We have all heard the adage about growing old that, "as long as you have your health, you have everything." Yet many factors-by themselves or in combination-including lack of awareness and knowledge, inadequate education and financial resources, poor lifestyle choices, to name a few, can result in unhealthy aging.
In my view, aging well is a combination of good health, continuing functional and cognitive abilities, and access to a range of resources that enable independent living. What does it take to support not just the concept, but also the reality of aging well? Whose responsibility is it? Because we are an aging society, how do we find the resources to move toward a nation of healthy elderly? There is, of course, no one answer: it takes individual responsibility, family effort, school and community programs, public policy, and allocation of adequate funds. The U.S. Department of Health and Human Services is taking steps to effect programs and policies that facilitate prevention with some success. 1 It is a move toward progress and one that requires both caring and commitment.
We are seeing a proliferation of health-related prevention programs because the importance of effective services aimed at preventing disease and decline is shown to save lives and costs. 2 Another area of activity is the management of conditions that impact not only the lives of the affected older adult but also family and other caregivers. However, these efforts require consistent, meaningful, and relevant education and the support of a community in which older adults can thrive.
Health promotion for older adults takes many forms and many formats. This issue of Family and Community Health illustrates the diversity of interests, research, models, and venues that focus on those who are aging in the community.
The eight articles in this issue share several themes. The first two articles look at how the broader community can be measured as an environment friendly to healthy aging. Burdine and colleagues postulate measures for rating the readiness for a community's capacity to improve the health of its residents. Feldman and Oberlink, who discuss the results of focus groups testing the development of indicators to determine the level of "elder friendly communities," take a different approach in their pilot project.
Two articles address specific, individual conditions. LaFramboise and her colleagues describe a pilot project testing ways to best monitor cardiac problems in the home. Williams' article discusses the issues of reaching and treating African Americans of all ages including older adults with HIV/AIDS and raises the special problems experienced by this community. Outreach to African American and Hispanic women for breast cancer screening is the focus of Kiger's article on working with multiethnic, multicultural, and multilingual women. She presents a model using combination of bilingual, multi-ethnic staff and volunteers.
Two additional articles focus on those who take care of older adults and the importance of keeping them well. Kaye et al. present their project supporting family caregivers, while Cotter and colleagues discuss a training program for home aides working with dementia patients. The final article presents yet another description of community involvement facilitating healthy aging. Lubben and Damron-Rodriguez have developed four community models focusing on health from a global perspective. Hopefully readers will appreciate the breadth of programs needed to improve the health and well-being of older adults in the community. Only a few were presented in this issue, and much more is yet to be accomplished.
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