Social participation and healthy ageing: a neglected, significant protective factor for chronic non communicable conditions

Abstract

BackgroundLow and middle income countries are ageing at a much faster rate than richer countries, especially in Asia. This is happening at a time of globalisation, migration, urbanisation, and smaller families. Older people make significant contributions to their families and communities, but this is often undermined by chronic disease and preventable disability. Social participation can help to protect against morbidity and mortality. We argue that social participation deserves much greater attention as a protective factor, and that older people can play a useful role in the prevention and management of chronic conditions. We present, as an example, a low-cost, sustainable strategy that has increased social participation among elders in Sri Lanka.DiscussionCurrent international policy initiatives to address the increasing prevalence of non-communicable chronic diseases are focused on cardiovascular disease, diabetes, respiratory disease and cancers, responsible for much premature mortality. Interventions to modify their shared risk factors of high salt and fat diets, inactivity, smoking and alcohol use are advocated. But older people also suffer chronic conditions that primarily affect quality of life, and have a wider range of risk factors. There is strong epidemiological and physiological evidence that social isolation, in particular, is as important a risk factor for chronic diseases as the 'lifestyle' risk factors, yet it is currently neglected. There are useful experiences of inexpensive and sustainable strategies to improve social participation among older people in low and lower middle income countries. Our experience with forming Elders' Clubs with retired tea estate workers in Sri Lanka suggests many benefits, including social support and participation, inter-generational contact, a collective voice, and facilitated access to health promotion activities, and to health care and social welfare services.SummaryPolicies to address the increase in chronic non-communicable diseases should include consideration of healthy ageing, conditions that affect quality of life, and strategies to increase social participation. There are useful examples showing that it is feasible to catalyse the formation of Elders' Clubs or older people's associations which become self-sustaining, promote social participation, and improve health and well-being of elders and their families.

Impact of vision impairment and self-reported barriers to vision care: The views of elders in Nuwara Eliya district, Sri Lanka

“…The elders' accounts show that both near and distance vision problems restrict the lives of elders. We have found that community Elders' Clubs can reduce the social isolation of elders who cannot see well (Holmes & Joseph, 2011).…”

Evaluating the psychometric properties of the Arabic version of the Groningen Frailty Indicator among Lebanese elderly people

“…It consists of the following factors: age (0-3), self-reported health status (0-1), physical disability (0-2), and functional disability (0-4). It is a 13-item simple functionbased questionnaire which is helpful for identifying vulnerable elderly persons in the community [20][21][22][23]. Each question on the test has a point scoring system beside it, and these numbers are totaled to give an overall score with the highest possible score of the scale is 10.…”

An Ethnographic Meta‐Synthesis of Three Southwestern Rural Studies

“…First, successful efforts to address and resolve rural health disparities must engage the voices of community residents and advisers from all key stakeholder groups, planners, researchers, and organizations. Regionally, nationally, and internationally, strategies of engagement and collaboration are recommended by researchers, policymakers, and public health advocates to reduce disparities and eliminate health‐related inequities (Borders, ; Holmes & Joseph, ; Kotelchuck, Lowenstein, & Tobin, ; Weinhold & Gurtner, ; WHO ). This recommendation applies to public health nurses (PHNs) in practice, as well as to rural health researchers.…”