ASTHO Challenges States to Maximize Wellness of Older Americans

October 07, 2014|2:06 p.m.| Jane Esworthy

Aging is not a process that starts mid-life, but a continuum that begins the day you are born. Healthy aging is synonymous with healthy living, therefore you have to be a healthy kid in order to become a healthy adult.Healthy aging is synonymous with healthy living, therefore you have to be a healthy kid in order to become a healthy adult.

According to the National Association of Chronic Disease Directors, healthy aging is most likely to be achieved in safe physical environments and communities that support adopting attitudes and behaviors known to promote the health and well-being of the community. This is done specifically through the effective use of health services and community programs to prevent or minimize the impacts of acute and chronic disease.

In September 2014, ASTHO President Jewel Mullen, commissioner of the Connecticut Department of Public Health, issued her President's Challenge: Healthy Aging—Living Longer Better. Families across America are confronting the question, "How will we care for mom and dad?" Mullen wants to address this problem by helping adults live and age well in their communities. Below, she shares her healthy aging challenge and her passion for public health.

What do you hope to achieve with the healthy aging challenge?

Everybody has a story when you say aging, whether it's a memory of a patient, a relationship with a neighbor, or a history with a loved one. Part of my goal is to really help raise the profile of older adults, so that as we continue to invest wisely in public health, we remember to include our older communities. In the next 35 to 40 years the population over the age of 65 is going to double.

My ultimate goal for the healthy aging challenge is to build a national movement that supports families across America. I want to convene the nation—through the support of state health officials, their public health teams, state and local experts in aging, and a broad network of partners—to look at how an aging population presents opportunities to our society. Right now we focus too much on how healthcare costs incurred by older adults present a burden to society. I want to shift the conversation to focus on prevention and start a movement where older means bolder.

What sparked this challenge? What gave you the idea to make it your own?

I have a longstanding interest in the well-being of older adults. While working in Massachusetts, I started a wellness program at a senior center to promote older adults' living and thriving in the community, outside of the hospital. A key message I learned from the participants was, "We might be older, but we are not old."

During my public health training in the 1990s, my primary focus was successful aging. I had a wonderful mentor, Stan Kasl, who took me under his wing. His research focused primarily in aging. At the same time, I was fortunate to also work with Lisa Berkman, another researcher on aging who is currently director of the Harvard Center for Population and Development Studies. Their influence rooted me along the healthy aging path.

When I was in residency, I had a patient in her 90s who was very proud that I was a young African American woman physician. I got to know this patient during her office visits, and I was always impressed with her wit and wisdom. I'll never forget the wedding gift she gave me, a one dollar bill and a very sheer negligee. I have to say I was a bit surprised to receive such a gift from a woman in her 90s, but it reminded me that people don't shut off part of their personality when they reach certain ages. Inhibition did not get in her way of giving me that present. And she was always full of advice - solicited or not. Seniors are great in that way. I've often found that grandkids would rather talk to their grandparents than their own parents.

What about healthy aging personally resonates with you?

Back in 1907, life expectancy for an African American woman was 34 years. Today, my grandmother, who was born in 1907, is 107 years old. She is a personal inspiration for me. People who bemoan aging often do so because of how they feel, not because of how old they are. People who bemoan aging often do so because of how they feel, not because of how old they are. Over time people encounter physical ailments, chronic disease, lack of social support, and depression. The more that we can do to mitigate the risk of these issues, the better. We can't measure the health of the population by life expectancy. Rather, we need to look at healthy years of life.

If you were to dream big, how would healthy aging look in 10 years?

Healthy aging would be much more normalized. We would be a nation focused on the notion of intergenerational design. Builders would be more innovative, developing properties that can better house people of different functional abilities. Older adults want to stay in their communities, so we would design communities that suit people's need for transportation, safety, food access, and social connectedness.

Today, many middle-aged people are still raising children and they are also caring for older adults. Increasingly, families have multiple generations, and as people live longer, you get more and more stacks of people on either end that need attention. I like to compare this to a Dagwood sandwich—caregiving happens in both directions. Many family members don't even consider themselves caregivers. Ten years from now we should have a robust system for caregiver support.

What would you love to see happen as a result of the healthy aging challenge?

When we convene at next year's [ASTHO] annual meeting in Salt Lake City, I want everyone to share stories about the people they met in their communities during this challenge. I want to hear from health officials who helped form the partnerships necessary to make communities livable for older adults. This can be done in such ways as building skills of caregivers, providing transportation, or promoting healthy eating and active living. I'd also like to engage colleagues to become better partners for community housing and help ensure it is designed in an age-friendly way.

I hope we will facilitate some important federal partnerships through ASTHO and their work between agencies, in addition to expanding partnerships with private organizations. When the year is over, the challenge will keep going. We will have built momentum and we will continue to make progress.


Jewel Mullen

Jewel Mullen, MD, MPH, MPA is commissioner of the Connecticut Department of Public Health and president of ASTHO. Learn more about the 2015 President's Challenge on healthy aging at