Improving the health and well-being of the Baltic Sea Region’s ageing population

The topic of active and healthy ageing is more and more relevant in Europe including the Baltic Sea Region. The life expectancy rate is increasing and this process seems to be continuing despite the turbulences caused by the COVID-19 pandemic.

The share of the older population in Baltic Sea Region countries is also increasing. It is forecast that in 2030 more than 25 % of the population in the region will be aged 65 or older. This demographic and societal transformation needs a new approach, proper policies at all levels, innovative actions and adequate initiatives.

One of the 14 policy areas in the EU’s Strategy for the Baltic Sea Region is health and one of the actions is ‘Promoting active and healthy ageing to address the challenges of demographic change’.

This strategic document indicates great opportunities for Baltic Sea Region communities, as well as the challenges to meet, especially in the health and care systems. I asked Dr. Ülla-Karin Nurm, Director at the Secretariat of the Northern Dimension Partnership in Public Health and Social Well-being, about her opinion on the challenges, needs and activities to address for improving active and healthy ageing in the Baltic Sea Region.

What are the most important region-wide challenges and how they could be handled?

First, we should remember that an ageing population is actually a great societal achievement. It is a testimony to improvements in health and social care systems and of the general living standards in our countries. We have added more years to our lives; now the challenge is to add more life to those additional years.

While there are many different challenges, there is one that is overarching: ageism, the stereotypes, prejudice and discrimination based on age. Our own needs assessments in the region as well as research done by WHO and others have shown that ageism is widespread and it is impacting peoples’ lives in negative ways, at work but also in private life.

And we need to remember that this kind of discrimination impacts young and old people alike! For example, younger and older workers in particular are met with prejudice at work, are underestimated by their colleagues or overlooked for promotions, or are considered to be either too inexperienced or too old-fashioned.

At the core of the issue lies the fact that we judge people based on their age and that we assume people of the same age to be a homogenous group, which is very far from the truth.

What needs to be done is a shift in attitude. We need to consider the diversity of all age groups and stop judging people based on their age. That shift includes not judging and defining ourselves and our abilities by our age.

Furthermore, we need to acknowledge the substantial contribution older adults make to our societies, often providing financial support to their families, and child and informal care or volunteering and mentoring. To change the way we think, we also need to change the way we speak. For instance, at our partnership, we try to avoid the term ‘elderly’, because it implies a person is frail and dependent – but most older people are not.

Another avenue for developing solutions is, in our view, intergenerational exchange. There is great potential in creating exchanges and mutual learning between younger and older people, especially considering that they share a joint challenge in ageism. This potential is still untapped.

What are the needs for improving active and healthy ageing in the Baltic Sea Region?

Through our AgeFLAG project (see more information below), we have conducted a regional needs assessment in the field of active and healthy ageing. The needs we identified can be broadly categorised into four areas:

• Creating age-friendly environments ­– increasing social inclusion of older people and dismantling ageism.
• Adapting health and social services to the needs of older adults, including an analysis of care deficits, training for health care personnel and overcoming the fragmentation of services.
• Promoting education and life-long learning, including health and digital literacy.
• Increasing the labour participation of older adults by making workplaces more flexible and adapted to the needs of older workers.

What all these needs have in common is the necessity for a change in policymaking and service design: older adults (as well as younger people) need to be included in the decision-making processes that concern them. To be able to adequately adapt to an ageing population, we need to use co-creation as a tool of social innovation and we need to work across sectors.

The changes that are needed require all sectors and layers of society to be involved. We need not only government and administration, but also companies and civil society to pull in the same direction.

How does the EU’s strategy help to find solutions? How is the partnership included in the undertaken actions?

The EU’s Strategy for the Baltic Sea Region, as a framework for regional cooperation across sectors and across levels of governance, is ideally suited to generate, spread and implement solutions to the challenges described above. The strategy allows us to identify and reach out to stakeholders outside of our own area of expertise, since only through these kinds of collaborations are we able to achieve change.

It is for this reason that the partnership has placed an increasing focus on cross-sectoral cooperation in the revised action plan for the strategy. We have initiated a flagship process on active and healthy ageing, based on the outcomes of the AgeFLAG project, and actors from all fields are invited to participate.  Furthermore, we are promoting the Economy of Well-being, a new approach to development, which puts sustainability and the well-being of people at the heart of policymaking.

What is the AgeFLAG flagship? What is its background, activities, outputs and outcomes?

AgeFLAG is a flagship initiative of the policy area ‘Health’ under the EU Strategy for the Baltic Sea Region. The aim of the flagship is to contribute to the health and well-being of the ageing population and therefore, to make our societies more inclusive for people of all ages.

The flagship process started in 2019 with a project funded by the Swedish Institute and the German Ministry of Health, which culminated in a roadmap that describes the partnership’s future actions to improve the health and wellbeing of the ageing population.

The roadmap was co-created with people from the Baltic Sea Region and is based on national and regional needs assessments. Therefore, the planned actions directly respond to the needs of the people across our region, as described before. They also contribute to the priorities of the UN Decade of Healthy Ageing 2021-2030.

The roadmap aims at systematising the partnership’s work on active and healthy ageing. Through this, the ambition is to establish the partnership as a regional thought leader in the field. In the upcoming years, the partnership has two ambitions: (1) driving discourse on age and ageing, and (2) encouraging intergenerational contacts and decreasing intergenerational conflict.

The Northern Dimension Partnership in Public Health and Social Well-being  has set up a Task Force to take lead on the implementation of the roadmap. The Task Force consists of experts from the field of ageing from across the Baltic Sea Region.

More information about the AgeFLAG flagship is available on the project’s website.

Summing up what Dr. Nurm described, even though much has already been done and achieved, there is still a lot to change and improve the healthy ageing and well-being of the older generation in the region. Recognising this important issue in the strategy’s action plan and taking such actions like AgeFLAG give hope to our societies to be able to meet the challenges faced by ageing population in the Baltic Sea Region countries in the future. The new, commonly accepted approach is necessary. The involvement of governments, and as many stakeholders from different sectors as is possible also seems to be essential.

Dr. Ülla-Karin Nurm holds the position of Director at the Secretariat of the Northern Dimension Partnership in Public Health and Social Well-being in Stockholm, Sweden. Its  mission is to intensify regional collaboration through professional exchanges, capacity building, and policy advice, striving for inclusive societies with equal opportunities for good health and well-being for all. Ülla-Karin Nurm’s background is a medical doctor with long-term experience in public health, health systems, health promotion, and international health policy. She is committed to working in the partnership and across the sectors for the benefit of the wider public, supporting informed decision-making, and building healthy and sustainable communities in the Baltic Sea Region.