Tag Archives: Diana Kingsbury

Can the Arts Promote Health-Related Quality of Life in Australia?

As the global population ages, it is important to start designing strategies to address quality of life among older adults. The World Health Organization defines health as “a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” Designing programs and policies to encourage quality of life across the age spectrum should not focus solely on addressing health issues as they arise, but rather promoting positive ways of living that can impact health in all realms – physical, mental, and social – throughout one’s life.

Strategies for healthy aging should include promoting activities that foster both individual growth and community participation. One such option is participation in the arts, which has shown to have a positive impact on both the individual and society.

Studies have shown that participating in visual arts, music, dance, drama, storytelling, etc. can improve mental and physical well-being, provide increased opportunities for friendship and meaningful social contact, foster a sense of social cohesion between different age groups, and break down stigmas associated with aging.

In Australia, several initiatives have been put in place to encourage “creative ageing,” which is defined as “the utilisation of the arts to excite imagination and support older people to age well.” For example, creative ageing was included in the Eastern Australian state of New South Wales’ Ageing Strategy, where community-based organizations such as the Creative Ageing Centre and Institute for Creative Health were established to encourage older adults to engage in the arts.

Results from the 2014 report titled Arts in Daily Life: Australian Participation in the Arts showed that participation in the arts increased from 41 percent to 48 percent since community arts centers became part of health policy. Among adults aged 55-64, participation increased from 36 percent to 44 percent.

The number of Australians aged 65 and over is expected to increase to 6.2 million by 2042, up from an estimated 3.4 million in 2014. Australia’s population is ageing. Now, more than ever, is the time to think creatively about aging and how these innovative strategies can have positive effects beyond for both the individual as well as society as a whole.

Diana Kingsbury is a doctoral student and graduate assistant in prevention science at Kent State University College of Public Health.

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Does Participation in Organized Sports Help Australia’s Older People?

With the conclusion of the Summer Olympics last month, there is an opportunity to reflect on the accomplishments and physical prowess of the athletes who competed. Sports and wellness are important for the human body especially given the decreasing participation rates in physical activity and increasing rates of chronic disease worldwide.

While the benefits of regular participation in physical activity on both physical and mental health have been widely established, participation rates remain low among older adults. It has been shown that participation in organized sports typically peaks in early adulthood and steadily decreases as a person ages. In addition, when viewed in light of gender, men typically report higher levels of participation in sport compared to women, regardless of age.

In Australia, the participation rate in organized sports among older adults is estimated at around 6.8 percent for males aged 55 to 64 and 8.9 percent among females 55-64. Among men 65 and older, participation in sport is estimated around 9.1 percent for men and 8.9 percent for women. Though rates are low, the benefits of regular participation in sports for older adults have been identified. In a 2012 cohort study, it was shown that older adults who participated in popular organized sports experienced a 20-40 percent reduction in all-cause mortality compared with older adults who did not participate in sports. Social benefits of participation in organized sports also include decreased feelings of isolation and reports of stronger support systems, two important contributors to quality of life in older adults.

The benefits of participation in organized sports are many, however, it is important to address potential barriers that might prevent an older adult from getting involved. While one third of older adults who report they are physically active are participating in organized sports in some form, older adults who are not commonly report lack of time, lack of opportunity, and physical limitations as reasons why they do not. It has been acknowledged within Australia that creating more opportunities for older adults to participate in organized sports through targeted programming should be a priority.

There is an opportunity to engage older adults both physically and socially through organized sports. Perceived barriers should be addressed to make physical activity through organized sports accessible to older adults.

Diana Kingsbury is a doctoral student and Graduate Assistant in Prevention Science at Kent State University College of Public Health.

Health Profile of Older Adults in Tasmania

Photo Credit: Stefano Lubiana
Photo Credit: Stefano Lubiana

Tasmania (Pop. 517,000) is an isolated island located off Australia’s Southern Coast. It is the smallest of six states in Australia, with an area of about 26,410 square miles. When considering the demographic makeup of Tasmania compared to Australia as a whole, Tasmania has the second oldest population (after South Australia), where 18.4 percent of the population is aged 60 years and over. However, when compared to other Australian states and territories, the Tasmania’s population is aging more rapidly than any other state.

Recent estimates projected the majority of population growth in Tasmania to occur in older age groups over the next 10 years. By 2019, it is expected that Tasmania will have the oldest population in Australia, where roughly 25 percent of the population will be 60 years and older. Such estimates help society to understand and respond to the needs of older adults living in Tasmania, ensuring that elders maintain good health and positive aging experiences.

In the Health Indicators Tasmania 2013 report, people aged 60 and over reported high levels of social support. 75.7 percent of seniors reported that they were in good, very good or excellent health and few (9.0 percent) reported that they currently experienced very high or high levels of psychological distress.

Of the health issues of concern, arthritis ranked highest, with 52.8% of Tasmanians aged 60 and older self-reporting they had been diagnosed with arthritis, followed by cataracts at 28.6%, depression/anxiety at 19.1%, heart disease at 18%, and cancer at 17.2%. In terms of behaviors that can improve personal health, 96.1% of older adults reported they had received a blood pressure screening in the past 2 years, 82.3% reported they had received a cholesterol check, and 76.5% reported they had received a diabetes test. Of the screenings that were reported, only 38.7% reported they had received a bowel cancer screening, which could be a target for future public health action. When reporting fruit and vegetable consumption, smoking status, and alcohol consumption, older adults were more likely to report they consumed fruits and vegetables, were less likely to smoke, and less likely to consume alcohol when compared to other segments of the adult population.

It is important to consider, however, how these indicators may vary by region within Tasmania, and also, how the health of younger segments of the adult population may impact their future health as older adults.

Diana Kingsbury covers Australia for Global Health Aging. She is a doctoral student and Graduate Assistant in Prevention Science at Kent State University College of Public Health.

Strategies to Promote Positive Aging in New Zealand

 Photo Credit: Dunedin Public Libraries

Photo Credit: Dunedin Public Libraries

Much like elsewhere in the Western world, the population in New Zealand is aging; the number of people over 65 has doubled since 1980, and is expected to double once again by 2036. This increase in the aging population is largely the result of a rising life expectancy, as it is estimated that the average individual in New Zealand now lives up to 81.16 years of age – an increase from 78.64 years since 2000.

It is therefore important, now more than ever before, to promote strategies that improve quality of life among the aging. Creating policies that promote health across the life-span can enhance the physical, social, and functional mobility of the aging, and could have far-reaching positive impact.

One such strategy, as described by the Centers for Disease Control and Prevention, is Aging in Place, which refers to “the ability to live in one’s own home or community safely, independently and comfortably, regardless of age, income or ability level.” Research shows that aging in place is linked to health and emotional benefits, and the opportunity for families, governments, and health systems to make considerable cost savings, as compared to placing older people in traditional institutional care.

In an attempt to support these strategies, the Ministry of Social Development in New Zealand created the New Zealand Positive Ageing Strategy in 2001, which seeks to promote “a society where people can age positively, where older people are highly valued, and where they are recognized as an integral part of families and communities.” The Positive Ageing Strategy promotes ten goals to improve the quality of life of older adults, including:

  • Improved Health: Promoting equitable, timely, affordable, and accessible health services for older people.
  • Aging in the Community: Ensuring older people feel safe and secure, and can age in the community.
  • Opportunities for Growth: Increasing opportunities for personal growth and community participation for older adults.

According to a 2015 annual report about the Positive Ageing Strategy, there have been many successes in implementing this policy. These include an increase in the number of senior health programs as well as movement toward increasing the number of health care workers available and trained to care for the aging.

There has been additional success in providing elder abuse and neglect prevention services, providing support to those who serve as caregivers for the elderly through the New Zealand Carers’ Strategy Action Plan, and presenting local solutions to combat social isolation.

Finally, strides have been made to connect older and younger people to promote understanding between age groups; implement positive aging strategies in local communities; and provide opportunities for older people to advocate for their needs and well-being within the government.

With a projected rise in the aging population over the next couple of decades in New Zealand, promoting  policies that support aging in place can have a significant positive impact on the quality of life of the aging.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at Kent State University College of Public Health.

The Health Plight of Older Refugees in Australia

Since World War II, Australia has taken in an estimated 675,000 refugees and is ranked among the world’s top countries for refugee resettlement. As of 2015, there were 35,582 refugees living in Australia.

Photo Credit: migrationmuseum
Photo Credit: migrationmuseum

Classified by the United Nations as someone who “owing to a well-founded fear of being persecuted for reasons of race, religion, nationality, membership of a particular social group or political opinion, is outside the country of his nationality, and is unable, or owing to such fear, is unwilling to avail himself of the protection of that country,” a refugee faces a plethora of stresses – many even after resettlement – that adversely affect his health and well-being.

Increased risks for infectious and chronic diseases, post-traumatic stress disorder, and difficulties accessing necessary health-related services are some of the widespread effects of living in refugee settlements, being exposed to war or persecution and learning to navigate foreign cultural contexts. These effects are significantly exacerbated in older refugees.

In Australia, there are two categories of older refugees – individuals who were over the age of 60 upon resettlement, and individuals who resettled as young people and aged in Australia. While data is limited, some studies have shown that older refugee populations fare worse than their native counterparts.

Specific health conditions identified as a concern for older refugees include age-related memory problems, psychological health status, physical health needs, and social isolation. While these problems may seem related to elders in general, their effects are particularly pronounced among refugees.

To add to this issue, the health needs of the elderly in times of conflict are also often overlooked. The United Nations High Commissioner for Refugees explains that “lack of mobility, weakened vision and chronic illnesses such as arthritis and rheumatism (issues typically face by older adults) can make access to support difficult, and aid services often do not take these issues into consideration.”

The crisis that compels individuals to seek asylum and resettlement in other countries are often physically, mentally, and emotionally traumatic. Elderly individuals often suffer great upheaval and are at greater risk of experiencing social isolation and separation from family upon their displacement.

We are at a point in history where we are seeing the largest number of refugees ever since World War II. In order to address the needs of older refugees in Australia as well as elsewhere in the world, it is crucial that policy makers consider refugees as a distinct group in need of specific services that are unique from the rest of the population. It is also important to consider the needs of refugees across their entire lifespans and across stages of resettlement.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at Kent State University College of Public Health.

Homelessness Among Older Women in Australia

Photo Credit: Michael Coghlan
                                                                                 Photo Credit: Michael Coghlan

According to the 2011 Australian Census, 36 percent of the older homeless population comprises of women. While men are more likely to experience homelessness across their lifespans in Australia, women are more likely to first experience homelessness after the age of 50. Issues of homelessness among older women in Australia have been described as a symptom of entrenched social and economic issues that compound, and then implode later in life. Financial disadvantages, often caused by poor educational opportunities and/or work history may be setting the stage for homelessness among older Australian women.

Other factors influencing this problem include pay gaps between men and women (which have been noted to be as high as 17-18 percent over the span of a career), poor superannuation savings for retirement, domestic problems (such as divorce, separation, or domestic violence), personal health crises, and a lack of affordable housing. Due to many of these factors, women are more likely to experience poverty than men, which in turn can cause homelessness. These challenges are unique to women, and potential solutions may lie in addressing the structural inequalities that put women at risk in the first place.

The cost of housing has also been cited as a contributing problem, where both affordability and availability can be a challenge. Across the Australian continent, nearly 500,000 low-and moderate-income earners are unable to buy or rent homes. Women at or nearing retirement age seem to be making up a growing subsection of this demographic.

Relationship breakdowns also contribute to homelessness, as they often leave financially dependent women in a vulnerable position. According to the Housing for the Aged Action Group, 70 percent of the women seeking assistance from their organization are women living in poverty as a result of a relationship breakdown. Many of the women at risk of homelessness are facing these challenges for the first time in their lives.

The implications for homelessness among older adults can be far reaching. Older adults who experience homelessness likely do not have access to the physical and mental healthcare that is essential for healthy aging. Older homeless adults may also be at an increased risk for premature mortality. A study conducted in the U.S. found life expectancy among the homeless population to be 10 or more years shorter than the general population.

In global studies of homelessness among the aging, it has been found that contributing factors to this problem tend to be a reflection of structural issues (such as fewer job opportunities or poor housing availability) more so than personal risk factors (such as mental illness or substance abuse). In general, more work needs to be done to identify the potential causes and subsequent risks for homelessness among older adults. As a whole, there is an urgent need to advocate for preventative structural measures that can mitigate the risk of vulnerability among older adults in Australia, as well as elsewhere in the world.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Dementia Among the Aging in Australia

For Australians aged 65 and older, dementia has been identified as the third leading cause of disability and its prevalence is expected to rise as the population ages. Among this age group, roughly nine percent are living with dementia and among those aged 85 and older, the percentage increases to nearly 30 percent. As a disorder, the risk for dementia increases as an individual ages and it is expected that cases may increase to as many as 900,000 among older adults in Australia by the year 2050.

Photo Credit: Pixabay
                                                                                 Photo Credit: Pixabay

Dementia is not considered a single specific disease, but rather describes a series of symptoms associated with more than 100 different diseases.The symptom most commonly associated with dementia is impaired brain function, which often manifests as problems with language, memory, perception, personality, and/or cognitive skills. Typically, the decline in brain function that is the hallmark of dementia is significant enough to create challenges in daily living.

In Australia in 2010, dementia was the third leading cause of death overall and among adults aged 65 and over, it was the leading cause of morbidity. From a structural perspective, there are many barriers to the provision of quality care for older adults living with dementia in Australia. It has been estimated that by the year 2029, there could be a shortage of more than 150,000 caregivers for those living with this disorder – a bleak prospect when considering the projected rise in those diagnosed. Additionally, it is estimated that the costs of care to the healthcare system associated with dementia will arise and reach nearly one percent of Australia’s GDP in the next 20 years.

Among Australia’s indigenous groups, the risk for dementia is higher than the general population. Research has suggested that the prevalence of dementia among “remote and rural indigenous people” could be nearly four to five times higher than the general population. For individuals aged 45 and older among indigenous groups, dementia prevalence was 12.4 percent compared to 2.6 percent compared to 2.6% in the broader Australian population. Research has also shown that among indigenous groups, dementia tends to be higher among males while the rate is generally higher among females in the overall population.

The Australian government has recognized the importance of addressing dementia risk among the aging population. In 2012, the Australian Health Ministers included dementia as the ninth National Health Priority Area and it is the newest health issue to be added. By including dementia as a priority area, it is recognized as a significant issue of concern for the Australian population and allows for more concerted, focused efforts to combat its effects. Continued efforts and prioritization will be necessary to ensure older adults in Australia, particularly those living with dementia, may continue to age while experiencing improved quality of life.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

The Impact of Sleep Disorders Among the Elderly

Getting adequate sleep is a very common recommendation for achieving and maintaining good health. Insufficient sleep has been linked to a variety of chronic diseases (such as diabetes and heart disease) as well as unintentional injuries (such as motor vehicle accidents and workplace injuries). Poor sleep quality can also contribute to other issues that affect quality of life such as irritability, depressive symptoms, and inability to focus and stay on task.

Photo Credit: Pedro Ribeiro Simões
Photo Credit: Pedro Ribeiro Simões

The global adult population in general experiences a high prevalence of insufficient sleep, with some variation in terms of age, gender, and socioeconomic status. Among the elderly, however, the prevalence and subsequent effects can be especially pronounced. While it is not clear if this increase in prevalence of disrupted sleep and sleep disorders is due to aging itself or co-morbid conditions associated with aging (i.e, chronic pain, dementia), it is important to consider the impact such conditions have on the elderly.

It has been noted that common sleep disruptions among the elderly include trouble falling asleep, snoring, sleep apnea, insufficient time spent in deep sleep, rising early, and achieving fewer hours of sleep each night. The implications for sleep disruptions within this demographic can include a 2 to 3 times increased risk of stroke and mortality.

In considering the impact of sleep disorders among the elderly in the Americas, a study conducted in the Dominican Republic, Peru, Venezuela and Mexico found that 23-31% of older adults aged 65 to 80+ years experienced sleep disruptions. The prevalence appeared higher among women than men. In comparison to previous studies, it was found that among individuals aged 40 and older in Uruguay, Chile, and Venezuela, 34.7% reported trouble falling asleep. Previous findings have also included reports that 25% of individuals aged 18-77 years old in Buenos Aires, Sao Paulo, and Mexico City reported being moderately or severely impacted by sleep problems, with severity increasing with age.

To address sleep disruption among the elderly, it is important that health care providers, community support systems, and social support systems work with the aged to ensure they are experiencing the best quality of life possible. This includes working with the elderly to achieve optimal sleep.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

The Risk of Smoking is Not Just for the Young

It is well-known that smoking and tobacco use are among the leading causes of preventable disability and death worldwide. Efforts to promote smoking cessation have featured prominently on the public health agenda, though rates continue to remain high in many parts of the world. An often under-looked segment of the population that needs access to information about smoking cessation is senior citizens.

Photo Credit: Pixabay
Photo Credit: Pixabay

Like other age demographics, the elderly experience significant health risks associated with smoking. However, in addition to traditional concerns such as increased risk for lung cancer, heart disease, respiratory disease, and many others, older adults also experience risks that are specific to aging. Elderly who smoke are at risk for developing cataracts (the leading cause of blindness worldwide), loss of bone density among postmenopausal women, and increased risk for diminishing cognitive capabilities associated with dementia and Alzheimer’s disease.

Tobacco users over the age of 65 have smoked longer than younger age groups, thus putting them at increased risk for detrimental health effects. It is possible that older adults are less likely to be aware of the potential health risks associated with smoking. A lack of awareness about the negative health effects of smoking may decrease the likelihood of quitting and lead to fewer quit attempts. Also, social issues associated with aging such as life stress, social isolation, and lack of community infrastructure to support positive aging can influence the likelihood that elderly smokers do not quit.

In terms of global smoking rates among the senior citizens, high-income countries have a 10% higher prevalence than low- and middle-income countries. Within Latin America and the Caribbean, a study found that among older smokers in seven major cities (Buenos Aires, Mexico City, Santiago, Havana, Montevideo, Bridgetown, and Sao Paulo), current older smokers were more likely to be male, have begun smoking around the age of 17, and were more likely to smoke cigarettes than other types of tobacco. Smoking prevalence among the elderly was highest in Havana (31.8%), followed by Mexico City (16.5%), and Sao Paulo (15.8%). Promisingly, smoking rates steeply declined with age as the odds of smoking became 5.9 times lower among individuals over the age of 81.

It is important to consider that smoking is not just a young person’s habit. Efforts to reduce smoking among all age demographics, especially the elderly, should continue to be a vital consideration within the global public health community. Moreover, promoting smoking cessation and highlighting the significant health risks associated with smoking must persist across the life span.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.

Increasing Access to Oral Health Care for the Elderly

dentist

Oral health, which includes adequate care for teeth, gums, and mouths and screening for oral diseases, is an important contributor to health and well-being. Access to oral health services is necessary for oral health maintenance, but varies across the globe, as well as across age segments within the population. Globally, an increase in the aging population calls for a need to consider oral health among the elderly, an often-overlooked component of physical health. Among the concerns associated with poor oral health for adults are constrained food choice, weight loss, reduced chewing ability, diminished communication ability, low self-esteem, and decreases in self-reported quality of life. The World Health Organization (WHO) has called for a greater public health response to the oral health needs of the elderly. Included within this call to action are improved public health policies that target oral health, improved access to oral health services for older adults, and increased efforts to improve dental hygiene among older adults.

Poor oral health among the elderly typically manifests as high levels of tooth loss, dental caries, periodontal disease, xerostomia, and oral cancer. According to the global World Health Survey, approximately 30% of adults aged 65-74 years across the globe are impacted by complete tooth loss. When considering prevalence of tooth loss by demographic characteristics, this problem is particularly pronounced among individuals in the lowest economic strata living in low- and middle-income countries. In Latin American and Caribbean countries, it has been noted that the adult population is aging at “unprecedented rates”. It is estimated that the elderly population will increase by about 300% by 2050 in developing countries, particularly those in Latin America. While access to oral health services are high in developed countries, utilization among the elderly remains low. In developing countries, where access to care is diminished, elderly people report higher levels of oral health problems.

In the U.S., the Centers for Disease Control and Prevention (CDC) states that many oral diseases are common for older Americans who did not grow up with fluoridation, a process that has been shown to improve oral hygiene and health. Decreased access to dental insurance, low income, increased use of prescription drugs, and being disabled, home bound, or institutionalized are also contributing factors for diminished oral health among older Americans. It has been noted by the CDC that about 25% of adults 60 and older in the U.S. “no longer have natural teeth”, a phenomenon that varies state to state. To improve the quality of life of the elderly across the globe, oral health should be included in physical health assessments. Increased access to oral health care should also be advocated. Improvements to the oral health of older adults can contribute to improved quality of life and improved management of additional health concerns that are associated with aging.

Diana Kingsbury is a PhD student and graduate assistant in prevention science at the Kent State University College of Public Health.