THE POLICY FRAMEWORK
The AFM approach relies on the WHO “active ageing” policy framework which means “a process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age”. Thus defined, active aging not only means to be physically active or to take up a job but it also presents ways of promoting a healthy life and a quality of life as long as possible during this life phase.
A broader audience, particularly among decision-makers, is getting more interested in this policy framework in shaping public policies for seniors. In terms of public policies in Quebec, it has been in the background of the implantation of the AFM approach since 2008.
1. The WHO model
During the 1990s, the benefits of physical activity on health, presented under the designation of “healthy ageing” (WHO, 1993) encourage the WHO to promote active aging. During the International Year of Older Persons that was organized by the United Nations in 1999, the WHO launched the project “Active ageing makes the difference” (WHO, 1999a). Here is a first definition of the concept :
“Health is vital to maintain well-being and quality of life in older age, and is essential if older citizens are to continue making active contributions to society” (WHO, 1999b, p.3).
In 2002, during the Second World Assembly on Ageing in Madrid (UN, 2002), the WHO renews its interest in the concept of active aging by publishing a policy framework (WHO, 2002). This time, the WHO considerably expands the scope of the concept by identifying a series of factors related to active aging and developing specific measures to encourage action. The concept then takes a meaning that it is more commonly defined today as “… a process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age” (WHO, 2002, p. 12)
There are three main dimensions that can also determine as being the three bases of active aging including health, participation and security. The figure, taken from the guide “Active Ageing: A Policy Framework” (WHO, 2002) illustrates the concept.
Firstly, given the mandate of the WHO, it is not surprising to find health as one of the dimensions of active aging. This dimension takes into account the fact that individuals live better and longer by limiting the emergence of chronic diseases and functional decline. Moreover, being healthy provides greater autonomy and well-being among individuals, thus reducing the needs for medical care or pharmaceutical treatments.
However, in return for the attention given to the health of individuals, the WHO indicates that society has the obligation to act from individuals, that is when care is needed, it is important to develop adequate, affordable and accessible social and health services. This is an important indication given that the WHO moves the social obligation of seniors to a recognized individual right, that is to be full and equal members of society.
People live better and longer by limiting the emergence of chronic diseases and functional decline. Moreover, being healthy provides greater autonomy and well-being among individuals, thus reducing the needs for health care and social services. But still, society must meet people’s needs by developing adequate, affordable and accessible health services.
The “health” aspect must not be focused on health care but on opportunities to adopt and maintain an active and stimulating lifestyle, that is to say, regular leisure activities including participation in physical, recreational, social, cultural and intellectual activities.
Secondly, in pursuing the first dimension, the WHO specifically targets the recognition of needs and rights regarding the participation of seniors, and this, in all areas of an individual’s life: social, economic, cultural and spiritual. The social participation refers to any gainful or non-gainful activity which allows seniors to fully contribute to the community life, for example, volunteer activities and ongoing training, citizens’ activities or paid employment.
Seniors have the need and have the right to fully participate in society, and this, in all areas of an individual’s life: social, economic, cultural and spiritual. With this participation, seniors will continue to contribute to activities that still mean something to them, as well as being meaningful for society. Participation is being part of our life environment.
Thirdly, the WHO highlights once again active aging from the social aspect, because it is important that society supports and assists aging people who are no longer able to protect themselves and to provide for their needs. According to the WHO, the dignity of seniors is ensured when the social security, financial and physical needs are met.
This concept refers not only to the security of physical locations but also in the sense of security felt by seniors, for example, the lack of lighting, sidewalks poorly maintained, feelings of insecurity for some public places, etc. In this regard, security becomes a prerequisite to the implementation of the other two dimensions. This can be clearly seen, the “active ageing” policy framework transcends these three dimensions (health, participation and security) in order to include, a priori, the rights of seniors as defined in the United Nations Principles for Older Persons (UN, 1991).
It is essential that society should support and help aging people who are unable to protect themselves or to provide for their needs. Security is the primary condition to ensure dignity for older citizens. This is ensured when social security, financial and physical needs are met.
2. The Alan Walker Model
In Quebec, active aging is partly based on the WHO guidelines; however, this concept is also developed through seven principles elaborated by sociologist Alan Walker (2002, 2009). These principles are :
Active ageing entails all meaningful pursuits which contribute to the well-being of the individual concerned, his or her family, local community or society at large, and should not be concerned only with paid employment or production ;
Active ageing must encompass all older people, even those who for various reasons are frail and dependent ;
Active ageing is primarily a preventative concept and implies adopting a life course approach to understanding the ageing issue ;
The centrality of intergenerational solidarity is a defining feature of active ageing ;
Active ageing entails both rights and responsibilities ;
A strategy for active ageing should be participative and empowering ;
The concept of active ageing must respect cultural differences and promote diversity.
These principles make it necessary to develop public policies based on collaboration between seniors and society. The role of the Government in such a context consists of introducing initiatives where seniors are directly implicated, educated and committed.