The magazine of the UW School of Public Health

From the Editor

Aaron Katz

I started out in aging. That is, my first health policy job in Washington State (circa 1978) was in “long-term care,” a term often used synonymously with “aging.” Even though the field was led by some very independent and feisty elders—including a few of my own mentors at the time—we often approached long-term care as if all older adults needed long-term assistance with one problem or another, as if aging was a constant state of dependence on services and programs.

The main issue back then was how to break away from warehousing older people in institutions, such as nursing homes. Federal and state policy seemed to strongly favor nursing homes and to discourage in-home or in-community social and health services; nursing home use and cost could be controlled (build only so many beds, regulate price per day), while these non-institutional services were more amorphous (how many visits per week by a personal care attendant were really necessary?). Much lipservice was being given to family caregivers and social support systems, but that was just a sideshow to the debate over programs, services, buildings, and budgets.

We collectively voiced a vague anxiety about the distant future when Baby Boomers would reach retirement, overwhelming the ability of formal and informal care networks to support them. Now, that distant future is here, and vague anxiety is rapidly giving way to stark reality. Fortunately, we’ve learned a lot over the past 30 years about intergenerational relationships, about communities, about aging, and about health.

Today, it’s easier to see that “the elderly” represent various points on a continuum of assets, desires, and needs on which, in fact, we all fall. Who hasn’t needed help getting to the doctor’s office or the grocery store due to some malady or malfunction? Who shouldn’t watch their diet and exercise? Who isn’t better off contributing to the well-being of community through volunteer activities?

That’s the lens through which I read the articles in this issue of Northwest Public Health. For example, look over Northwest Region at a Glance; the health indicators are really the same indicators we might look at for any segment of the population. Likewise, both the Viewpoint from Klein and Piering’s article about expectations suggest that those entering retirement age have priorities similar to the generations before and after (family focus, purpose, choice).

The pieces by Lowe, Knopf, and Jones highlight the importance of community connections, including intergenerational relationships, in promoting quality of life. Articles by Johnson and Reischl and Snyder and Belza explore broad-based approaches to optimize both physical and mental health among the elderly—the former through community planning and zoning, the latter through a comprehensive health and wellness program. Still, we don’t ignore more traditional “public health” discussions about aging: Gray, Felton, and Wangsmo describe efforts to reduce transmission of noroviruses in care facilities; Graves, Saylor, and Shavings comment on the complex topic of elder abuse in Alaska Native cultures; and a series of short articles discusses seniors and public health preparedness activities. I hope you enjoy this issue of Northwest Public Health. Let us know what you think.

Aaron Katz, Editor-in-Chief
Director, Packard-Gates Population Leadership Program