Applying Healthy Aging Practices and Policies to Advance Brain Health and Caregiving

June 18, 2026 | Kellie Waugh, Tyrone Bethune

Public health departments nationwide are implementing policies, interventions, and partnerships to support health throughout the life course. Actions across ASTHO’s five Healthy Aging and Older Adult Health Technical Package objectives also serve as pathways for supporting brain health and caregiving at the state level. Consider using the following objectives, resources, and examples as you work for positive change in your jurisdiction.

1. Expand Paid Family and Sick Leave

Paid leave policies support working caregivers in maintaining their economic well-being while providing care, including for those living with dementia. Inclusive leave policies help reduce employment-related stress among caregivers and allow greater focus on caring for their loved ones as well as themselves.

Health departments may influence the development of flexible paid family and sick leave policies that support caregiving responsibilities, and provide evidence of the positive economic, physical, and mental health benefits. Additionally, health agencies can collaborate with multi-sector partners (i.e., labor and workforce agencies, aging services, health care providers, caregiver coalitions, and community organizations) to develop, share, and promote strategies that better support working caregivers through:

• Resources like those from Minnesota’s Board on Aging.
• Toolkits (e.g., Massachusetts Employer Toolkit to Support Working Caregivers).
• Public education efforts (e.g., New York’s working caregivers’ initiative).

2. Support Healthy Community Design

Designing communities for lifelong health helps individuals navigate streets and community spaces, prevents chronic disease and injury, and keeps people socially connected. These measures make it easier for people of all ages to thrive, and especially support those living with Alzheimer’s Disease and Related Dementias (ADRD) and their caregivers. Public health champions have the skills and data needed to apply built environment core competencies, actively participate in planning discussions, and identify and address community needs.

Transportation policies promote physical activity and reduce environmental pollutants, which support chronic disease prevention and dementia risk reduction. Similarly, efforts for affordable and adaptable housing assist individuals living with ADRD and their caregivers to safely live and age in place. Public health can:

• Increase awareness of the link between housing and health.
• Influence policies for affordable housing development and universal design.
• Embed safety assessments into existing home-based programming.

Together, accessible communities, safe housing, and reliable transportation ensure access to essential care and services that support independence for people living with ADRD and their caregivers.

3. Promote Fall Prevention and Mobility

Among the older adult population, those living with ADRD may experience higher risk for falls. Jurisdictions are strengthening policies and engaging partners in coalitions to prevent falls among older adults. These collaborative networks bring together organizations, multi-sector champions, and community members to address falls through coordinated strategies and shared resources. Fall prevention coalitions align public health, health care, and community-based efforts, and translate evidence-based strategies into sustainable action. With these coalitions, health agencies strengthen community-clinical linkages, elevate falls prevention as a public health priority, and identify initiatives that intersect brain health and caregiving.

ASTHO’s guide for expanding falls prevention outlines how health departments can implement CDC’s Stopping Elderly Accidents, Deaths & Injuries framework by enhancing surveillance, care coordination, and community-based pathways to assess risk and prevent falls among older adults. These efforts reinforce the aging in place movement, providing older adults and caregivers with the necessary tools to live independently.

4. Increase Telehealth Access

Expanding telehealth services is a key public health approach to improve access to care, especially for people living with ADRD and in rural communities. Telehealth services facilitate early brain health assessment and remote monitoring of chronic conditions such as ADRD, while reducing isolation among those living with dementia and their caregivers.

Ensuring access to telehealth services for urban and rural communities often depends on Medicaid reimbursement. Public health can partner with state Medicaid programs to strengthen coverage for telehealth services, and health agencies may also be able to support provider regulation or related policies that improve telehealth access in the state. Additionally, data collected or utilized by health departments can shed light on the communities and programs that may benefit from having a virtual care component.

Public health is focusing on patient and provider education as another avenue to increase telehealth access. Collaboration with academic medical centers, state Medicaid programs, and reliable internet providers are all promising opportunities to leverage digital care technologies. Health agencies can support provider workforce strategies (e.g., Project ECHO) to equip professionals with dementia-specific training, especially in areas that are rural or have a shortage of providers. And they should continue to monitor the evolving state and federal policy landscape to identify changes related to telehealth access and minimize potential barriers to care.

5. Strengthen the Health Care, Long-Term Care, and Public Health Workforce

Public health encourages workforce readiness to support healthy aging, ADRD, and caregivers. The National Healthy Brain Initiative State and Local Road Map’s Workforce domain is a key pillar for advancing brain health and reducing dementia risk at scale. In 2025, 32 health departments reported working on at least one Workforce domain action. Agency-led activities such as training, technical assistance, and capacity building equip cross-sector professionals with evidence-based implementation strategies.

Trust for America's Health has established the Age-Friendly Public Health Systems Recognition Program recognizing public health agencies for advancing workforce capacity and system-level improvements that naturally address the intersection between brain health. To date, six state health departments have achieved recognition, and Tennessee was the first to earn it across the state health agency and every local health department.

Visit ASTHO’s Healthy Aging and Brain Health webpage for additional resources, and reach out to healthyaging@astho.org for technical assistance requests.