From the Dean: A Better Future
Thanks to public health initiatives, the human lifespan is now an estimated 25 years longer than it was at the turn of the 20th century—but, as the cover of this issue of Findings suggests, we have not yet found a way to ensure that those years are good ones. For its 2012 World Health Day, the World Health Organization coined the phrase “Good health adds life to years.” This, to me, sums up one of our greatest challenges.
Shakespeare understood the downside of a too-long lifespan. In his famous “seven ages of man” speech in As You Like It, a morose Jacques describes the final phase of life as “second childishness and mere oblivion, sans teeth, sans eyes, sans taste, sans everything.” A spate of new books would seem to support this bleak view, among them Katy Butler’s Knocking on Heaven’s Door: The Path to a Better Way of Death and Jane Gross’s A Bittersweet Season: Caring for Our Aging Parents—and Ourselves. Both works provide first-person accounts of an experience all too common among my generation—that of caring for an elderly parent, or parents, who are suffering from catastrophic illness and/or disability. Other recent entries in this genre include reporter Joe Klein’s “The Long Goodbye” (Time, June 11, 2012) and Michael Wolff’s “A Life Worth Ending” (New York Magazine, May 20, 2012).
At the opposite end of the spectrum are the hopelessly romantic images of old age we see so often in TV commercials and magazine ads—the Viagra-touting grandparents holding hands as they gaze off into a Hawaiian sunset; the nonagenarian parachuting from 5,000 feet; the 80-year-old winning her fifth marathon.
Where does reality lie? Somewhere in between, it seems, as research by U-M’s own Robert Kahn demonstrates. In their landmark 1998 book, Successful Aging, Kahn and co-author John W. Rowe report that, contrary to popular myth, older Americans are generally healthy. But health in older age depends on such critical factors as access to nutritious foods, safe places to exercise, and affordable health care. One of our primary goals in public health must be to help guarantee that these ingredients so necessary for “successful” aging are made available to the widest number of people possible—not just the affluent. Another key factor in healthy aging, as research by SPH Professors Neal Krause and Vic Strecher underscores, is a sense of purpose in life. People who perceive their lives as purposeful tend both to make healthier choices and to cope better with the stresses of aging. Again, public health has a vital role to play here by fostering the means for people to age as healthily as possible, at all stages of life. A strong public health infrastructure is a critical component of what I think of as a truly healthy society—one that provides a majority of its people with the opportunity to find a life-sustaining sense of purpose.
Equally important, a healthy society regards aging as a normal part of life—not an aberration. And a healthy society fosters a powerful sense of community. Rare is the individual who can age healthily in isolation, as study after study demonstrates.
Aging is more than just the passing of time—it’s a complex dynamic involving biology, environment (both social and physical), socioeconomic status, and mental health, among other factors. Although technology has given us the means, for perhaps the first time in human history, to live healthily with disease, the phenomenon of what many call “successful” aging is about so much more than simply treating disease.
If we are truly to create a “better old age” for all the world’s people, we need to maximize opportunities for the elderly to thrive. Instead of keeping our fragile elders out of sight and mind—and deepening our own detachment from the wisdom of the ages—we must recognize and celebrate their extraordinary potential. We have a resource in the elderly that goes largely wasted in Western culture. By creating a better old age, then, we will create a better future—a better life—for all of us. For as members of the human community, we are all connected. The elderly have merely gone further down a path that many of us are destined to travel. The more connected we are with them, the more connected we will be with ourselves.
Dean and Professor of Toxicology