Researching into Commitments for Sustainable Development Goals and Healthy Aging

*Santosh Kumar Mishra*

#### **Abstract**

Implementing the Programme of Action (PoA), for the purpose of attaining Sustainable Development Goals (SDGs, also known as the *"Global Goals"*, adopted by UN Member States in the year 2015) requires, among other contributing factors, specific strategies on: (a) *aging*, and (b) *health*. The PoA was adopted at the International Conference on Population and Development (ICPD) that took place at Cairo, Egypt, in the year 1994. In view of these facts, the author of this paper makes two research statements: (a) *"SDGs and healthy ageing (HA) are connected"*, and (b) *"international community, across the regions of the globe, needs to make advocacy efforts for HA"*. These considerations gain increased significance if one looks at demographic trends: significant portion of the world population are older (also known as *"older people"*, *"older adults"*, and *"older citizens"*), with projections that share of older people (over the age of 65 years) will double by the end of 2050. The "UN Decade of Healthy Ageing (2021-2030)", is, thus, a significant development. The author, in the present work, *primarily* attempts to discuss and debate specific initiatives (in terms of strategic interventions) that stakeholders need to undertake for the purpose of ensuring HA. It has been concluded on several platforms that *"attainments of SDGs are closely linked with HA"*. This research note also presents quick highlights on how SDGs and HA are inter-linked. In terms of research mythology employed here, the author has collected secondary data (largely *'qualitative'* in nature) from various sources (*quoted under references*). Method of data analysis is '*descriptive'*. To sum up, key for HA aging lies in enlarging opportunities for positive health at all stages of life.

**Keywords:** Healthy Aging, Sustainable Development Goals (SDGs), Elderly Population, Millennium Development Goals (MDGs), Aging, Older People, Initiatives, Strategic Interventions, and Programme of Action (PoA)

#### **1. Introduction**

It has been increasingly recognized that all persons (of both sexes: males and females), in all parts of the planet, should be accorded with an opportunity that will facilitate them to live both *"long and healthy life"*. As against this commitment to long and healthy life, several international research institutes [including the office of the World Health Organization (WHO)], however, is of the opinion that the environments in which people live can (a) either favor health, or (b) be harmful to it [1]. The author of this paper makes a specific point here that the term

*'environments'* refer to situation which is multi-dimensional in nature. Environmental situations, from this point of view, are influenced together by four broad sets of contributing factors, namely,


The term "healthy *aging"* (HA) refers to a situation wherein the policy makers and other involved stakeholders definitely resort to a process that ensures *'developing'* and *'maintaining'* the functional ability of older population. HA is, therefore, about creating the opportunities and environments that enable people to be (and to do) what they value throughout their live span. Under favorable situations, everybody can, therefore experience HA. However, it is pertinent to note here that merely being free of disease (or infirmity) is not a requirement for HA. This is because of the fact that since many older adults have one or more health conditions that, when well controlled, have little influence on their *"general well-being"* and overall "*better quality of life"* [1].

In the context of Sustainable Development Goals (SDGs) and HA, the conceptual framework of *"functional ability"* gains increased significance. The author of this policy paper briefly discusses here the modality of inter-connections between functional ability and HA (which, according to the WHO, can be defined as *"the process of developing and maintaining the functional ability that enables wellbeing among older age population"*). The WHO, *further*, states that the term "functional ability" is indicative of having the capabilities that enable people to be (and do what) they have reason to attach values in day-to-day life. *Furthermore,* in a more generalized sense, the relevant aspects of functional ability include a person's ability to make achievements in five matters, namely:


*Most importantly*, in addition to what have been stated above, the concept of functional ability envisages the intrinsic capacity of the individual, relevant environmental characteristics, and the interaction between them. The author makes a point here that "intrinsic capacity", the context of HA, comprises all *'mental'* and *'physical'* capacities that an individual can draw on in his/her life. In addition, these capacities (both *"physical and mental"*) include peoples' ability in five key aspects, as outlined below:


*Researching into Commitments for Sustainable Development Goals and Healthy Aging DOI: http://dx.doi.org/10.5772/intechopen.97674*

c. *to see,* d. *to hear, and* e. *to remember* [1].

In the context of discussion on developing capacities in the five areas, as indicated above, it is important to note that the level of intrinsic capacity is shaped and influenced by several factors, such as (a) the presence of diseases, (b) injuries, and (c) age-related changes occurring in the individual human being. Apart from this, the author, in this introductory part of the paper (which primarily aims to give an insight into commitments for SDGs and HA), states that environments include:

a. *the home;*

b. *community and broader society; and*

c. *all the factors within them* [1].

Notably, the factors within them, as outlined above, are comprised of aspects such as, (a) the built environment, (b) people and their relationships, (c) attitudes and values, (d) health and social policies, (e) the systems that support them, and (f) the services that they implement. The author of this research note makes a specific point here that being able to live in enabling environments that support and maintain peoples' intrinsic capacity and functional ability is key to HA [1].

HA is, therefore, one of the demographic indicators that all nations and societies strive to achieve, as mandated under the UN Decade of Healthy Aging (2021–2030). The functional ability, *in turn*, enables well-being in older age. *Further*, HA and functional ability (which, in broader sense, indicates: *"having the capabilities that enable all people to be and do what they have reason to value"*) of an individual are closely inter-connected. *Furthermore*, demographers, policy makers and other stakeholders are of the view that implementing the global strategy and action plan on two significant aspects will contribute to the realization of the SDGs: (a) *aging,* and (b) *health well-being* [2]*.*

#### **2. Materials and methods**

#### **2.1 Rationale and context**

The SDGs (which are reflection of: *"universal call to action to end poverty, protect the planet and ensure that all people enjoy peace and prosperity by 2030"*) were developed in order to secure the future for present and future generations. The 17 universally and unanimously accepted SDGs are integrated: they recognize that: (a) action in one area will affect outcomes in others, and (b) development must balance social, economic and environmental sustainability [3]. The author does not find it appropriate to highlight more about conceptual framework and scope of SDGs, as it is beyond the objectives of this research work. Findings of several research studies are indicative of the fact that many people from across the regions of the globe are, today, in a position to live longer. Also, it has been discovered that sizeable portion of the world's population are in the age that reflects *"older population"* (aged 65 years and above). There are projections (based on data published by the WHO) that the world's population of people over the age of 65, by the year 2050, will

double. Demographic change and/or indicator of this type has implications for sustainable development (SD). The SD is a concept that signifies economic development linked with non-depletion of natural resources. It has been found (in findings of several longitudinal studies conducted by national and intergovernmental agencies, including the WHO) that *"as people grow older, their health outcomes, needs and what they value can change"*. This scenario (connected with old age population) mandates that these changes must be researched into and tackled in appropriate and scientific manners. This will require envisaging *"multi-sectoral actions on ageing and health"*. This aspect, therefore, is critical. It requires support from researchers, academicians, university/higher education administrators, and other stakeholders [2]. The facts presented above signifies relevance of this work. The objectives and other details about methodology employed are outlined in subsequent sections.

### **2.2 Objectives**

The author has divided objectives of this research paper into (a) general objectives, and (b) specific objectives. They are outlined in the following sections. Detailed description on objectives is presented below:

#### *2.2.1 General objectives*

In terms of general objectives, this policy paper outlines the concrete actions that are required if the current decade (or twenty-first century) is to be a success in terms of HA for all. Relevant discussion on policy matters pertaining to HA for all are presented by the author at appropriate sections of the work.

#### *2.2.2 Specific objectives*

With regard to specific objectives, this work primarily attempts to discuss and debate initiatives that stakeholders need to undertake for the purpose of ensuring HA for all on the globe. Specific initiatives, suggested by the author, are in the form of *"strategic interventions"*: both at macro and micro levels. *Most importantly*, the author has outlined actual initiatives (outcome/s of projects) undertaken in various parts of the globe in support of each suggested strategic intervention. Further, in view of the fact that attainment of SDGs is closely linked with HA, this research note also presents quick highlights on how SDGs and HA are inter-linked. In addition, in view of global COVID-19 pandemic (considered as one of the hardest medical and health emergency the mankind has ever encountered), the author has attempted to make quick presentation, in this work, on how national governments are addressing "healthy lives and well-being for all at all ages" (which come under the category of SDG-3). Since this does not come within direct purview of the objectives of this paper, brief discussion on COVID-19 response has been incorporated.

#### **2.3 Type, nature and sources of data**

In this section, attempt has been made to highlights the type of data used in this paper. Also, it discusses the nature of data and source (s) from where they (required for analysis purpose, in view of defined objectives) have been obtained. With regards to type of data, secondary data haven been used by the author. Data used are largely *'qualitative'* in nature. Required data have been collected by the author from the secondary sources, largely published on internet platforms. They (data

*Researching into Commitments for Sustainable Development Goals and Healthy Aging DOI: http://dx.doi.org/10.5772/intechopen.97674*

sources) have been quoted under reference section of the work, as per standards research ethics. At this juncture, the author makes two specific points:


#### **2.4 Processing and analysis of data**

As outlined in the previous sections, the author has used data which are largely *'qualitative'* in nature, in view of objectives and scope of the paper. Thus, an attempt has been made to analyze the collected data (from secondary sources, quoted under references) in descriptive manner that ensures to meet objectives of this work; both general and specific objectives. No sophisticated statistical techniques have been used in this work. Nevertheless, the author makes a specific point in this section of the work that: "non-use of statistical or mathematical tools" (for the purpose of data analysis) does not defeat, in any manner, the purpose of *"qualitative research work method"* (which has been used in this paper to investigate into strategies needed to improve HA for all).

#### **2.5 Methodology of data analysis**

In this section of the paper, tool of data analysis has been discussed. As outlined above, the author has collected secondary data (largely '*qualitative'* in nature) from various sources (*quoted under references*) like books, book chapters, government publications, and publications of inter-governmental agencies (like WHO, EU, etc.). In terms of mythology of research employed here, method of data analysis is *'descriptive'*. Since this paper envisages secondary data collected from various sources, it involves *"desk-based research"*. In addition, brief description of some of the key terms used in this research has been presented in the subsequent section. Conceptual framework of the frequented used terms has been briefly outlined.

Most importantly, in terms of plagiarism (which means *"the practice of taking someone else's work or ideas and passing them off as one's own"*), these issues are not prevalent in this research work. *However*, the author makes a specific point here that the readers of this work might find plagiarism (in terms of copying previous work) in some parts of this paper, although very limited in nature. This has resulted from the fact that while quoting examples of actual initiatives on HA on outcome/s of projects, undertaken in various parts of the globe (as outlined above, under subheading: General and Specific Objectives), not much changes the author of this work could make in presentation of the facts (data analysis). The author was, thus, inclined to make not much changes in text derived from various secondary sources

(indicated under reference section), failing which, the intended meaning (including the context) will be (or is likely to be) lost.

#### **2.6 Scope and significance**

This paper will give significant insight into strategic interventions that policy makers and stakeholders need to undertake for the purpose of ensuring HA all. This initiative will, *in turn*, facilitate achieve SDGs for all on a healthy planet by predefined time framework, i. e., the year 2030. Also, this work outlines selected actual initiatives (outcome/s of projects) undertaken in various parts of the globe in support of each strategic intervention suggested by the author in this work. Thus, based on findings and data analysis, lessons can be leant. Some of the lessons (including programme innovations) can be replicated elsewhere in the area of HA. Importantly, the author has used three terms in this work: "older people," "older adults," and "older citizens". They all carry the same meaning (people aged 65 years and above).

Additionally (and most significantly), the author categorically mentions herewith that, in this paper, these words have been used inter-changeably: (a) work, (b) research work, (c) research paper, (d) review paper, (e) manuscript, (f) research note, *(g) chapter*, and (h) policy paper. All these words, used in this manuscript, carry the same meaning.

#### **2.7 Review of literature**

Review of literature forms an integral part in research studies, especially in the field of social science research. It is for this reason that description on review of literature related to objectives of the research paper (and work done previously in the subject area, under study) needs to be presented. However, the author of this work did not find, despite several academic and research efforts (including consultation with experts in the field, located both in India and abroad), any relevant and meaningful research work that can be presented here as part of review of literature. This may be because of the fact that not much scientific work (that is available either in online or offline modes) has been done in the area of HA (for all). The author, thus, decided to not present any information under this section (review of literature) of this research work.

### **3. Description of key terms**

In this section, the author briefly presents meaning and conceptual framework of some of key terms used in the present work. The idea behind this is that readers of this paper will understand the functioning framework within the context of which this research on strategies for HA for all has been authored. The key terms, arranged alphabetically, are defined below:

a. *Active Aging* (AA): It is a concept recently coined mainly by two international development agencies, namely (a) the European Commission (EC), and (b) the WHO. The conceptual framework of AA evokes the idea of longer activity, with a higher retirement age and working practices. The concept of AA is based on three pillars, namely (1) participation, (2) health, and (3) security. The key aspects of AA are:

*Researching into Commitments for Sustainable Development Goals and Healthy Aging DOI: http://dx.doi.org/10.5772/intechopen.97674*


1.*meet basic needs;*

2.*learn, grow and make decisions;*

3.*be mobile;*

4.*build and maintain relationships;* and

5.*contribute to society.*

In the context of HA, policy makers and demographers opine that longer life brings with it opportunities, not only for older people and their families, but also for societies as a whole. It is advocated that additional years provide the chance to pursue new activities in several new areas (such as further education, a new career, or pursuing a long neglected passion). Today, in the 21st century, with emergence of Internet technology, many more avenues exist and await ahead for older people (who also contribute in many ways to their families and communities). The extent of these opportunities and contributions, however, depends mainly on one single factor: health. There is, however, not much research evidence to suggest that older people today are

experiencing their later years in better health and well-being than their parents. Improving HA for all, is, thus, need of the hour in the new millennium.

	- 1.provided a foundation for the Millennium Development Goals (MDGs); and
	- 2.contributed to significant improvements in poverty reduction, health, education, and gender equality.

g. *Population Aging*: Population aging is considered as one of greatest demographic challenges of the modern era. With the international community already entering in the 21st century, it estimated that global aging is likely to add to increased demand for socio-economic amenities and other developmental infrastructure on economies of all countries in the regions of the globe. Although older people are precious (in terms of enriched knowledge and life experiences they possess), they are often ignored resource that has potential to make an important contribution to the fabric of the societies. Demographers, from across the regions of the globe, are of the considered opinion that national governments, international organizations and civil society need to join hands together to enact *"active ageing policies and programmes"* that favor enhancement of health, participation, and security of older citizens in all possible manners.

*Researching into Commitments for Sustainable Development Goals and Healthy Aging DOI: http://dx.doi.org/10.5772/intechopen.97674*

h. *Sustainable Development* (SD): The theory of SD provides guiding principle for meeting human development goals, while sustaining, at the same time, the ability of natural systems to provide the resources and ecosystem services on which the survival of the economy and society depends, from long-term point of view. The desired outcome of SD initiatives is situation wherein resources are used to continue to meet human needs without undermining the integrity and stability of the natural system. In its simplest form, the conceptual framework of SD can be defined as *"development that meets the needs of the present without compromising the ability of future generations to meet their own needs"*. Sustainability goals [such as the UN-level Sustainable Development Goals (SDGs)], address the global challenges, including:

1.*poverty,*

2.*inequality,*

3.*climate change,*

4.*environmental degradation,*

5.*peace,* and

6.*justice.*

The dentition of SD, as outlined above, was developed for the first time in the Brundtland Report in the year 1987. The author of this work makes a point here that *"Our Common Future"*, also known as the Brundtland Report, was published in October 1987 by the United Nations (UN). The UN is an intergovernmental organization which strives, in consultation and close coordination of its several specialized agencies (spread all over the globe), to (1) maintain global peace and security, (2) develop friendly relations among nations, and (3) achieve international cooperation. Also, it (the UN) serves as a center for harmonizing the actions of nations, across the continents.

Specifically, SD, today, is considered as a way of organizing society so that it can exist in the long-term. What it implies is that there is need to take into account both the imperatives of the present and those of the future (such as the preservation of the environment and natural resources, or social and economic equity).

i. *Sustainable Development Goals* (SDGs): The SDGs are also sometimes known as the *"Global Goals".* They were adopted by United Nations (UN) Member States in the year 2015. This development (of adoption of SDGs or Global Goals) took place in response to universal call for action to end poverty, protect the planet, and ensure that all people enjoy peace and prosperity by the year 2030. In total, there are 17 SDGs. Most importantly, they are integrated, in the sense they recognize:

1.*that action in one area will necessarily affect outcomes in other areas,* and

2.*that development must balance social, economic and environmental sustainability in a balanced manner.*

j. *UN Decade of Healthy Aging (2021–2030)*: It is also termed as *"Decade of Healthy Ageing"*. The UN has designated 2021–2030 the Decade of Healthy Aging. Under this initiative, the WHO has proposed a series of actions aimed at improving the lives of older people, their families, and communities. The author of this chapter makes a point here that initiatives proposed to be undertaken as part of the Decade (i. e., Decade of Healthy Aging) will seek the participation of older people, who will be central to and fully engaged in this multi-stakeholder collaboration.
