Tom Wright
Group CEO, Age UK
We are seeing a clear increase in longevity across the globe, with life expectancy at age 60 increasing, particularly in high-income countries. By 2050, in every region except Africa, a quarter or more of the population will be ages 60 and older. According to the United Nations, around the world generally, higher numbers of older people are a certainty in the short to medium term.
While this information is great news, it presents challenges. For example, we are increasingly surviving infectious diseases, but we are living longer with long-term chronic conditions (or noncommunicable diseases). This does not have to be the case, however. With better diet, more exercise, and a reduction in smoking and alcohol consumption, the risk factors for many chronic conditions can be substantially reduced. This is true for dementia and cognitive decline too, and it is why Age UK and Age International (Age UK’s international arm) have joined forces with AARP as founding members of the Global Council on Brain Health (“Council”). We intend that the Council will provide expert but accessible public information around perhaps the biggest frontier of health: brain health.
The UK is no stranger to the present trend of living longer with related challenges. One in five people is already over age 60, and that cohort is set to increase from 14.9 million in 2014 to 18.5 million in 2025. The media often portrays this growth as a “crisis” and older people as a “burden” on society. But the truth is that an aging population can be a great benefit—provided the right policies are in place.
In the UK, older households spend £145 billion a year, and among older people there is considerable resilience and a spirit of independence. Older people also contribute significantly to society. They are valued members of their communities and account for many of our volunteers and caregivers.
The impact of a degree of austerity on public services in the UK means that older people are increasingly being left to rely on their own resources without the information and support they need. Nonprofit organizations, such as Age UK, play a vital role in filling these gaps and in maximizing the opportunities that an aging society brings.
Like many other nonprofits, one of our core purposes at Age UK is giving an effective voice to the people we represent and work for, campaigning and influencing on their behalf with local, regional, and national decision makers. We provide a wide array of services, both independently and in partnership with public services, giving a voice to the excluded; fostering capacity, agility, and flexibility; joining up services around the needs of the individual; and leveraging the contribution of volunteers.
A service we are very proud of at Age UK is our information and advice. We offer support and guidance on age related issues through Age UK’s free national phone service, its website, extensive range of guides and face-to-face through local Age UK partners. At a time when public services are stretched or simply nonexistent, access to good, trustworthy provision of this kind is more important than ever to older people and their families, and demand for it is increasing.
The fact that nonprofits start with the people they exist to serve—reflecting their voices and needs—is crucial. Many governments have recognized this and espouse a policy of “co-production of services.” To achieve the best outcomes, nonprofit organizations must be included as equal partners from the outset and given an opportunity to shape the agenda. Involving nonprofits in service delivery isn’t about making a service cost-free; it is about doing things better, not necessarily cheaper.
Another area where nonprofits play a vital role is in scaling up innovation. This is where networks such as Age UK’s can come into their own—providing a test bed for innovation, supporting the smaller organizations in their networks and projecting their voices, highlighting best practices, and reproducing successful pilots.
A good example is Age UK’s integrated health and care model, which health and social care partnerships are currently piloting in areas across the country. The model brings together clinical commissioning groups—the physician-led groups responsible for planning and designing local health services, local government, acute and community health providers—with local Age UKs. They work together and develop a joint vision to improve outcomes for older people, and they save money in the health and social care system, primarily by reducing avoidable unplanned hospital admissions. The model was originally piloted in Cornwall, England, and has so far achieved a 34 percent reduction in non-elective admissions, a 20 percent increase in well-being for older people, and an 8 percent reduction in the use of social care.
Community is important to many older people, and nonprofits can help enable social action through establishing and supporting local groups and forums that give members a powerful voice. Nonprofits also benefit greatly from the willingness of older people to volunteer and make an active contribution to civic and community life. When older people engage in this way, it often improves their physical and mental health. In addition, volunteering helps combat loneliness and brings communities together.
Since 2012, Age International and Age UK have partnered with the World Health Organization (WHO) to develop and pilot a knowledge translation framework on aging and health. The framework identifies key health issues from data and policy reviews, site visits, and interviews. The results are then compared with evidence from other heath interventions, with the aim of identifying recommendations for policy and practice. This model was piloted in Ghana in 2013 and in China in 2014–15. Country assessment reports were then produced for each project and meetings held between government officials, academics, and international experts, including WHO, Age UK, and Age International. These meetings provided valuable opportunities to discuss how to promote healthy aging, integrate health and care, and develop new ways to address long-term care needs.
This collaboration is an example of how the nonprofit sector can contribute its own and its networks’ experience and expertise to major international policy development and, in the process, learn lessons for the United Kingdom from very different contexts.
Finally, in terms of aging, nonprofits also have a role in addressing, through social enterprise, product and service gaps in the market. Age UK has more than one million customers, and we are proud of the products and services we offer because they are tailored to the needs of older people. We believe that older people should be able to obtain products that suit their needs throughout their later lives. Although private-sector providers are focusing on older people now more than ever before, this market is still largely overlooked in the United Kingdom. There continues to be a gap between what is provided and what older people say is right for them, and nonprofits are well placed to bridge this gap.
Longevity is to be celebrated, but we are living longer with long-term conditions and not necessarily with the health or financial security we would like. Through providing a voice, information, advice, support, services, and innovation, and—crucially— by working with public services, the nonprofit sector has a hugely important role, both in meeting the challenges and in leveraging the opportunities of global aging.
About the author
Tom Wright is Group Chief Executive of Age UK, the leading charity and social enterprise supporting people in later life. Tom also chairs the Richmond Group, a coalition of leading health charities, is Chair of the Fuel Poverty Advisory Group within the Department of Energy and Climate Change, and a Trustee of Go ON UK, the digital skills charity.