Arts & Events
Sometimes it’s hard to figure out what crisis we should focus on: Global warming? Growing food shortages? The energy crunch? The looming danger of a deadly flu epidemic?
What sometimes gets lost in the drama of the headlines and journalism’s addiction to “If it bleeds, it leads,” are the quiet stories that may not have the sizzle of rising sea levels or riots in Haiti, but which none-the-less present a challenge to our society as daunting as the media’s “catastrophe of the week.”
By the year 2050, the number of people aged 65 or older will increase from 600 million to two billion. The U.S. will double its over 65 population by 2030, and the fastest growing demographic in the country is people over 85.
At the same time as this population is on the rise, the number of doctors, nurses and caregivers who specialize in geriatrics is shrinking. There is one geriatrics doctor for every 5,000 patients, and only nine out of the 145 medical schools in the U.S. have geriatrics departments. Less than one percent of the 2.7 million nurses in the U.S. and Canada are trained in geriatrics, and the vast majority of nursing schools do not require courses in the subject. Lastly, the key demographic section of the population that currently cares for the elderly-women age 35 to 55-is shrinking.
“The aging of the human populations represents one of the most significant public policy issues facing society,” writes William A. Satariano, a professor of epidemiology and community health at the University of California at Berkeley’s School of Public Health in his illuminating book on the epidemiology of aging.
But aging is an intricately complex thing. It is rather like the old gospel song: “The knee bone’s connected to the thigh bone, the thigh bone’s connected to the hip bone, the hip bone…” Gerontology, Satariano writes, “is a multidisciplinary field that focuses on the biology, psychology, and sociology of aging.”
How people age and what the outcome of that process is depends on issues such as gender, race and ethnicity, physical environment, networks of interpersonal relations, health behavior, and psychology. Women live longer, but are not as healthy. Why? Minorities have significantly worse health problems than whites. Why? Seniors who stay in their homes do better than those in care facilities. Why?
To answer these questions, Satariano proposes an “ecological model,” that argues that the “differences in levels of health and well-being in populations are due to a dynamic interplay among biologic, behavioral, and environmental factors, a broad interplay of multilevel factors that unfolds over the life of individuals, families, neighborhoods, and communities.”
The book examines subjects like disease, cognition, depression, and accidents, among others, breaking each general topic area into the “dynamic interplay” model. The book also suggests practical solutions to problems like housing and transportation. Satariano, for instance, says that a partnership between public health professionals and communities can tackle problems like seniors’ access to food, safe parks, and local support services.
A central theme in Satariano’s book is his argument that “aging is not associated uniformly with the risk of disease, disability and death.” Extending people’s life span is not enough, he says. The idea is not just to live longer, but to live better.
“The Epidemiology of Aging” is extremely thorough but easily accessible to the average reader. Its steep sticker price will probably restrict it to policy makers, but every city planning commission in the country should have one on its desk. The model it proposes helps organize the various overlapping fields of study in a way that gives a reader an overall picture without losing the details.
No one can avoid getting old, but what the quality of our lives are as we age is something we have some control over. This book is a helpful roadmap to all of our futures.
Epidemiology of Aging:
An Ecological Approach
By William A. Satariano, PhD, MPH. $76.95.
Jones and Bartlett Publishers. 2006.