This book explains how to promote and prolong “healthy ageing,” which constitutes maintaining daily functioning and well-being until the end of life. In this context, the editor of the book and the international team of authors, all of whom are experts on the various aspects of ageing, demonstrate the value of this new approach in clinical practice. The systematic integration of a functional assessment, if not a complete and comprehensive geriatric assessment, is fundamental in daily clinical practice. Identifying risk factors at midlife will help to promote health at any age. Moreover, randomized control trials are making it increasingly clear that interventions could help ageing and elderly adults enjoy their remaining years without disability. Indeed, wellbeing will also increase, allowing elderly adults to stay independent until a very advanced age. The book also shows how considerable societal benefits can be easily forecast when more lifetime is spent without disability, followed by a dignified end of life. This book will be of interest to all medical doctors, general practitioners and organ specialists as well as geriatricians who want to have a complete overview of what healthy ageing means.

This report focuses on preventing potentially disabling conditions from developing into disabilities and on minimizing the effects of such conditions on a person's productivity and quality of life. It describes disability as a social and public health issue and not just a physical condition. The report begins with an executive summary, an introduction which discusses prevention issues in general and defines concepts, and a list of 27 recommendations. Subsequent chapters discuss: (1) the magnitude and dimensions of disability in the United States; (2) a conceptual approach to disability prevention and use of the tools and principles of epidemiology; (3) major areas of disability (developmental disabilities, injury-related disabilities, chronic diseases and aging, and secondary conditions associated with primary disabling conditions); (4) government and private sector programs concerned with disability prevention; and (5) conclusions and recommendations in the areas of a national program for the prevention of disability, surveillance, research, access to care and preventive services, and professional and public education. Appendixes contain a paper by Saad Z. Nagi titled "Disability Concepts Revisited: Implications for Prevention"; a statement of one committee member dissenting from this majority report of the Committee on a National Agenda for the Prevention of Disabilities; a response to the dissenting statement by committee members; and committee biographies. (Approximately 375 references) (JDD)

This Open Access book highlights the ethical issues and dilemmas that arise in the practice of public health. It is also a tool to support instruction, debate, and dialogue regarding public health ethics. Although the practice of public health has always included consideration of ethical issues, the field of public health ethics as a discipline is a relatively new and emerging area. There are few practical training resources for public health practitioners, especially resources which include discussion of realistic cases which are likely to arise in the practice of public health. This work discusses these issues on a case to case basis and helps create awareness and understanding of the ethics of public health care. The main audience for the casebook is public health practitioners, including front-line workers, field epidemiology trainers and trainees, managers, planners, and decision makers who have an interest in learning about how to integrate ethical analysis into their day to day public health practice. The casebook is also useful to schools of public health and public health students as well as to academic ethicists who can use the book to teach public health ethics and distinguish it from clinical and research ethics.

The future of disability in America will depend on how well the U.S. prepares for and manages the demographic, fiscal, and technological developments that will unfold during the next two to three decades. Building upon two prior studies from the Institute of Medicine (the 1991 Institute of Medicine's report Disability in America and the 1997 report Enabling America), The Future of Disability in America examines both progress and concerns about continuing barriers that limit the independence, productivity, and participation in community life of people with disabilities. This book offers a comprehensive look at a wide range of issues, including the prevalence of disability across the lifespan; disability trends the role of assistive technology; barriers posed by health care and other facilities with inaccessible buildings, equipment, and information formats; the needs of young people moving from pediatric to adult health care and of adults experiencing premature aging and secondary health problems; selected issues in health care financing (e.g., risk adjusting payments to health plans, coverage of assistive technology); and the organizing and financing of disability-related research. The Future of Disability in America is an assessment of both principles and scientific evidence for disability policies and services. This book's recommendations propose steps to eliminate barriers and strengthen the evidence base for future public and private actions to reduce the impact of disability on individuals, families, and society.

Social isolation and loneliness are serious yet underappreciated public health risks that affect a significant portion of the older adult population. Approximately one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and a significant proportion of adults in the United States report feeling lonely. People who are 50 years of age or older are more likely to experience many of the risk factors that can cause or exacerbate social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and sensory impairments. Over a life course, social isolation and loneliness may be episodic or chronic, depending upon an individual's circumstances and perceptions. A substantial body of evidence demonstrates that social isolation presents a major risk for premature mortality, comparable to other risk factors such as high blood pressure, smoking, or obesity. As older adults are particularly high-volume and high-frequency users of the health care system, there is an opportunity for health care professionals to identify, prevent, and mitigate the adverse health impacts of social isolation and loneliness in older adults. Social Isolation and Loneliness in Older Adults summarizes the evidence base and explores how social isolation and loneliness affect health and quality of life in adults aged 50 and older, particularly among low income, underserved, and vulnerable populations. This report makes recommendations specifically for clinical settings of health care to identify those who suffer the resultant negative health impacts of social isolation and loneliness and target interventions to improve their social conditions. Social Isolation and Loneliness in Older Adults considers clinical tools and methodologies, better education and training for the health care workforce, and dissemination and implementation that will be important for translating research into practice, especially as the evidence base for effective interventions continues to flourish.

As the first of the nation's 78 million baby boomers begin reaching age 65 in 2011, they will face a health care workforce that is too small and woefully unprepared to meet their specific health needs. Retooling for an Aging America calls for bold initiatives starting immediately to train all health care providers in the basics of geriatric care and to prepare family members and other informal caregivers, who currently receive little or no training in how to tend to their aging loved ones. The book also recommends that Medicare, Medicaid, and other health plans pay higher rates to boost recruitment and retention of geriatric specialists and care aides. Educators and health professional groups can use Retooling for an Aging America to institute or increase formal education and training in geriatrics. Consumer groups can use the book to advocate for improving the care for older adults. Health care professional and occupational groups can use it to improve the quality of health care jobs.