Author:Tiago Moreira (Durham University)
Paper short abstract:
This paper examines the multifarious uncertainty which has underpinned healthy ageing policy instruments and programmes since the late 1990s.
Paper long abstract:
Public health policies and programmes concerned with the management of population and individual ageing have, since the late 1990s, been enfolded by the concept of 'healthy ageing'. Defined usually as the 'process of optimising opportunities for physical, social and mental health' so as to support older people's participation in society, healthy ageing policy instruments aim to monitor and extend healthy life expectancy ('adding life to years'). In so doing, such instruments have relied on the assumption that the relationship between ageing and illness is malleable, a conjecture mainly associated with the 'compression of morbidity' hypothesis (Fries, 1981). Since Fries original paper, there has been disagreement on whether 'compression of morbidity' is found in actual aging populations. In this paper, I argue that this divergence is underpinned by differences in the way population scientists define age-associated illness, how they value, measure and enact health, and how they articulate its network of accountability: what/who is fashioned to legitimately affect the production of health. Analytically, I distinguish and describe three different repertoires: one dominated by the ambiguous role of technology on the relationship between the quantity and quality of remaining life, a second concerned with equipping individuals with capacities for healthy behaviours, and a third emphasising the collective, interacting dimensions of health. I suggest this analysis has implications for rethinking public health policies in the ageing domain.
From person to population and back: exploring accountability in public health