An Ecological Approach to Understanding and Enhancing Older Adults' Health

Background and Significance: Older adults (people over 65) currently account for 13% of the total U.S. population and are expected to nearly double in size by 2050. Eighty percent of older adults have at least one chronic illness requiring increased use of health care services. Yearly, older adults account for 26% of all physician visits, 34% of prescriptions, 35% of hospitalizations, and 38% of EMS responses. The increase in the older adult population is expected to be accompanied by a corresponding increase in their use of health care services (IOM, 2008).

Purpose: To identify intrapersonal, interpersonal, community and societal factors influencing older adults' health and corresponding points of intervention that influence older adults' health.

Theoretical framework: A socio-ecological model (SEM) provides a comprehensive framework for examining older adults' health, as this model recognizes the existence and interconnection of relationships between older adults' health and their environment. Influencing factors and points of intervention include several levels: 1) intrapersonal (gender, age, cognitive status, income, health literacy, etc.), 2) interpersonal (social support from family, friends, and neighbors), 3) community-mediating structures (neighborhoods), and 4) public policy laws that regulate or support health actions and practices for disease prevention, early detection, control, and management.

Conclusion: The SEM supports a public health approach that addresses older adults' health and the social and environmental systems that influence it. A strong multi-level emphasis promotes development of cross-sectional interventions to enhance older adults' quality of life and health (WHO, 2010).