Determinants of active ageing

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In a recent publication on women Ageing and Health A Framework for Action by the WHO sent to the medical profession, determinants of active ageing for women has been described thus:

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The report based on a WHO study says.

Three pillars for action

The ideas presented in this report build on the WHO active ageing framework, which calls on policy-makers, service providers, nongovernmental organizations and civil society to take action in three areas or “pillars”: participation, health and security (see Figure 2,).

The policy framework for active ageing is guided by the United Nations Principles for Older People: independence, participation, care, self-fulfilment and dignity. Decisions are based upon an understanding of how the social, physical, personal and economic determinants of active ageing influence the way that individuals and populations age. This framework aims to reduce inequities in health by understanding the gendered nature of the life course.The priority areas for action described in Chapter 10 of this report are grouped under the three pillars.

Active ageing is the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.

The gender and age responsive lens

Under the active ageing framework, the overall goal is to improve the health and quality of life of ageing women by implementing gender responsive policies, programmes and practices that address the rights, strengths and needs of ageing women throughout the life course.

These efforts need to take into account the special situations of older women with disabilities, members of minority groups, those who live in rural areas, and those who have low socioeconomic status.

Fulfilling this goal means that governments at all levels, international organizations, nongovernmental organizations and other leaders in civil society and the private sector need to:

• mainstream gender and age perspectives in all policy considerations by taking into account the impact of gender and age-based roles and cultural expectations concerning ageing women’s health, participation and security;
   
• systematically eliminate inequities based on gender and age and their interaction with other factors such as race, ethnicity, culture, religion, disability, socioeconomic status and geographic location;
   
• acknowledge and address diversity among older women and men;
   
•  enable the full and equal participation of older women and men in the development process and in all economic, social, cultural and spiritual spheres of community life;
   
• adopt a life course perspective that understands ageing and cumulative disadvantage as a process that spans the entire lifespan and provides supportive policies and activities at key transition points in a one’s life;
   
•  encourage intergenerational solidarity and respect between generations.

Gender analysis has become a common policy tool in many settings. This report proposes that policy-makers apply a dual perspective to their decisions - a perspective that takes both gender and age into account (Figure 3).

Some questions to ask

Taking gender, age and equity into account

1. Does the policy/programme address gender- and age - specific concerns?

2. Does the policy/programme take gender, age and culturally based traditions and roles into account?

3. Does the available evidence take gender and age differences into account?

4. Does the policy/programme support equity and ensure equal access without discrimination based upon age, gender, class, race, ethnicity, health status, income and place of residence?

Outcomes

5. In what ways does the policy/programme enhance the health/participation/security of older women and older men?

6. How will the policy/programme affect women and men differently throughout the life course, and particularly in older age?

7. Does the policy/programme acknowledge the contribution and strengths of older women and men and the heterogeneity of the older population?

8. Does the policy/programme respect the United Nations Principles for Older People: independence, participation, care, self-fulfilment and dignity?

9. Does the policy/programme support integenerational solidarity for both women and men and encourage a ‘society for all ages’?

A determinants-of-health approach

There is now clear evidence that health care and biology are just two of the factors influencing health. The social, political, cultural, and physical conditions under which people live and grow older are equally important influences.

Active ageing depends on a variety of “determinants” that surround individuals, families and nations. These factors directly or indirectly affect well-being, the onset and progression of disease and how people cope with illness and disability. The determinants of active ageing are interconnected in many ways and the interplay between them is important.

For example, women who are poor (economic determinant) are more likely to be exposed to inadequate housing (physical determinant), societal violence (social determinant) and to not eat nutritious foods (behavioural determinant).

Figure 1 shows the major determinants of active ageing. Gender and culture are cross-cutting factors that affect all the others. For example, gender and culture related customs mean that men and women differ significantly when it comes to risk-taking and health-care-seeking behaviours.

Culturally driven expectations affect how women experience menopause in various parts of the world. The gendered nature of caregiving and employment means that women are disadvantaged in the economic determinants of active ageing.

Health News Summary

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Following is a summary of current health news briefs.

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New drugs needed to fight flu pandemic

Experts urged governments on Friday to diversify their stockpiles of drugs and called for more new medicines to fight what could be the world’s next flu pandemic caused by the H5N1 bird flu virus. Many advanced countries stock up on oseltamivir and zanamivir, two varieties of the same class of drugs that stops the H5N1 virus from multiplying.

Birth control knowledge lacking in developing world

In developing countries, young women’s use of modern methods of contraception is limited by a range of factors, a review of seven studies conducted in five countries suggests. Lack of knowledge, access problems and side-effect fears were the “overarching themes” limiting the women’s use of hormonal contraceptives such as the birth control pill or hormone implants, Dr. Lisa M. Williamson of the MRC Social and Public Health Sciences Unit in Glasgow and her colleagues report.

Probiotics may help some with chronic fatigue

Supplements containing “good” bacteria can help some people with chronic fatigue syndrome feel better, but they may make others feel worse, report Swedish researchers who conducted a small study.

“I think that it’s worth trying,” Dr. Birgitta Evengard of the Karolinska Institutet in Stockholm, study co-author, told Reuters Health. Evengard said she recommends her patients with chronic fatigue syndrome try taking the probiotics tested in her study, and stop if they start feeling worse, but stick with it for 3 weeks if they feel better or if they don’t notice an immediate effect.

Workout for breathing muscles may aid some athletes

Some athletes may be able to boost their performance by working out the muscles that control breathing, a small study suggests.

The study, of 27 college soccer players, found that five weeks of respiratory muscle training improved the athletes’ “intermittent” exercise performance — those short bursts of intense effort needed in sports like soccer, basketball and field hockey.

Study of spit offers insight into human health

Bacteria found in people’s spit does not vary much around the world, a surprising finding that could provide insights into how diet and cultural factors affect human health, researchers said on Thursday. Because the human body harbors 10 times more bacterial cells than human cells, scientists are trying to understand more about the bacteria we carry.

Hostile men more prone to weight gain, study shows

Hostile men may pack on more pounds over time than their less hostile, more laid-back peers, new research shows.

The more hostile a man’s personality, the more his body mass index (BMI) increased over the following two decades, Dr. Hermann Nabi of Hopital Paul Brousse in Villejuif, France and his colleagues found. BMI is the ratio of height to weight, used to determine if someone is within a normal weight range or is underweight, overweight or obese.

REUTERS

Health education:

What is hearing loss

by Audiologist Mihiri Wickremarachchi

Hearing loss results in the inability to hear many speech and environmental sounds. The severity of a hearing loss depends on the type and degree of hearing loss.

There are three types of hearing impairment:

Sensorineural hearing loss

This is the most common type of hearing loss. It has its origin in the inner ear or along the auditory nerve. Most commonly, the damage occurs in the inner ear (cochlea).

In this instance, the hair cells in the cochlea are damaged or absent and cannot cause nueruoelectrical impulses to be sent to the brain.

Sensorineural hearing loss can be congenital (present at birth) for acquired after birth.

Common congenital causes include:

• Hereditary factors
   
• Viral infections
   
• Prematurity
   
• Birth trauma such as anoxia

Acquired causes include:

• Reactions to ototoxic drugs
   
• Ear infections
   
• Meningitis
   
• Encephalitis
   
• Head injury
   
• Noise exposure

Conductive hearing loss

This type of hearing loss occurs when the outer or middle ear is dysplastic, blocked or does not work properly. Consequently, sound waves cannot be conducted to the inner ear. In case of a temporary dysfunction, it is often possible to correct the conductive hearing loss with surgery and or treatment with medication. Common causes of conductive hearing loss include:

Injury of the outer ear itself Blockage of the ear canal due to cerumen or other small objects like food, beads or insects.

Infections of the outer or middle ear, often with effusion. Perforation of the tympanic membrane Congenital deformities

Mixed hearing loss

Hearing loss is caused by a combination of sensorneural and conductive factors.

Whatever type of hearing loss your child may be experiencing-sensorineural, conductive, or mixed - it’s important to remember that each hearing loss is unique. Even with the same hearing threshold, the impact of the hearing loss is different for every child.

Letter Box:

RE: How to prevent breast cancer

I would like to add something to Dr. Athukorale’s letter regarding the prevention of breast cancer, beginning with thanking him for bringing these health issues to the attention of the public from time to time.

While he rightly stresses the importance of diet to the prevention of cancer, his statement that “mammography and genetic tests does not appear to help in the prevention of breast cancer” masks the important fact that diagnostic measures such as mammography, while not preventive, are the most effective steps a woman can take to prevent death from cancer.

With modern treatments, long term survival rates are very good with early diagnosis, and the key to that is monthly self-exams for all and annual mammography for at-risk or older women, as evidenced by numerous reports from the medical field.

R. Jayasinghe Colombo

Animal protein

Increases infertility riskl:

Dr. D.P. ATUKORALE

Women who consume animal protein may be harming their fertility (ability to produce babies). Harvard researchers analysed dietary assessments from 18555 women trying to become pregnant in the Nurses Health Study and found that adding one serving of meat per day was associated with 32 percent greater risk of infertility (inability or diminished ability to produce off springs). Infertility sometimes called subfertility affects about 15 per cent of couples in U.K. and U.S.A.

After adjusting for confounding factors, the women who consumed the most total animal protein were at 41 per cent greater risk of ovulatory infertility than those who consumed the least.

Women with the highest animal protein intake had a 39 per cent increased risk while those with highest vegetable intake had a 22 per cent decreased risk of ovulatory infertility. This may be one of the reasons why the poor women in rural areas Sri Lanka who consume very little of animal protein (compared to rich urban women) have a high fertility rate.

Reference: Chavano J.E. Et al, American Journal of Obstetrics and Gynaecology, 2008 198, 210-217

Symposium on exercise in stroke prevention

The Institute of Sports Medicine (ISM) will conduct a symposium on ‘Exercise in stroke prevention’ in association with the Daily News and the Sunday Observer on March 8 at 10 a.m., at the Institute of Sports Medicine at the Sports Ministry at Independence Square, Colombo 7.

The ISM Director General Consultant Neurologist Dr. Githanjan Mendis, wants Healthwatch readers who may have any questions on this topic to send them to him through the Healthwatch by March 5 the latest, to be taken up at the symposium and answered by the symposium’s medical panel.

The medical panel will comprise among others Dr. Mendis as Chairman, Dr. Arjuna de Silva Consultant Physician, Nutritionist Sigrid de Silva and Exercise Specialist Kamal Chandana.

Questions can be sent to:

Preventing Strokes through Exercise Symposium

C/O Features Editor

Daily News Healthwatch

Lake House

D.R. Wijewardene Mawatha, Colombo 10.