The Healthy People 2030 initiative, led by the U.S. Department of Health and Human Services Office of Disease Prevention and Health Promotion, establishes clear public health goals spanning a decade and provides tools to monitor national progress toward those goals. The initiative envisions a future where all individuals and communities enhance their life span, and importantly their health span and well-being. As a designated Healthy People 2030 Champion, The John A. Hartford Foundation (JAHF) is dedicated to advancing these public health goals by empowering older adults and supporting their caregivers. In articles from April and July, I discussed how our organization is promoting Healthy People 2030 objectives by encouraging older adults to engage in health discussions with family and friends, and by improving access to comprehensive dementia care. We are also actively pursuing another Healthy People 2030 objective to reduce fall-related deaths among older adults by promoting screening and interventions that help preserve and increase people’s mobility. We encourage public health, health care and social service agencies to join us.
The Center for Disease Control (CDC) finds that from 2007 to 2016, there was a 31% increase in the rate of deaths from falls among individuals aged ≥65 years, impacting 30 states and the District of Columbia, and affecting both men and women. The Healthy People 2030 initiative aims to reduce fall-related fatalities in older adults, a goal we strongly support. We know from decades of research that falls and resulting harm and deaths can be prevented with a focus on enhancing mobility.
Healthy People 2030 shows that according to census data from the Centers for Disease Control and Prevention, in 2022, there were 64.4 fall-related deaths for every 100,000 people over age 65, serving as a baseline statistic. The Healthy People 2030 target is to decrease this rate to 63.4 deaths per 100,000 people 65+. Disparities in fall-related deaths among older adults are notable, with rates ranging from 81.6 deaths per 100,000 in non-metropolitan areas compared to 77.1 deaths per 100,000 in metropolitan areas. Developing strategies to assist older adults living independently or in care facilities to prevent falls, such as increasing physical activity, can mitigate deaths in this age group.
Alarmingly, recent Healthy People 2030 data indicate a worsening trend. Fall-related deaths among older adults have been rising since 2018 and reached a concerning rate of 76.9 deaths per 100,000 older adults in 2022. With the Healthy People 2030 goal set at 63.4 deaths per 100,000, urgent progress is needed within the coming years.
How age-friendly initiatives promote mobility care
JAHF is actively working with its grantees and partners to reduce death and harm from falls by promoting a focus on mobility. We encourage others to join us by participating in the following initiatives:
Age-Friendly Health Systems – an effort led by JAHF and the Institute for Healthcare Improvement, in collaboration with the American Hospital Association, The Catholic Health Association of the United States, and numerous other partners – promotes evidence-based, age-friendly care through the 4Ms Framework: what Matters, Medication, Mentation, and Mobility. Age-friendly care starts by encouraging older adults to talk to their families and friends about their health goals and priorities, and to share those with their health care teams. Age friendly care focuses on mobility to ensure that older adults move safely every day to maintain function and do What Matters to them. This includes assessing and acting on any medications that might hinder mobility or create circumstances prone to falls and addressing mentation (depression, delirium, dementia) to improve balance and strength.
The Age-Friendly Health Systems initiative and its 4Ms Framework have expanded to encompass over 4,000 practices, convenient care clinics, nursing homes, and hospitals nationwide. Health care teams can join seven-month Action Communities at no charge to receive coaching and learn from peers on how best to implement the 4Ms Framework. AHA is facilitating an Action Community right now that health care teams can join. IHI will start another Action Community in March 2025.
The Age-Friendly Health Systems initiative also produces resources that are freely available related to the 4Ms. IHI recently released an Insights blog, "Rethinking Mobility to Improve Care for Older Adults," and a corresponding toolkit with details on Age-Friendly Mobility Assessment Tools. The blog emphasizes the importance of mobility in promoting a healthy and independent life, highlighting its crucial role in age-friendly care. The related one-page collection of age-friendly mobility assessment tools is provided to evaluate mobility across various care settings. The publication advises selecting tools based on their ability to assess mobility comprehensively, rather than solely focusing on fall prevention. It also suggests considering factors such as the target population and practical aspects of administering the tests.
WebMD, in collaboration with JAHF, has also produced a series of articles and videos for the public focusing on the 4Ms of age-friendly care that can be found at webmd.com/agefriendly. They are designed to empower older adults and family caregivers, providing practical guidance on managing health as we age. One recent addition to this series includes a video specifically addressing mobility care, offering insights and strategies for safe mobility, navigating environments, and preventing falls.
In addition to these videos, the Geriatrics Workforce Enhancement Program (GWEP) offers ongoing age-friendly care resources. These resources, freely available through GWEP sites' federally funded projects, include specialized webinars, online trainings, modules, and support groups designed to enhance skills in mobility care for older adults, family caregivers, and healthcare providers. The GWEP Coordinating Center (GWEP-CC) at the American Geriatrics Society plays a central role in gathering and promoting these resources to support comprehensive care practices.
The U.S. Department of Veteran Affairs has been another leader and innovator in providing age-friendly care to older veterans. One example is Gerofit, which is an exercise initiative designed to enhance the health and well-being of Veterans. The program has been shown to significantly improve physical and mental functions among participants. Gerofit provides Veterans with opportunities to maintain active lifestyles through diverse activities including strength training, aerobic exercises, tai chi, dancing, walking, and balance exercises in group settings. Each Veteran receives a personalized exercise plan, supported by trained exercise professionals such as physiologists, nurses, or physical therapists who guide them through the program. Founded in Durham in 1986, Gerofit is now available at 33 VA Healthcare Systems nationwide and it provides a model for care settings within and outside the VA.
Engage in age-friendly initiatives and advance Healthy People 2030 objectives
In addition to clinicians and the public using the above resources from the Age-Friendly Health Systems initiative, WebMD.com/agefriendly, the GWEPs and the VA, state and local health departments, along with other public health organizations and practitioners, are encouraged to engage with the Age-Friendly Public Health Systems initiative. We encourage all public health professionals to utilize its tools, attend monthly virtual trainings, and consider joining the Age-Friendly Public Health Systems Recognition Program.
JAHF proudly supports Healthy People 2030 and invites others to join efforts in fostering conversations about health and priorities. Begin by exploring Healthy People 2030 objectives relevant to your work, participate in grant initiatives, use available resources and share your progress towards achieving Healthy People 2030 goals with us.
Learn more and apply to become a Health People 2030 Champion
Register for the upcoming National Healthy Aging Symposium on September 26, 2024.
Special thanks to Kiran Raja for co-authoring this article.
This article was originally published on LinkedIn by senior program officer Jane Carmody.