State and local health departments across the country are beginning to prioritize older adult health and well-being and are hungry for guidance, resources, and tools to help expand their programs and policies in this area. No one organization or agency has all the answers, but many are using their expertise and experience to develop interventions and promising practices to create sustainable healthy aging efforts, many of which can complement existing health promoting programs and services.

One such organization is the Association of State and Territorial Health Officials (ASTHO), which has created a “technical package”, or set of recommendations to guide public health’s work in equitable healthy aging. These include:

Expanding Paid Family and Sick Leave: Paid family leave and sick leave are benefits that support economic security and health for employed people and their families, including family caregivers, as well as care recipients of all ages, often older adults.

Supporting Healthy Community Design: Such design involves “planning and designing communities that make it easier for people to live healthy lives.” Designing healthy communities includes planning for equitable access to community resources such as nutritious food, recreation and transportation infrastructure, and affordable housing. 

Promoting Fall Prevention and Mobility: Falls are the leading cause of injury-related deaths in adults 65 years and older. Strikingly, the Centers for Disease Control and Prevention reports that nearly $50 billion is spent annually on medical costs related to older adults’ nonfatal fall injuries. Increasing mobility, the ability to move freely and easily, is a vital strategy for reducing the risk of falling and offers additional health benefits for older adults.

Increasing Telehealth Access: Telehealth usage became widespread during the COVID-19 pandemic and has shown valuable benefits not only for older adults but also for people of all ages and abilities in accessing health services. This is crucial for people who live in rural areas, are homebound, and/or have limited transportation access. Sustaining Medicaid telehealth reimbursement policies that were expanded during the pandemic would also be beneficial.

Strengthening the Long-term Care, Healthcare, and Public Health Workforces: Long-term care workforce shortages are a persistent challenge across settings, illuminated by the COVID-19 pandemic, with significant implications for the health, safety, and independence of older adults and people with disabilities who have long-term care needs.  There is also a need to grow the capacity of healthcare and public health professionals to focus on and advance the health and well-being of older adults.

ASTHO is also involved in work around sustainability and the intentional integration of strategies that support long-term success of public health programs. Sustainability strategies include:

Planning for Sustainability: Long-term sustainability of programs and services doesn’t just happen. Health departments should engage both internal and external teams in the planning process to ensure buy-in including the formation of and responsibility for long-term attainable goals.

Collaboration: Collective effort is essential to achieve shared goals. Investing in existing partnerships with other agencies, organizations, or individuals is as important as creating new opportunities for collaboration. When putting sustainability into action, keep these partners near and seek opportunities for mutual, long-lasting success.

Community Engagement: Building trust through partnerships with community members ensures a shared understanding of collaborative priorities. Engagement at the community level allows for improved support, informed planning, and effective action to support improved health outcomes.

Operationalizing Equity: Equity is an essential element of public health practice and should be foundational to all Age-Friendly Public Health Systems efforts.

For more information and resources, visit

ASTHO’s Healthy Aging website or reach out at healthyaging@ASTHO.org.

Paid Family Leave Policies And Population Health | Health Affairs

CDC – Designing and Building Healthy Places – Home

Expanding Falls Prevention Through Surveillance, Community-Clinical Linkages, and Strategic Planning and Evaluation (astho.org)