Protecting the Health of Our Elders

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Protecting the Health of Our Elders

• Kathy Sykes, Senior Advisor,
• EPA Aging Initiative
• Theodore Coopwood
• Intergenerational Coordinator
• Office of Childrens Health Protection

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Ancient American Indian Proverb

• Treat the earth well It was not given to you
  by your parents, it was loaned to you by your
  children. We do not inherit the Earth from our
  ancestors we borrow it from our children.

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Demographic Shift Growing Aging Population in
USA

• In 2000, 35 M 65
• 4.2 M 85
• By 2030, 71.5M 65
• 9.6 M 85
• 85 fastest growing age cohort

Source US Census 2004
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Indicator 1 - Number of Older Americans
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Facts about Women and Children

• By the year 2010, almost half of all women will
  be at least 50 years old.1
• An increasing number of older people are
  providing care for grandchildren and
  great-grandchildren.2
• Baby Boomers can expect to spend more years
  caring for older family members than caring for
  children. 2

1 National Policy and Resources Center on Women
and Aging at Brandeis University 2 Grantmakers
in Aging A Tool Kit Funding Across Ages
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National Agenda for the Environment and the Aging

• Identify research gaps in environmental health
• Translate research findings into public health
  prevention strategies
• 3. Create tools to address the impact a rapidly
  aging society will have on the environment
• 4. Provide opportunities for older adults to
  become environmental stewards in their
  communities

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Why Focus on Older Adults?

• Decrease in organ function reserves
• Impaired chemical clearance and detoxification
• Vulnerable to medication-environment adverse
  interactions (example - heat/psychotropic drugs)
• Legacy of past occupational and environmental
  cumulative exposures to persistent agents.

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Poison Control Center Data 1993-1998

• Older adults accounted for a small percentage of
  poison control center reported incidents (2.8).
• However, they accounted for 5.9 of all cases
  with a moderate to major medical outcome and 28
  of the deaths.
• Source Dr. Jerry Blondell OPPTS, EPA

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PM a Major Public Health Risk

• Diabetes 60,000 people die annually in the US
• End-stage Renal Disease 60,000 deaths/yr
• Particle Pollution 60,000 deaths/yr
• Source Wayne E. Cascio, MD, Professor of
  Medicine and Chief, Division of Cardiology, Brody
  School of Medicine, East Carolina University

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WHO Estimates of Premature Death Due to Air
Pollution

• In 1995, WHO estimated that 460,000 avoidable
  deaths occur annually as a result of suspended
  particulate matter.
• In 1997, WHO and others estimated that each year,
  nearly 700,000 deaths are related to air
  pollution.
• About 8 million avoidable deaths will occur
  worldwide by 2020.

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Ozone and Particulate Matter (PM)

• Ozone PM have the greatest potential to affect
  the health of older adults.
• PM is linked to premature death, cardiac
  arrhythmias, heart attacks, asthma attacks, and
  development of chronic bronchitis.

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Hospitalizations for asthma, 1998-2000
Hospitalizations per 10,000 population
Total
Black
White
Total
Black
White
White
Black
Total
Children under 5 years
Persons 5 to 64 years
Persons 65 and older
I 95 confidence interval Note Data are age
adjusted to the 2000 standard population. Data
for Hispanics, American Indians, Alaska Natives,
Asians and Pacific Islanders are unreliable.
Obj. 24-2 a, b, c
Source National Hospital Discharge Survey
(NHDS), CDC, NCHS
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Asthma deaths by age, 1999-2000
Deaths per 1,000,000 population
2010 Target
1999
2000
5-14
15-34
65 and over
Under 5
35-64
Years of age
Obj. 24-1 a-e
Source National Vital Statistics System, CDC,
NCHS.
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Activity limitations among persons with asthma,
1994-96
Age-adjusted percent
Total
Female
Male
White
Poor
Hispanic
Black
Middle/ high
Near poor
Not Hispanic
Family income
NOTE Data are age adjusted to the 2000 standard
population.
Obj. 24-4
Source National Health Interview Survey (NHIS),
CDC, NCHS
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Highest rate of symptoms in older
adults(California HIS)
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More than 70 Could Better Manage Asthma Triggers

• Only 30 of US pop. with asthma are taking simple
  steps to reduce exposure to asthma triggers.
• Exposure to asthma triggers such as second hand
  smoke, cockroaches, dust motes, mold, and ozone
  can set off asthma attacks.
• Source US EPA survey

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Indicator 27 - Air Quality
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Indicator 27 - Air Quality
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Who is at Risk from Extreme Heat?

• Older adults and young children are at high risk.
• Living alone or being confined to a bed and
  unable to care for ones self increases risk.
• Chronic illness, mental impairment or obesity are
  also risk factors.

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Heat-Related Mortality --- Arizona, 1993--2002,
and United States, 1979--2002
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Intergovernmental Panel on Climate Change
Predicts

• Increases in frequency and duration of Extreme
  Heat Events (EHE)
• Increases in urbanization and heat island effects
• Trend increase in of US population over 65 yrs
  
• Trend More people living alone

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Gastrointestinal Illness in the U.S.

• 211 million episodes of acute gastrointestinal
  illness occur each year in the US.
• Result in more than 900,000 hospitalizations
  6,000 deaths (Mead 1999).
• Many of these cases may be of infectious origin
  due to food or waterborne transmission.
• Slide provided by Jack Colford, UC Berkley

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Burden of Waterborne Disease

• Studies have found that 1/3 of GI illness cases
  are related to drinking water, suggesting that up
  to 70 million cases of GI illness may be caused
  by waterborne pathogens.
• Source Payment 1991 1997

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Older Adults at Increased Risk for GI

• Older adults may be at increased risk for
  infectious GI illness, severe diarrhea, or dying
  from diarrheal illness.
• Source Peterson 2003, Mounts 1999, Gerba 1996,
  Lew 1991

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Bacterial and Viral Enteric Diseases as
Contributing Causes of Death by Age, 1989 - 1996
Viral 89-90
91-92 93-94
95-96
Bacteria 89-90
91-92 93-94
95-96
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Hospitalizations and Deaths

• Highest rates of death related to enteric disease
  are seen among people older than 75 years.
• Deaths related to bacterial enteric disease in
  older adults are increasing at a greater rate
  than in any other age category
• Source Peterson 2003

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EPAs Drinking Water Hotline [phone]
http//www.epa.gov/safewater/faq/
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Building Healthy Communities for Active Aging

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Building Healthy Communities for Active Aging

• Raise awareness in communities about the
  importance of Smart Growth and Physical Activity
  for older adults.
• Communities will have the opportunity to assess
  themselves. Cities, counties and tribes.

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Built Environment

• Developments where we live, work, shop and play
  has direct and indirect effects on the natural
  environment
• Where and how we develop directly impacts natural
  resource areas and wildlife habitat an replaces
  natural cover with impervious surfaces such as
  concrete or asphalt.

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Smart Growth can Build Healthy Communities

• Provide environmental benefits
• Less air pollution
• Less water pollution
• Less sprawl
• Less traffic
• More open space

• Promote physical activity
• More opportunities to walk
• More bike lanes
• Better access to parks, trails, and
  recreational areas

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Benefits of Physical Activity and Costs of
Inactivity

• 38 of Americans age 55 is sedentary
• 50 of women age 75 engage in no physical
  activity
• Regular physical activity reduces risk of
  coronary heart disease, risk for stroke, colon
  cancer, diabetes, and high blood pressure by
  30-50

Source CDC
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65 Engaging in Physical Activity 2003-2004

• 22 of population 65 reported engaging in
  regular physical activity
• The percentage engaged in physical activity drops
  off at older ages
• 30.5 45-64
• 27.5 65-74
• 19.4 75-84
• 8.6 85
• Source NHIS- (civilian non-institutionalized
  pop.) Federal Interagency Forum on Aging Related
  Statistics. Older Americans 2006 Key Indicators
  of Well-Being. Washington, DC

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Supporters of BHCAA

• AARP
• Active for Life (AFL)
• America Walks
• The Administration on Aging (AoA)
• The American Medical Association (AMA)
• The American Public Health Association (APHA)
• The Atlanta Regional Commission (ARC)
• The American Society on Aging (ASA)
• The Council of State and Territorial
  Epidemiologists (CSTE)
• Generations United (GU)
• The Gerontological Society of America (GSA)
• The Healthy Aging Research Network (HAN)
• The International City/County Management
  Association (ICMA)
• The International Council on Active Aging (ICAA)
• The Local Government Commission (LGC)
• The Milton H. Erickson Foundation, Inc.
• The National Association of Area Agencies on
  Aging (n4a)
• The National Blueprint Initiative
• The National Council on Aging (NCOA)

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United Nations Conference on the Human
Environment, Stockholm

• "Every human has a fundamental right to an
  environment of quality that permits a life of
  dignity and well-being

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Fact Sheets www.epa.gov/aging

• Age Healthier, Breathe Easier
• Effective Control of Household Pests
• Its Too Darn Hot--Planning for Excessive Heat
  Events
• Environmental Hazards Weigh Heavy on the Heart
• Water Works
• Translations
• Spanish, Portuguese, Chinese, Korean, Vietnamese,
  Russian,
• Italian, French, Japanese, Arabic, Haitian
  Creole
• Purple Series For those with limited reading
  ability

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Aging Initiative List Serve

• Join the EPA Aging Initiative List serve for
  monthly updates
• www.epa.gov/aging
• Funding opportunities http//www.epa.gov/osp/tri
  bes/announce/fund.htm
• Kathy Sykes
• sykes.kathy_at_epa.gov [phone]

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Ecological Footprint

• Ecological Footprint is a resource management
  tool.
• It measures how much land water area a human
  population requires to produce the resources it
  consumes and to absorb its wastes, taking into
  account prevailing technology.

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Ecological Footprint

• Humanitys footprint is 20 larger that what the
  planet can regenerate. It takes more than a year
  and two months for the Earth to regenerate what
  we use in a single year.
• http//www.myfootprint.org/