ViewpointsHeader_400Recently, I had the privilege of discussing issues important to the John A. Hartford Foundation on The Ohio State University’s podcast, Viewpoints of Innovative Health Care Leaders.

It was a great opportunity to talk about the key trends we see in health care today, what still needs to be done, the impact of the Affordable Care Act on aging, and how the Hartford Foundation is seeking to address these issues. The biweekly podcast provides a forum for leaders in the field to share the best evidence-based practices and emerging thoughts in health care.

It is hosted by Bernadette M. Melnyk, PhD, RN, associate vice president for health promotion, university chief wellness officer, and dean of The Ohio State University College of Nursing. I’d like to thank Bernadette, who was dean of the Arizona State University College of Nursing and Health Innovation when it became a Hartford Center of Gerontological Nursing Excellence, for inviting me on the program. You can listen to the podcast by visiting Viewpoints of Innovative Health Care Leaders. The full interview is about 15 minutes, and is divided into five sections by topic.

Corinne H. Rieder, PhD, executive director and treasurer, John A. Hartford Foundation Corinne H. Rieder, PhD, executive director and treasurer, John A. Hartford Foundation

Today, I’d like to share some of the main points we discussed. First, the good news. Here are a dozen positive trends we have seen in aging and health in recent years:

  1. There has been a significant reduction in mortality due to new medicines, better procedures, and earlier detection and prevention. For example, 40 years ago, 95 percent of children with leukemia died. Today, only 5 percent do, so more children will live to old age. And mortality from heart disease is down 63 percent, which translates to 1.1 million deaths prevented every year.
  2. There are more trained health care professionals in nursing, social work, and medicine who have the knowledge and skills to care for older adults. Competencies and curriculum have been developed in geriatrics (such as these for medical students), and, more generalists also know more about geriatrics.
  3. More funds in recent decades are going to biomedical research.
  4. More attention is being paid to medication management.
  5. The new field of palliative care, which focuses on relieving pain and other symptoms of chronic conditions at any stage of illness, has developed and is increasingly available. And hospice, which promotes comfort near the end of life, also continues to grow.
  6. Major strides have been made in the use of information technology—including electronic health records—and the development of new technologies, especially mobile and telehealth, which in the next decades will bring about even more dramatic changes to health care.
  7. Innovative models—developed with private sector, foundation, and government funding—are delivering better health care in more cost-effective ways to older people.
  8. There are greater efforts to design environments—recreational, commercial, and residential—that are more age-friendly.
  9. More attention is being given to improving health literacy. For example, the Centers for Disease Control (CDC) has created a Health Literacy website to help health professionals make health information and services understandable for everyone regardless of their literacy skills.
  10. Since Hurricane Katrina, more effort is going to protect vulnerable older adults in emergencies such as national disasters, especially those who are in institutions such as nursing homes and hospitals.
  11. Efforts are increasing to protect and promote health among older adults by identifying key health indicators, setting goals, and reporting on their attainment. For example, a recent CDC study reports on 15 indicators of older adult health and functional status. Taken together, these indicators are beginning to present a more comprehensive picture of the health of older adult health in the U.S. (Read The State of Aging and Health in America 2013 for more information.)
  12. The public is also being better informed about aging and health issues through the media. Over the past decade, there has been a significant increase in aging-related health and retirement content in magazines, newspapers, books, television, and, of course, on the web. Additionally, the Hartford Foundation and others have made an effort to better understand the views and needs of older adults through polling.

As much progress as we have seen, a lot of work still needs to be done. Here are six areas that stand out for me where we need to increase our efforts:

  1. Provide better and more cost-effective care in our communities, homes, clinics, and hospitals. In short, we need to continue to develop, test, and disseminate better models of care. Of special importance is the need to integrate long-term services and supports with health care. This is a need that Hartford and a few other foundations are working to address collaboratively with the U.S. Administration for Community Living.
  2. Despite the efforts of foundations and government agencies, we still do not have enough specialists in geriatrics in nursing, social work, medicine, pharmacy, and other areas, nor do our country’s generalists and other specialists have the needed knowledge and skills to care for older adults.
  3. As a society, we have not paid sufficient attention to the needs (training, a living wage, and respite) of our country’s caregivers, both direct care workers and family members who care for their loved ones.
  4. We need to continue to develop and promote measures, standards, and health information technology that support appropriate care for older adults, especially for those with multiple chronic conditions and complex medical and social needs.
  5. More attention needs to be given to the area of long-term care.
  6. Ageism is still a crucial fact in people thinking about older people.

At the Hartford Foundation, we believe that with an aging population and rapidly changing health care delivery system, our work is more important than ever. So while it’s important to recognize the real progress that has been made in recent decades, we will continue to focus on our core mission of working to improve the health of older Americans.