease outbreaks through epidemiological surveillance, public education, and ensuring the availability of vaccines. They play an essential role as educators, informing the public about issues ranging from seatbelts, to safe sex, to the dangers of drugs and alcohol. All members of the community benefit from these services, but public health departments can—and should—have an even bigger impact on the lives of older adults.

In the spirit of helping local public health departments become more age-friendly, The John A. Hartford Foundation and Trust for America’s Health (TFAH), a nonprofit leader in national public health policy, created a roadmap to harness the power of public health to better support our aging population. Together, we developed the Age-Friendly Public Health Systems initiative, based on an innovative framework to show state and local leaders how public health can play a larger role in healthy aging. We’re now putting that framework into action in Florida to adopt approaches that work with health systems and community partners. In the process, we’re learning about the opportunity public health departments have to improve overall population health by making a focused effort to focus on the needs of older adults.

Fundamental to this work is collaboration across agencies and departments. The emphasis on collaboration teaches us how to improve communication among the many players focused on these shared goals, which leads to increased coordination, efficiency, and capacity.

In Florida, we’re learning that collaboration between the state departments of public health and elder affairs starts with the very basic work of creating a shared understanding about each department’s scope of work, responsibilities, and interests. To begin the process of increased collaboration, in 2017 TFAH created a forum that provided an engaging environment for national and Florida state leaders to identify common goals and talk openly about challenges. They discussed ways state agencies and county public health departments could support each other and realize common goals.

A key area of collaboration is the collection and sharing of data. Through the Florida effort, the departments of public health and elder affairs for the first time began to share data and the Florida Department of Health created aging profiles of each of the state’s 67 counties, allowing local agencies to better understand the make-up and needs of their older residents. These Aging in Florida Profiles, unique to the state, were the result of monthly calls, webinars, and expert technical assistance. Now, every Florida county has an online tool, plus instructions for its use, that details life expectancy, infectious disease rates, and many other categories of older adult health and demographics. They now have new and important pieces of information, such as how many grandparents are raising grandchildren in their community, which can lead to more tailored services.

It’s not just Florida where change is occurring. Similar efforts are underway in California, Louisiana, Michigan, Massachusetts, and Oregon. In California, the Los Angeles Alliance for Community Health and Aging (LAACHA) shows how public health and aging sectors can coordinate to best serve the needs of the community’s older adults. Since 2013, LAACHA has implemented programs that teach health management skills to older adults with chronic conditions, help seniors avoid falls, and support family caregivers. In Oregon, the State Unit on Aging’s Long-Term Care Program Analyst is now co-located within the Public Health Division offices. This breaking down of silos has increased coordination between the two state agencies and spurred the Public Health Division to focus specifically on the needs of older Oregonians—something that to date has not been a specific charge of their agency.

Our goal is to spread these collaborations between public health departments and agencies focused on the needs of older community members to all 50 states. Michigan already stepped up and is creating a collaborative of public health departments and community-based organizations.

This public health initiative is part of a broad effort at The John A. Hartford Foundation to systematically improve the lives of older adults in the United States and help public health departments recognize the need to focus on older adults as a public health priority. In addition to reframing the way public health departments and aging services agencies work together, we’re also working to improve the care delivered by hospitals and health systems to older adults. In all our work, we’re focused on making care for older adults more age-friendly.

Sincerely,

Jane Carmody, DNP, MBA, RN
Program Officer, The John A. Hartford Foundation

Learn more at Trust for America’s Health website.