The health of the American public has become a central concern in many domains: federal, state, and local governments, health research institutes, private foundations, health insurers, the medical community, and disease-based organizations. These entities recognize that the population’s health status has worsened and that individual choices and changes are crucial to regaining good health. In 2000, according to the Public Health Service, U. S. Department of Health and Human Services, poor diet coupled with lack of exercise was the second leading cause of death in the U.S., accounting for an estimated 17% (400,000) of deaths. Tobacco use was the leading cause; however, the gap between these two factors had narrowed considerably in the past decade. Together, poor diet and lack of physical activity [words missing here]

The State Advisory Council on Aging began its discussion of health promotion/disease prevention by identifying some issue areas for presentations. Despite the fact that more issues were raised than time would allow, several key topics were explored. Some of the issues considered were nutrition and health; state and local public health initiatives; urban minority health status; and specific disease prevention initiatives, e.g., diabetes. These are discussed in other sections of the report.

Council members expressed the concern whether health promotion/disease prevention initiatives were even directed at older people. Despite research indicating that even those age 75 could benefit from adopting some health habit such as walking or eating better, the Council was concerned that the aging network, service providers, and health care systems were failing to give older adults the health promotion message.

The Council was also concerned that people in mid-life realize the importance of making healthy choices and take advantage of the health promotion opportunities. For those who work with older adults, the Council supported staff participation in health promotion activities. They adopted the principle that you must be willing to do what you ask of others. Council members' activities, including some of these practices es, are listed in subsequent sections.

Michigan has many weaknesses and shortcomings in the area of health. We have high numbers of obesity and we have low numbers of physical activity among our population. Yet, we have an abundance of knowledge and experience in our healthcare resources, we have dedicated health advocates, such as the Michigan Surgeon General, and we have available programs to help support healthy choices. The Council identified two factors as significant: an “elderfriendly” community will include health promotion/disease prevention activities for people of all ages, and the aging network must be the “town crier” to reach older adults with the message that it’s never too late to make healthy choices.

The State Advisory Council on Aging, therefore, recommends that

The Commission on Services to the Aging, the MI Office of Services to the Aging, and the Area Agencies on Aging focus on health promotion/disease prevention as a means of aging in place.

The State Advisory Council on Aging suggests the following action steps to implement this recommendation:

· Provide informal education, community forums, or other outreach to older adults on health promotion/disease prevention.

· Utilize community volunteers to help increase health awareness, increase physical activity, and support older adults in becoming more active.

· Distribute the Michigan’s Surgeon General's “Prescription for a Healthier Michigan” to senior programs, services, and healthcare providers.

· Provide incentives/recognition for community and individual participation in health promotion activities.

· Develop partnerships with organizations/entities outside the aging network to reach mid-life people with information and opportunities for health promotion/disease prevention.

· Utilize existing collaborative entities, e.g., multi-purpose collaborative bodies, to focus on health promotion/disease prevention activities.

· Identify opportunities for health promotion/disease prevention activities in the planning and delivery of services, such as information and assistance, housing, transportation, and community and in-home services.

· Explore innovative outreach to Chambers of Commerce, health systems, private and public foundations, and community education resources to reach mid-life and older adults outside the aging network’s service system.

· Support intergenerational health promotion opportunities, such as using schools for walking clubs after classes.

The Council revised the factors that create an “elder friendly” community from its 2004 Annual Report. The 2005 factors for an “elder-friendly” community are

1. Walkability

2. Supportive community systems: the ability to give and receive assistance

3. Access to health care

4. Safety and security

5. Housing

6. Transportation

7. Health promotion/disease prevention programs for all ages