This weekend there is a major World Health Organization Conference. Delegates are meeting in Switzerland to discuss how to implement “functioning”. Traditionally the W.H.O. has monitored a nations health with mortality and morbidity. How many people died and how many got ill. The nature of the diseases has changed.

Communicable diseases are in decline all over the world. Many have succumbed to the onslaught of modern medicine. Diseases such as smallpox and polio have been all but eradicated. Their place has been taken by chronic diseases much more associated with old age. Diseases like cancers and cardiovascular illnesses are different. They can be treated and are being beaten. Often though they reduce the quality of life from those suffering and recovering. "Functioning" is the ability to live a normal life. Measuring functioning and emphasising rehabilitation will change the global view of a healthy nation. Part of “functioning” is the ability to contribute to Society.

“Societal Participation”

The McKinsey Health Institute showed the difference that participation can make to the individual. They surveyed older people all over the world. The best predictor of happiness in old age is the to have good relationships. It is through those relationships that people get a sense of purpose in their lives. That purpose increases happiness but also improves health. They define “societal participation” as:

It is more than casually “helping out”. Such participation does more than help the individual. There are significant “Longevity Dividends” that can come to a country as well. Engaging in work as we age contributes directly to the health of the economy ( (Newsletter #182 “The Longevity Dividend”). McKinsey estimated the economic value of being able to “work if you wish” for US citizens over 55. It would contribute an extra 7.2% to the US economy or $1.7TN. The "retired" contribute huge amounts of unpaid work through caring and volunteering (Newsletter #183 “The Longevity Dividend II”).

Making Participation Happen.

Purpose can come simply and cheaply. In Hanoi an NGO has organized 94 intergenerational self-help groups. Their objective is to help the disadvantaged old. The groups set their own agendas and decide how they can help each other. They have created micro-finance initiatives and helped older people to get home care. Of course, the sense of purpose instilled by the process has benefitted all. Being empowered to set theit own agendas was crucial.

A “peer to peer” self-help program in Cape Town has achieved the same double impact. Both the helpers and the helped have benefited. They adopted over 200 older people from a deprived area. Volunteers who were themselves over 65 befriended them. They helped them find appropriate medical and social care, tapping into existing resources. Mental health benefits accrued to both groups at very little cost.

The US “Experience Corp” has mobilized older volunteers. They help disadvantaged school children in their communities. That personal help has improved child literacy significantly . An unexpected benefit has been an increase in teacher retention. After a successful pilot the program was adopted by the AARP. There are now over 2000 volunteers who are able to help 30,000 students across 21 US cities.

The integration of different organizations can create powerful impact. In Santiago the Red Active Bands have done this. The University worked with the Traffic Management Authority. The Transport Company and local firms all worked together with them. They used a user centric approach and asked older people what would help. The resultant silicon wrist bands have unique functionality. They can be used to extend the time at pedestrian crossings controlled by traffic lights. They offer free access to restrooms in participating businesses. They allow users to signal preferential stops on public transport. All increase the ability of older people to function in complex cities.

Investing in the Older Workforce

There are many integrated initiatives for the old in Singapore (Newsletter #120). One focused on returning older people to the workforce. There is a large retraining program to allow older people to reskill. The scheme covers 90% of fees. The second part was legislative. It gave older people the right to remain in work. The third was a grant program to help firms redesign jobs to fit the needs of older workers. This included everything from the physical layout of workspaces to the creation of job sharing programs. The initiative has continued. 24,000 workers aged 50 and over have so far benefitted from job redesign grants to some 2500 companies. 99,000 older workers have currently been retrained on over 1000 courses.

Participation Breaks Down Ageism

One of the most powerful ways to break down ageism is intergenerational contact. It is difficult to stereotype someone that you know. It is even more difficult if you know many older people. The value of using the stereotype is eroded. The more that older people participate in Society the more that ageism is weakened.