Gaining health : analysis of policy development in European ...

Chapter 4
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A first policy for older people was published in 1988, The
years ahead: a policy for the elderly. Its main recommendations
– to maintain or restore older people to their home
environment, to encourage the care of older people in the
community and to provide high-quality hospital and residential
care when necessary – were later recognized in the
1994 broad health strategy and the 1995 health promotion
strategy.
Although these broader health strategies of the mid-1990s
identified older people as a priority population group with
particular health promotion needs, their main focus was
on the under-65s. Furthermore, a study of older people
found that almost half of the respondents had major health
problems, and one in four suffered from psychological
distress provoked more by the onset of poor health than
old age itself (40). In 1995, therefore, the National Council
on Ageing and Older People proposed the development
of a healthy ageing programme to improve life expectancy
and the health status of people at age 65 and beyond, and
to improve the lives and autonomy of older people already
affected by illness.
The programme had three strands, the first of which was a
health promotion strategy for older people: Adding years to
life and life to years (41). This strategy, formulated in association
with the DoHC, marked the launching of the Council’s
Healthy Ageing programme. It was seen as a further
refinement of the 1994 health and the 1995 health promotion
policies, and a follow-up to the 1988 policy for older
people. The main objectives are to improve:
• life expectancy at age 65 and beyond;
• the health status of people aged 65 and beyond; and
• the lives and autonomy of older people who are already
affected by illness and impairment.
It recognizes that older people are sometimes left out
of more general health education and health promotion
interventions, and that owing to the broad diversification
of older people in terms of health status and dependency
levels, different approaches may be needed than those for
younger age groups.
CVD accounts for 48% of deaths among those aged 65
years and over, and cancer is the second most common
cause of death in this age group. The strategy sets quantified
targets to reduce the death rates from these causes
among older people and to deal with risks such as smoking
and hypertension. It also deals with broader determinants
of health, including tackling ageism and supporting participatory
structures such as the Irish Senior Citizens National
Parliament.
The second strand involved the development of an information
and support network, including a database on health
promotion practice and a fact file series, Ageing in Ireland.
The third strand aimed to evaluate new or existing initiatives,
starting with a home accident prevention programme,
a health education programme in the north-east and an
intersectoral programme, involving the Irish Sports Council
(“Go for life”), encouraging physical activity.
As is the usual practice, the strategy takes fully into account
similar international developments. It also makes provision
for evaluation of interventions.
2.8. Broad intersectoral policies with a health
component
A number of important developments with implications
for social inclusion issues, including efforts to reduce health
inequalities, took place in Ireland in 2006 and early 2007.
• A new 10-year Framework Social Partnership Agreement
for 2006–2015, Towards 2016, was published in
June 2006.
• The National Report on Strategies for Social Protection
and Social Inclusion was forwarded to the European
Commission in September 2006, outlining key objec-
Case studies: policy development in countries for tackling noncommunicable diseases