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February 2008
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CommentariesBuilding Extension's Capacity Through Knowledge of Global Aging Issues
Debra M. Sellers Local Needs, Global AnswersExtension professionals are firmly grounded in local communities. We are proud of our ability to improve the lives of our neighbors. At times, we extend this definition of neighbor to include individuals living in our state, nearby states, or region. Sometimes we expand the definition to a national level. It can be more difficult to think of a neighbor as an individual living in another nation; this may seem too far from the Extension tradition and may be thought to occur at the expense of local needs. Incorporating a global perspective into daily Extension work is not, however, a zero-sum game. The advantages of thinking globally have been outlined by several Extension professionals (Gallagher, 2002; Lev, 2001; Ludwig, 2002; Sundermeier, 2006). A willingness to explore the global stage can improve and embellish program development, implementation, and evaluation methods. Knowledge of other countries' successes and failures builds Extension's capacity to have a positive impact in local communities. Insight into global issues thus becomes an additional resource for Extension professionals. One common global concern is the aging of the population. In 2002, those aged 65+ comprised 7% of the world's population. By 2050, that number is expected to rise to nearly 17% (U.S. Census Bureau, 2004). This trend points to serious social, political, and economic consequences around the world and is a signal that for many countries, current programs are inadequate and must be reformulated. China's Importance on the Global Aging StageFor those interested in the impact of global solutions related to aging communities, an exploration of China's alternate viewpoints and models is instructive. China has several features that demand immediate attention.
Program Development and Implementation in ChinaInsight into aging in China is outlined here through a presentation of selected observations from the Seminar in Beijing conducted by the American Society on Aging in May 2007. This event was experiential in nature, and the 24 of us who participated were provided with entrée not normally granted to foreigners. An investigation of Chinese perspective through visits to aging centers in Beijing; interaction with medical professionals, academics, and government officials; and an exploration of the culture were integral components of the seminar. China's rapid social and economic reforms, coupled with future population projections, provide openings to develop innovative aging programs on a scale never before attempted in world history. In particular, efforts in personal development, health care, and family caregiving have possible implications for programming in the United States. Personal DevelopmentPersonal development for older adults is positioned within China as a crucial central tenet in terms of quality of life. Women retire at 55; men at 60. Thus, there is a critical need to develop non-employment interests for a stage of life that could last upward of 30 years. Recreation, leisure, and sport are viewed as an important aspect of personal development. This value is evident in the approximately 47,000 recreation and activity centers for older adults. For those interested in education, individuals can attend one of more than 26,500 senior universities. Varying across communities, senior universities consist of facilities and programming. A senior university in Beijing provides classes in a variety of areas, such as dance and computer instruction. The cost to attend is minimal (about $8.00 per term). Health CareTraditional Chinese Medicine (TCM) is a comprehensive and holistic view of health and is composed of five foundational concepts: nutrition, lifestyle, emotion, exercise, and mental fitness. Prevention and wellness are viewed as critical aspects of the overall framework. Physical activity is highly encouraged in China and is a habit for many people, young and old. Exercise can occur for its own sake, but the incorporation of physical activity into daily lives is a cultural norm. Education about prevention is a primary focus in China for its potential impact upon quality of care and quality of life. As approximately 60% of all older Chinese live in rural areas (IOSCPRC), education about health-related topics is primarily disseminated through use of various media, including television and radio. Family CaregivingIn 1996, a law concerning the rights of elderly people was adopted, with one article stating explicitly that the main provision of support to old people is the family (Legislative Affairs Commission of the Standing Committee of the National People's Congress of the People's Republic of China, 1996). The Chinese presenters commented frankly concerning the breakdown in thousands-year-old traditions of familial values related to reverence for older people. Through the use of words such as "abandonment," it became evident that social attitudes are quickly changing. As part of a response to changing attitudes, the government is encouraging family support contracts: a legal document that outlines what children will provide for their parents. By 2005, approximately 13 million such contracts had been enacted (IOSCPRC, 2006). What Extension Can Learn from China's ResponseI pose the questions below as examples of initial thoughts concerning another country's responses to aging and the applicability of that response to Extension programming. Personal Development
Health Care
Family Caregiving
Consideration of China's responses and the possible applicability to the United States is worthy of reflection as we are also facing broad and comprehensive changes to our population. Thinking globally about this issue presents an opportunity to expand possible Extension programming possibilities for older adults through assessment of the relevance of global answers to local communities. By thinking of the Chinese as neighbors, Extension professionals can learn about diverse and unique solutions and incorporate the 'best of' into their own programs and services. How Extension Professionals Can Go Global Without Leaving Their OfficeAlthough Extension professionals may acknowledge the benefit of thinking globally, it can be easy to allow the active development of a global perspective to slide to the bottom of the pile. Here are some activities that can be helpful, and all of these can be completed without leaving the office!
What Does Global Aging Mean to My Neighbors and Me?The pressing problems that have and will come to the United States as the result of our aging population sweep across areas as diverse as agriculture, family relationships, finances, health, and nutrition. Taking an expanded view of the needs of an aging clientele and possible solutions is one way to serve in our local communities. Extension professionals clearly will have an important role in shaping the vision for this future old age society. We can build capacity in the role of educator through understanding global efforts and increasing our knowledge of other countries' failures and successes as they attempt to address aging populations. Engagement in active reflection and assessment of diverse answers results in the development of new perspectives. Thinking beyond the state, region, and nation powerfully influences the creation of solutions and development of programs for our neighbors. ReferencesChina National Committee on Ageing. (1999, January 9). Ageing and development. Beijing: Author. Gallagher, T. J. (2002). Going international in Extension: A done deal? Journal of Extension [On-line], 40(3). Available at: http://www.joe.org/joe/2002june/comm1.html Information Office for the State Council of the People's Republic of China. (2006, December). The development of China's undertakings for the aged (1st ed.). Beijing: Foreign Languages Press. Legislative Affairs Commission of the Standing Committee of the National People's Congress of the People's Republic of China. (1996). Law of the People's Republic of China on Protection of the Rights and Interests of the Elderly (1st ed.). China National Committee on Ageing: HuaLing Publishing House.
Lev, L. (2001). Leave home! International sabbaticals as unfreezing experiences. Journal of Extension [On-line], 39(4). Available at: http://www.joe.org/joe/2001august/comm1.html Ludwig, B. G. (2002). Global in our backyard. Journal of Extension [On-line], 40(2). Available at: http://www.joe.org/joe/2002april/comm1.html McDevitt, T. & Rowe, P. M. (2002, February). The United States in international context: 2000. Census 2000 Brief (Report No. C2KBR/01-11). Washington, DC: U.S. Census Bureau. Sundermeier, A. (2006). Become an international ambassador with People to People. Journal of Extension [On-line], 44(5) Article 5TOT6. Available at: http://www.joe.org/joe/2006october/tt6.shtml U.S. Census Bureau. (2004, March). Global population at a glance: 2002 and beyond. International Brief (Report No. WP/02-1). Washington, DC: Author. U.S. Department of State. (2007, March 19). Consular information sheet: China. Retrieved June 14, 2007 from http://travel.state.gov/travel/cis_pa_tw/cis/cis_1089.html Now it's your turn. Engage in discussion with your colleagues. Participate in the JOE Discussion Forum on "Building Extension's Capacity Through Knowledge of Global Aging Issues."
USDA CSREES' Role in Broadening Support for an Aging Nation
Shirley A. Gerrior
Caroline E. Crocoll IntroductionThe aging of America is a major public concern and has far reaching implications for the nation and for rural communities (U.S. Census Bureau, 2003). With one-quarter of Americans living in rural settings, rural communities generally have a higher proportion of older persons in their total population than urban areas. This is largely due to aging-in-place, out-migration of young adults, and in-migration of older persons from metro areas and other regions of the world (ERS, 2005; U.S. Census Bureau, 2003). Additionally, older Americans living in these communities face a greater likelihood of poverty and food insecurity, geographic isolation, inadequate housing, and often inaccessible or costly health and social services (ERS, 2005). Non-farm rural elderly account for the majority of rural elderly and suffer from a disproportionate number of chronic health conditions and health problems and have more restrictions on their lives than any other group of older people (ERS, 2005). Of particular concern is the increase in overweight and obesity, the high incidence of hypertension and diagnosed arthritis, and incidences of cancer, diabetes, and arthritis (AOA, 2006). Many rural elderly do not participate in health promotion programs and services, resulting in undiagnosed conditions and higher rates of chronic disease (Wilcox, Bopp, Oberrecht, Kammermann, & McElmurray, 2003). Although the challenges facing rural communities are formidable, opportunities for improving health and health care services of older adults do exist. For example, the recent growth of the ethanol industry in rural areas may be advantageous to some rural families through employment and increased income (ERS, 2007). Older persons as members of these families may benefit indirectly through family resources and the potential for improved community infrastructure associated with economic development. The federal government as well as states and local communities can play a critical role in providing resources and supports to rural people and communities to improve health. This role and the coordination of services and educational outreach can be effectively supported through the U.S. Department of Agriculture's Cooperative State Research, Education, and Extension Service (USDA CSREES) in partnership with the land-grant university system.
What Is the Role of USDA CSREES?USDA CSREES is strategically directed to address many of the problems faced by older populations. Two of its six strategic goals align with the needs of rural aging populations:
Within each of these two goals are specific objectives that expand on CSREES' role to achieve these goals. Working with its land-grant university and Cooperative Extension System (CES) partners, CSREES promotes the well-being of Americans through effective research, education, and Extension to better understand the socioeconomic and environmental factors affecting rural communities and the people who live there. Cross-cutting programs within these two goals effectively align and bring together a number of content areas focused on rural aging issues to include; health; nutrition; financial security; housing; rural caregiving and community development. Improving the Nation's Nutrition and HealthEnvironmental barriers, geographic isolation, lower income, and lower education levels are common to the rural elderly (Vitolins, Quandt, Bell, Arcury, & Case, 2002) and may compromise health. Limited access to a nutritious diet or a diet of poor quality has the potential for inadequate energy and essential nutrient intake leading to malnutrition and dehydration (ADA, 2000, 2005) and may be a factor in the development of a number of chronic and debilitating diseases. In addition, a sedentary lifestyle is a significant health risk to aging individuals. Regular physical activity is associated with many physical and mental health benefits (NCHS, DHHS & USDA, 2005; Stepnick, 2006), but older people are often discouraged from doing physical activity, and regular leisure physical activity decreases with advancing age. Poorer adults are less likely to engage in physical activity than those with higher incomes (NCHS, 2005). Also, older rural residents, especially women, face a number of barriers to being physically active, including lack of family support, the fear of injury, caregiving duties, and unsafe or isolated physical environments (Wilcox, Bopp, Oberrecht, Kammermann, & McElmurray, 2003). USDA uses its nutrition and assistance programs and broader nutrition education efforts to promote healthier eating and more physical activity across the nation. CSREES sponsors research to improve scientific knowledge concerning nutrition and health and supports education and Extension to promote healthy diets, ensure access to healthy food, and encourage healthy living. CES' educational and outreach efforts strive to improve nutritional well-being and quality of life of older adults using a variety of effective strategies and research-based interventions and establishing community-based healthcare partnerships. Supporting Increased Economic Opportunities and Improved Quality of Life in Rural AmericaRural areas struggle with many forces that can negatively affect health and the well-being of older adults. To help meet the economic and quality of life needs of this population in rural areas, family members, neighbors, and friends often fill the service gap, providing both direct and indirect caregiving services. Finding resources to help with caregiving can be difficult. Rural caregivers are isolated from social support, resources, financial assistance, training, respite options, community programs, and information on caregiving (Rural Assistance Center, 2005). Additionally, caregiving demands often interfere with job responsibilities and workplace productivity. Unmet family needs, including access to accurate information and support among diverse populations, leave communities and employers unprepared to meet growing caregiving responsibilities. These factors can have a significant impact on the health and wellness of older family members. Rural communities should be able to provide basic services to families, including access to clean water, adequate housing, and reliable electricity and telecommunications, and such essential needs as quality education, health care, day care, public safety services, and cultural activities. To assist with these needs and services, CSREES and its nationwide partnership promote the well-being of rural communities through research, education, and Extension to better understand the economic, demographic, and environmental forces affecting older adults and use this knowledge to develop strategies that make maximum use of local assets. What Does CSREES Need to Do to Engage Individuals and Communities on Rural Aging Issues?Enhanced educational efforts and outreach to rural communities are needed to increase public awareness and community engagement on aging issues. Over the past decade CSREES and other USDA agencies have addressed population aging both as individual agencies and through coordination and collaboration in a variety of ways. Interagency working groups, task forces, multi-state initiatives, and local, state, and national communities of educators and social service professionals have joined forces to share and exchange resources, services, and educational materials to support for interventions to promote healthy aging. Partnerships between state and community agencies, as well as with private partners, facilitate coordination and expansion of nutrition, health, and housing information and supportive services for older adults living in rural areas. The need for these services and for education and outreach at the state, regional, and community level will continue to grow as the vast Baby Boomer generation ages over the coming decades. CSREES and its land-grant partners are uniquely positioned to reach out to older adults and their families in rural communities to inform and educate them about the many issues, challenges, and opportunities related to healthy aging. In 2007, CSREES supported research on healthy aging in rural communities through the Rural Health and Food Safety Education Program, and many other research and educational efforts are underway to serve this audience, including the emerging Family Caregiving Community of Practice sponsored by the eXtension Initiative. Through higher education programs, CSREES builds and strengthens the capacity for training the next generation of scientists and educators to care about the well-being and quality of life of older adults. More information about these age-related activities can be accessed at http://www.csrees.usda.gov/nea/family/in_focus/family_if_adultdevelopment.html ConclusionCES' Family and Consumer Sciences and Nutrition educators in the land-grant university system are ideal conduits to improve access for older adults, their families, and communities to high-quality educational resources and support services. However, to ensure program sustainability and effective educational programs serving rural communities, CES must document local program effectiveness and timeliness to meet current and future needs related to aging and caregiving. In particular, it is important that CES educators keep older adults and their families interested and participating in educational programming by making programs culturally and ethnically relevant and suited to an aging rural population in a safe environment with trained staff. CES can and should lead the way in the interpretation of relevant research, government policy, advocacy of nutrition programs, and promoting accurate health information to rural communities to strengthen families and improve quality of life for generations to come. ReferencesAdministration on Aging. (2006). A profile of older Americans: 2005. Retrieved June 7, 2006, from http://www.aoa.gov/PROF/Statistics/profile/2005/2005profile.pdf American Dietetic Association. (2000). Position of the American Dietetic Association: Nutrition aging and the continuum care. Journal of the American Dietetic Association, 100, 580-595. American Dietetic Association. (2005). Position of the American Dietetic Association: Nutrition across the spectrum of aging. Journal of the American Dietetic Association, 105, 616-633. Center for Health Workforce Studies. School of Public Health, University at Albany. (2006). The impact of the aging population on the health workforce in the United States. Rensselaer, NY. Economic Research Service. (2005). Briefing Room: Rural population and migration: rural older population. Retrieved September 6, 2005, from http://www.ers.usda.gov/briefing/population/older/ Economic Research Service. (2007). Rural America at a glance 2007 edition. Retrieved October 9, 2007 http://www.ers.usda.gov/Publications/EIB31/ National Center for Health Statistics. (2005). Health United States, 2005 with chartbook on trends in the health of Americans. (Library of Congress Catalog Number 76-641496) Washington, DC: U.S. Government Printing Office. Rural Assistance Center. (2005). Informal caregiving. Retrieved June 4, 2006, from http://www.raconline.org/info_guides/caregiving/ Stepnick, L. (2006). A new vision of aging: Helping older adults make healthier choices. Washington, D.C. U. S. Census Bureau. (2003). Internal migration of the older population: 1995 to 2000. (Census 2000 Special Reports. CENSR-10). Washington, DC: U.S. Government Printing Office. U.S. Department of Health and Human Services and Department of Agriculture. (2005). Dietary guidelines for Americans 2005. (Home and Garden Bulletin No 232). Washington, DC. Vitolins, M. X., Quandt, S. A., Bell, R. A., Arcury, T. A., & Case, L. D. (2002). Quality of diets consumed by older adults. Journal of Rural Health, 18, 49-55. Wilcox, S., Bopp, M., Oberrecht, L., Kammermann, S. K., & McElmurray, C.T. (2003). Psychosocial and perceived environmental correlates of physical activity in rural and older African American and white women. Journal of Gerontology: Psychological Sciences, 58B, 329-337. Now it's your turn. Engage in discussion with your colleagues. Participate in the JOE Discussion Forum on "USDA CSREES' Role in Broadening Support for an Aging Nation."Copyright © by Extension Journal, Inc. ISSN 1077-5315. Articles appearing in the Journal become the property of the Journal. 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