Public health initiatives, from promoting vaccines and family planning to ensuring safe drinking water, have effectively improved the health and quality of life of all people living in the United States. As the nation addresses the COVID-19 epidemic, the important role of public health science, polices, and interventions is becoming increasingly clear. The profound impact COVID-19 has had on older populations has drawn our attention to the impact that mitigation interventions have had on social isolation, safety, and access. Disparities in outcomes and suffering from COVID-19 have been particularly prominent among Black and Latino communities and American Indian and Alaska Native Tribes, and the burden has been even greater in these populations for those who are older.1 The pandemic has drawn national attention to a number of societal inequities and shortcomings that we may now have the ability to address. Creating a culture of healthy aging for all is one of those imperatives. Public health agencies can use their authority through policies and regulations designed to protect these groups and can leverage their influence in government and society to address issues that are outside the immediate realm of public health. In this commentary, we discuss specific approaches public health officials and agencies can take to develop a culture of healthy aging in our communities, creating positive health outcomes for all older adults.

1. Enact and advocate for healthy aging policies. Public health leaders have both authority and influence on policy decision making.2 In ASTHO's Essential Policies for Chronic Disease Prevention and Control and in the Healthy Aging Policy Statement, there are recommendations for policies that can both prevent poor outcomes in older adulthood and support quality of life among older adults, such as the adoption of community design policies to ensure infrastructure is conducive to all ages or strengthening preparedness plans to ensure it addresses the unique needs of older adults.1,2 Public health leaders, such as state, territorial, and local health officials, may be able to implement and promote policies as part of their existing authority. This could include promoting long-term care benefits and flexible work hours for employees reaching older adulthood and for those providing care to someone aging with a chronic condition and/or disability. For other policies, public health leaders can leverage their influence by building relationships and partnering with agencies that work in aging, social services, city planning, and other sectors that impact older adults to collectively work toward policy development and implementation.

2. Integrate aging and public health plans. Public health leaders are encouraged to work with leaders in agencies that serve older adults to integrate jurisdiction-wide public health plans with jurisdiction-wide aging plans to identify overlapping strategies and opportunities to prevent poor health outcomes. State, territorial, and local health departments have led the way by assessing the state health improvement plan (SHIP), state plan on aging, state Alzheimer disease plan, jurisdiction-wide strategic plans, emergency preparedness plans, and/or other plans informed by HHS's Healthy People objectives. There are several frameworks available to aid in integrating aging and public health plans, including Trust for America's Health's Age-Friendly Public Health Systems, the Alzheimer's Association and CDC's Healthy Brain Initiative Road Map Series, and AARP's Network of Age-Friendly States and Communities (a part of the World Health Organization's Global Network for Age-Friendly Cities and Communities). The forthcoming updated Public Health Accreditation Board requirements will include standards and measures specific to healthy aging. State and local health departments seeking accreditation or re-accreditation will need to ensure their organization is well suited to identify ongoing efforts to address the unique needs of older adults.3-5

3. Inclusion of aging in public health communications. A key role of every public health leader is telling the story of public health, and it is important that these stories include narratives of older adults and promote age-friendly policies and programs. As public health practitioners address prevention across the life span, they must consider all public health issues through an aging perspective. Chronic disease directors have developed innovative messaging for health topics such as heart disease and stroke prevention featuring positive images of older adults and promoting data and findings specific to the older adult population. These efforts provide an opportunity to promote a positive view of aging and build capacity of the public health workforce to address the well-being of older adults and their caregivers. Public health agencies are suited to apply that perspective now by identifying the unique needs of older adults for COVID-19 vaccine distribution and updating emergency preparedness plans with lessons learned from the COVID-19 pandemic response.

A culture of healthy aging will vary by jurisdiction but should ultimately underscore the value every person brings into helping communities to thrive. While it is important to take a life course perspective to promote health from an early age and support quality of life into older adulthood, it is also critical that health agencies apply a specific perspective to older adults as a population group throughout all public health areas of practice. Aging is a privilege developed through centuries of health advancements. Given the many challenges facing the nation, it is more critical now than ever for state and territorial agencies to collaborate on creating a culture of healthy aging and in supporting quality of life for all older adults.

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