Social determinants and healthy ageing Healthy ageing is arguably the most highly valued aspect of human development. It means living longer, free from illness and disabilities that limit the activities of daily life. Societies need to adapt in order to enable all older people to live healthy and fulfilling lives for longer. In policy debates about ageing populations, attention is often rightly given to addressing the increasing health care needs of older populations. Two related issues are worthy of policy attention. Firstly, that while more people are reaching ages 60 or 65 (ages most commonly used in research and discussions of ageing) in good health, this is unequally distributed within and between countries. In England, for example, the English Longitudinal Study of Ageing found that professional and managerial classes have fewer illnesses in their 70s than routine and manual classes do in their mid-50s (McMunn et al., 2003). The second and related issue is that attention must be given to the wider social determinants of health (the economic, social, environmental, political and cultural factors that affect health across the life course) and their impact at older ages. The linked agendas of health inequities and ageing are common to all Commonwealth countries, but the national contexts are very different. Measurement and monitoring of health outcomes and the social determinants of health, disaggregated according to dimensions of inequity, within each country are therefore key to the development of contextually appropriate policies to enable everyone to live long, healthy and fulfilling lives. Living longer in the Commonwealth Life expectancy at birth is the most widely available measure of ageing that can be compared across countries. Increases in life expectancy documented over the last 60 years are cause for celebration. Figure 1 shows average life expectancy data from 1950 projected to 2050 for five Commonwealth countries: the UK, a high-income country; South Africa, an upper-middle-income country; India, a lower-middle-income country; and Kenya and Bangladesh, two low-income countries.1 Life expectancy at birth in the UK has increased by 11 years since the 1950s. In the same period life expectancy has increased by Commonwealth Health Partnerships 2015 17 Ruth Bell and Michael Marmot Healthy lifestyles throughout the life course increase the chances of experiencing good health in older years Robert Kneschke /Shutterstock.com
Commonwealth Health Partnerships 2015
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