Six Shifts Needed for Healthy Aging
This analysis by McKinsey Health Institute recognizes many people will live from two to three decades past their retirement age, where one could choose to be in school at 50 and choose to be employed at 80. Society should focus on capacity, not age.
McKinsey Health Institute (MHI) has identified action on six important shifts that could make it possible for governments, businesses across sectors, not-for-profit organizations, health and well-being stakeholders, and individuals to unlock improvements in healthy aging.
Invest in the promotion of healthy aging
Improve measurements of health and get better data
Scale interventions proven to promote healthy aging
Accelerate innovation across the healthy aging ecosystem
Unleash the potential of all industries to enable healthy aging
Empower and motivate older adults to live to their full potential
Shift 1: Invest in the promotion of healthy aging
Globally, there is underinvestment in prevention of disease or impaired mobility. For example, European countries invest, on average, 2.8 percent of their health budget on prevention. While the path to healthy aging begins at adulthood, there is much that can be done for individuals in later years. More prevention efforts should be focused on conditions correlated to age, such as dementia and sensory impairments. Other prevention efforts could focus on how adults manage conditions such as depression throughout their lives, how older adults can continue to find purpose, social connections, and financial security, and strategies to encourage lifelong physical activity, even as mobility changes with age.
Moreover, previous studies have indicated that prevention programs—both clinical (for example, hearing technology for those hard of hearing) and nonclinical (for example, focusing on improving housing, social connections, and fitness) —can improve the quality of life for older adults, which can reduce the need for medical care over time. Interestingly, only 20 percent of the modifiable contributors to an individual’s health are related to medical care, with nonclinical factors driving the other 80 percent.
Shift 2: Improve measurements of health and get better data
Even in high-income, technologically advanced countries, no standardized data set can illuminate older people’s diverse health capacity over time across the four dimensions of health, let alone their surrounding personal attributes, behaviors, and environmental factors. Although technologies to capture the various data exists, gaining access to and integrating and linking these data sets remain a major challenge. Additionally, these measurements are limited and do not always reflect an older adult’s priorities, whether it’s lifting a grandchild, driving long distances, or still being able to sew.
The first step may be to define a standardized data catalog and measurements leveraging several existing examples. Governments may also consider sharing and integrating data sources across public institutions, healthcare, academia, businesses, and individuals to create high-quality, integrated longitudinal data spanning all four dimensions of health. Achieving this requires establishing a collaborative exchange of data that protects patient privacy, including strict data privacy measures and intellectual-property rights. This richness in data could enable a better understanding of the widely varying needs of older adults and passively track conditions specific to older adults (for example, cognitive performance over time), providing a solid evidence base for policies or personalized interventions. The long-term goal is to create data-driven measurements of holistic health, supported by standardized, integrated data.
Shift 3: Scale interventions proven to promote healthy aging
A recent study estimated that older adults’ disability-adjusted life years (DALYs) could be reduced by almost 30 percent, solely by applying proven interventions. These could include following a healthy diet; participating in physical activity; addressing social behaviors (such as smoking cessation); and ensuring access to vaccines, medicines for heart disease, diabetes and stroke prevention, and mental-health therapy. In the words of one doctor, “Exercise is the closest thing we have to an anti-aging pill.”
Examples of scalable interventions can include the following:
Boosting quality of life while managing age-related disease.
Engaging initiatives that combat isolation and provide a sense of purpose.
Programs and technology that promote independence and aging in place.
Humanistic approaches to care that promote a connection with direct carers and prioritize holistic care. (Such as Eden Alternative and The Green House model.)
Shift 4: Accelerate innovation across the healthy aging ecosystem
Innovation should include, but also exceed far beyond, the traditional focus on life sciences. To drive innovation across the four dimensions of health as a society, society needs to foster and fund collaborations at the intersection of life sciences, digital, technology, and services. There is already substantial venture capital entering the field of aging, and some companies are starting to tailor their product and service to the older population (for example, remote assistance and fast medical consultation services).
Governments could further support these efforts by taking a whole-of-government approach to healthy aging, promoting the role of collaboration and support across all departments. It could also champion “focused research organizations” for topics that fall through the cracks as neither viable for private-sector investment nor large enough for government investment—for example, availability of comprehensive data sets
Shift 5: Unleash the potential of all industries to enable healthy aging
Health is relevant across all sectors, and there is potential to develop products and improve infrastructure to support healthy aging. Non-health players could both develop products and services for the needs of older adults and provide inclusive infrastructure, especially in the workplace. Employers could offer eldercare funds, integrate older adults into the workforce (for example, by creating formal “second-career” pathways for older adults who have retired to reenter the workplace—such as Unilever’s U-Work program, first piloted in ten countries, which was so successful that Unilever began an internship program for those over age 60 in Argentina) —and work to reduce age discrimination in the workplace.
The most exciting interventions are likely to come from cross-sector collaborations—imagine receiving free rides on public transport for each completed short workout, stage-appropriate nutrition nudges at the grocery store checkout, or smart-home technology that could identify and prevent physical or cognitive decline. These interventions can complement “age tech” innovations seen in traditional older adult medical-care settings, such as the Bocco Emo robot, which monitors older adults in nursing homes and engages patients in “conversation” while notifying staff that nursing care is required.
Shift 6: Empower and motivate older adults to live to their full potential
Individuals have an important role to play in their own health. MHI believes that a combination of health education, public- and private-sector innovation, and the robust application of public policy will improve individuals’ ability to influence their own health outcomes. For the aging world, this will require several measures:
Education and widespread adoption of self-directed practices that enhance an individual’s role and responsibility in their healthy aging. This includes physical activity, healthy diets, social connections, and cognitive engagement—and it is important to adopt these habits as early as possible in life, ideally in childhood or early adulthood to reap the greatest gains later in life. To foster these activities, there should be sufficient support to maintain good vision (for example, financial support for cataract surgeries).
Ongoing community involvement by volunteering, working, or engaging in purposeful activity for as long as possible. In New York, the Department for the Aging is encouraging retirees from New York City government agencies to seek part-time, temporary work assignments that allow them to remain active and serve their community.
Inclusive public-sector infrastructure for an aging society to drive active participation over dependence. This includes, for example, focusing on stage, not age, in the distribution of social services, and providing an accessible, affordable, frequent, and safe public-transportation system that is designed for the needs of older participants (for example, increased volume of alarm sounds, larger-print signs).
The analysis recognizes the reality that many people will live from two to three decades past their retirement age, where one could choose to be in school at 50 and choose to be employed at 80. Society should focus on capacity, not age, recognizing the potential for many to contribute as volunteers, advisers, community leaders, workers, board members, active family members, and innovators.