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Summer 2005 Our Guest Editor
Public health brings unique perspectives and tools to the quest for healthy aging. This issue of Generations is about how those in the fields of public health and gerontology can work together to improve the lives of older people by promoting healthy aging, developing aging-friendly communities, and fostering health equity. This issue's guest editor has spent a career making those issues his own. Steven P. Wallace is a professor in the UCLA School of Public Health and associate director for public service at the UCLA Center for Health Policy Research. He is also chair of the Gerontological Health Section of the American Public Health Association, where he has worked to bring attention to aging issues. "The public health approach -- with its focus on health promotion and disease prevention and its programs and policies designed to address the collective good -- is more important than ever in an aging society," Wallace says. "In this country, we spend more per person on medical care, but we don't have the best health outcomes. There is a disconnect between what we spend and what we get. Medical care for elders, for example, is still focused heavily on treatment -- waiting until the problems happen, then treating the individual. "What is needed is for the entire structure of healthcare financing and delivery to focus not solely on curing, but also on preventive, collective approaches with incentives for 'healthy behavior' at all levels. But it's difficult to get support for a public health model. When it's working, it's invisible. An epidemic makes news." Wallace's prescription for healthy aging focuses on three goals: First would be a change in how the end of life is handled. "We need to focus more on quality of life at the end of life," he says. "Here is where the single-minded attention to cure is particularly inappropriate." Next is the need for a strong public commitment to public health and its effect on elders. "We spend only pennies on training in geriatrics and public health" he says. "Only one in twenty graduate public health students receives any training in aging." Third is improvement of the health of elders in minority populations. "As older people become increasingly diverse," says Wallace, "the 'standard' idea does not apply." All of these areas are natural concerns to Wallace. He grew up in a family that had lost many members to the Holocaust; family discussions were of societal problems and issues facing minority groups. Interested in how social factors influence the health of individuals and populations, Wallace earned a Ph.D. in medical sociology from U.C. San Francisco, working on gerontological research and policy -- an interest he credits to his mentor Carroll Estes, a national leader in aging policy, and to a close relationship with his grandparents. "I'd think about them and the issues they were facing," he says. "It helped to put what I was learning into the context of their lives." Since then, Wallace's research and teaching have focused mostly on issues of long-term care and health policy, including health equity. "My goal," he says, "is to come up with concrete ideas that can help improve the lives of people who aren't benefiting as much as they should from being in the wealthiest country in the world." - Mary Johnson with Dan Gordon From Generations Summer 2005 issue, 29(2): 4. © 2005 American Society on Aging
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