International Longevity Centre (ILC) – Prevention in an Ageing World

An interview with:

  • Lily Parsey, Global Policy and Influencing Manager

Prepared by Anna Dé and Adriana Mancilla Galindo

Introduction

The International Longevity Centre (ILC) is the UK’s specialist think tank on the impact of longevity on society.

 

Across the globe, societies are getting older. People are living longer, however, this doesn’t always translate to people living better.

 

One of the ILC’s main programmes of work for 2020 is on preventative health: Never too late: Prevention in an ageing world. Here, the ILC states how we are living longer but not necessarily healthier lives and how governments can improve their commitments to prevention across the life course, including through the utilisation of technology to deliver preventative interventions.

 

The COVID-19 pandemic has highlighted more than ever that in an ageing society, we need to ensure preventative interventions span right across the life course.

 

We asked Lily Parsey for her views on this topic. The conversation is summarised in this blog post. If you want to listen to the full interview you can check out our podcast here.

 

1. Welcome to Lily Parsey – Global Policy and Influencing Manager – from the International Longevity Centre (ILC). Please can you introduce yourself, highlighting your role and responsibilities at the ILC? 

I have a background in policy and generational questions which is what brought me to the ILC. As Global Policy and Influencing Manager, I work on how we at ILC can put forward our findings and research to engage policymakers, industry as well as third sector organisations around the need to rethink what ageing means.

 

2.Please tell us more about the ILC. What work do you do? What are your main objectives? 

ILC is the UK’s specialist think tank on the impact of longevity on society. And while we are UK-based, much of our work also has an international angle. We are part of the International Longevity Centre Global Alliance which has presence in 16 different countries around the world. And increasingly, we are growing our international focus, since longevity is an international matter and it is important to learn from best practices across the world.

 

ILC is not an older people’s organisation. Indeed, we look across people’s lifespans, from young to old and across a variety of different topics looking at what demographic change means now and in the future for society as a whole – from how we will need to adapt the way we save for retirement, the way we plan our cities, all the way through to how we plan our health systems to deal with an ageing population.

 

In particular, ILC looks at ageing through three key lenses:

 

We are making sure that in the long-term we have a sustainable system that works and thrives and to do this, we need to understand and adapt to the needs of an ageing society.

3. Could you tell us more about the role of prevention in terms of furthering healthier lives? What is the role of technology in delivering preventative interventions?

In an ageing world it is more important than ever that we invest in prevention.

 

ILC has contributed to this issue by carrying out a big global project on Prevention in an ageing world over the past year.

 

Through this programme, we have engaged senior policymakers and thought leaders across the world, including alongside the G20 Health Ministers’ meeting in Japan last October, around the need to make prevention across the life course a reality. But despite the clear economic and social benefits of investing in prevention, investment in preventative services remains consistently low at an average of 2-4% of total health spend across OECD countries. [Gmeinder, M., Morgan, D. and Mueller, M. (2017) ‘How much do OECD countries spend on prevention?’, OECD Health Working Papers, No. 101, OECD Publishing, Paris. doi.10.1787/f19e803c-en]

 

Preventative services are often the first to be cut in times of economic contractions. Currently, we are seeing a delay in the implementation of preventative measures in health systems.

 

Our report finds that in better off countries, in 2017 alone, 27.1 million years were lived with disability due to a number of largely preventable age-related diseases, with years lived in poor health set to increase by 17% over the next 25 years, if governments fail to prioritise preventative health interventions right across the life course.

 

Prevention is not just for children. Particularly in an ageing world, it is crucial to prevent ill health as a growing proportion of us will have underlying health conditions. As the COVID-19 pandemic has emphasised just how stretched our healthcare systems are, it is alarming to think how we will deal with another 17% increase in underlying health conditions. We have to make sure we are preventing some of those conditions from developing in the first place.

 

Throughout this project, we have engaged with people on the ground with deep expertise of health systems across the world. Three key priority areas emerged:

  • Democratising access to preventative interventions, in order to tackle growing health inequalities;
  • Inspiring and engaging people, communities, professionals and policymakers with the need to take action to promote good health and prevent illness; and
  • Effectively utilising technology to deliver preventative interventions.

Technology has a big role to play in terms of planning for prevention, especially in the future, and it can range from high tech to low tech. In the first place, we have to ensure we have the relevant data shared and assessed in order for healthcare professionals to make informed recommendations.

Technology can also be used to address barriers to healthcare to empower patients to access health services remotely, manage conditions, or access online GP records. This aspect needs to be addressed in an integrated way, linking up pharmacy records with GP records and so on.

 

For us, the next step for this programme is to move from the “why” to the “how” and to further develop the recommendations to really have an impact. Therefore, we are planning to work with policymakers and thought leaders across the world to develop toolkits around each of our recommendations to see the change we need and more spend go to prevention.

4. What is the role of prevention in the current COVID-19 context and beyond? How can we ensure people at particular risk aren’t being missed?

With the current situation, I think it has been made clear just how important public health is. Some countries have done a lot better than others managing this pandemic and there are some important lessons out of that that people can directly adopt. During the COVID-19 pandemic, we have seen people that are particularly vulnerable because of pre-existing conditions, such as, cardiovascular conditions or diabetes. And it doesn’t have to be like this. If we had more preventative interventions available to people, then we would have less people at risk in a pandemic like this.

We need to make sure that the people who might be at particular risk, who might be shielding and could be doing so for much longer, are not being left out of what might be considered routine appointments such as vaccines and screenings. The consequences of falling behind on this could be more far reaching and have significant impacts down the line. As we emerge out of lockdown, it will be important to make sure we are not leaving anyone behind. To do this, we will need to double up efforts and be proactive, especially as we’re preparing for the upcoming flu season this Autumn.

5. What should happen next to protect the ageing population now that the lockdown is easing down?

We must both balance the management of the acute current needs of people and make sure that preventive interventions are not falling behind. At the same time, it is essential that we double up efforts on more routine medical appointments as so many have been missed or delayed during this time.

 

There is also a big risk that a COVID-19 induced recession will see more cuts to health services, and preventative services in particular. The pandemic has highlighted just how high the costs are of cutting back on prevention when it is most needed, so it’s absolutely vital spending isn’t cut in these areas.

 

In the short-term, we need to invest in prevention and be ready for the next round of flu immunisation coming up in the Autumn. Hopefully, there will be an attitudinal shift and people will start to see the value more in immunisation, but at the same time we might see people who are still scared of going to the GP surgery or the pharmacy.

It is really for everyone to play their part, governments via clear messaging, charities and community organisations guiding and supporting people as they might be the first contact point for a large number of people, but also employers and individuals themselves by making sure that the message is clear:

 

“Prevention is vital coming out of this lockdown.” 

Lily Parsey, Global Policy and Influencing Manager for the ILC

 

6. What are the thoughts of the ILC on the impact that COVID-19 has had in care home settings?

 

We held a webinar looking at care homes and retirement housing in the context of the COVID-19 pandemic a few weeks ago. During the webinar, we did a poll asking people if they would be happy to send a member of their family into a care home in the current climate and, even with the majority of participants either in or linked to the care sector, the results were shockingly low, with less than 1 in 3 people feeling comfortable doing so. We need to regrow that confidence in care homes, as well as look at alternatives of retirement housing.

7. How do you engage with stakeholders and policymakers? What are your key activities for the rest of 2020 and into 2021?

We have started doing a weekly webinar series looking more broadly at the impact of COVID-19 on an ageing population.

 

We are focusing a big area of work on the longevity dividend and the economic opportunities of ageing, to which the prevention agenda is key.

 

And COVID-19 pending, we are also planning a series of global engagement events around prevention including:

 

  • An event alongside the G20 Finance Ministers and Central Bankers meeting in Washington DC in October 2020.
  • Events in countries that have been seen to have managed COVID-19 better.
  • A launch event alongside the G20 Summit in Italy where reflections on the impact of COVID-19 will play centre stage.

Further information on our prevention programme is available here. If anyone is interested in sharing ideas and recommendations on prevention in an ageing world with us, you can get in contact by emailing us at prevention@ilcuk.org.uk.

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