On October 12^th, 2023, the Global Coalition on Aging convened an expert roundtable that brought together healthcare providers, clinicians, patient representatives, and academics from Japan, the United States, Canada, Ireland, and the United Kingdom to discuss How to Better Support Older Adults and Their Families for Shared Decision-Making About Cancer Care. This discussion was prompted by recent policy changes in Japan that aim to improve cancer care for older adults through the integration of shared decision-making into the care system, but SDM is applicable across health systems worldwide.

SDM is the process by which medical providers, patients, and patients’ families come   together to develop mutually agreed upon, informed plans for cancer care. SDM can help healthcare systems better attend to the diverse needs of older cancer patients, leading to improved patient outcomes and healthier aging.

This report shares insights and key takeaways from the expert discussion, as well as recommendations on how to implement and expand upon SDM practices.

This new report from TIAA Institute sheds light on how Americans across demographic groups are making decisions about retirement, and what people’s attitudes and experiences today suggest for our nation’s financial future. The report examines big-picture decisions like when to retire and what to do in retirement, but also tactical decisions with significant implications—when to start saving, how to save and how much to save. This research informs efforts underway to address America’s retirement crisis and close equity gaps.

Key insights include:

• Two thirds of Americans are saving for retirement, but nearly one in four don’t know how much they have saved.
• Fewer than half of non-retirees are “very” or “somewhat” confident they will retire when intended. People ages 22-34 and Hispanic Americans tend to be least confident.
• 44% of households have less than $50,000 in liquid investable assets, and one in four Hispanic Americans, Black Americans and Native Americans have none.
• One in four Black Americans expect to pursue paid employment for income in retirement—that’s at least 10 percentage points higher than any other race or ethnicity.
• One in eight Americans could not come up with $2,000 to pay for an unexpected need.

On June 12, 2023, the Global Coalition on Aging organized a panel session at the International Association of Gerontology and Geriatrics Asia/Oceania Regional Congress 2023. The session brought together experts from aging and elder care, including from the World Health Organization, for a discussion on the importance of life course immunization and the need for health systems to shift towards a focus on prevention and the growing role for integrated person-centered care. This transformation of health systems, including a greater prioritization of life course immunization, could ensure better responsiveness, better quality of care, greater efficiency, and, ultimately, improved sustainability for health systems and support for health aging. 

This report shares insights and key takeaways from the expert discussion.

The IQVIA Institute for Human Data Science released a new report at the 2023 Silver Economy Forum, Trends in Global Adult Vaccination: A View from Five Global Cities. The report, which was created in collaboration with GCOA and funded by GSK, explores the role of social and structural determinants of health in adult vaccine access and uptake across five global cities with strong data about their aging populations: Bangkok, Thailand; Brussels, Belgium; Chicago, US; Manchester, United Kingdom; and New York City, US.

The data demonstrate that vaccine use varies substantially even within a single city and suggest that policies, such as improved access to pharmacies or other points of vaccination, should be implemented to drive equitable access to adult immunization. Key findings include:

• In both Brussels and Manchester, easier access to pharmacies and other points of vaccination was associated with higher vaccine uptake, with additional factors in Brussels including access to transport and reimbursements for vaccines.

• In Bangkok, adult vaccine use within a district is correlated with the number of vaccination points, such as hospitals and clinics, as well as with indicators of economic growth in the district.

• In both New York City and Chicago, household income, education and median house value are highly correlated with vaccination rates across all vaccines studied. Race and ethnicity also play an important role in uptake in both cities, with white populations more likely to be vaccinated.

According to the report, optimal use of adult vaccines can be potentially enhanced with a focus on tracking adult vaccination data regularly at national and sub-national levels, ensuring financial considerations do not impact vaccine uptake, increasing the number of vaccinators, ensuring that vaccine policies account for sub-city level differences in vaccine use, and providing the basis for a growing and robust market that has incentives for ongoing innovation.

After a diagnosis of Alzheimer’s disease or another dementia, people are often left with many questions: How will this effect my ability to control my own finances? Will I be able to keep my driver’s license? How will this affect me at work? Does the law protect or affect me? This GCOA report provides a look at the legal implications associated with a diagnosis of Alzheimer’s or another dementia in each US state across a variety of areas, including financial management, guardianship, the justice system, genetic testing and access issues. The report also provides policy recommendations to better protect people living with Alzheimer’s or other dementias across these topic areas. This report was made possible by GCOA member Eli Lilly & Company.

This GCOA report demonstrates the economic imperative for APEC economies to invest in healthy aging broadly, and adult immunization in particular, amid rapid population aging. The APEC region is at the leading edge of the global demographic shift, and programs that keep populations healthy, active, and productive – like adult immunization – are increasingly becoming a prerequisite for economic stability and growth.

Launched alongside the 2023 APEC Economic Leaders’ Week, hosted in 2023 by the United States, the report highlights the dual connection between immunization and increased workforce participation and economic activity on one side and decreased healthcare system utilization and spending, on the other.

This paper provides background and data – including new research from the International Longevity Centre-Singapore, a Tsao Foundation initiative – underpinning the economic value and overall importance of routine immunization for older adults and suggests priorities for action among APEC economies:

1. Prioritize prevention for older adults, including through robust national immunization programs to increase vaccine uptake.
2. Invest in health education and awareness-raising for older adults and those they trust.
3. Integrate immunization programs into community-based programs, resources, and health systems.
4. Quantify the costs of vaccine-preventable diseases and the returns on investment in prevention and immunization to support evidence-based decisionmaking.

As the United States workforce ages – by 2060, the number of people aged 65 and
older will double – providing benefits that match an employee’s life stage becomes
increasingly important for employers trying to attract and retain talent. The needs
of employees differ greatly depending on their situation and life stage. The needs of
younger employees just entering the labor market are not the same as those of middleaged
employees juggling family and caregiving responsibilities or older employees
caring for a loved one.

As the needs of employees differ throughout their lives, so should employee benefits
throughout an employee’s career. Employers should consider structuring and adjusting
employee wellness offerings to attract and retain talent at different life stages. This
Global Coalition on Aging (GCOA) and TIAA Institute policy brief provides an overview of
best practices for employee benefits in different life stages.

Post-fracture care through Fracture Liaison Services is the key to secondary fracture prevention.

On World Osteoporosis Day 2023, the Global Coalition on Aging’s Bone Health Initiative released “Improving Bone Health in the UN Decade of Healthy Ageing,” providing a snapshot of the importance of bone health to healthy aging and the need to implement effective intervention in the form of Fracture Liaison Services, a proven, integrated model of care which provides personalized care to help prevent secondary fractures.

The Bone Health Initiative calls on global and national policymakers, officials in age-friendly cities and communities, healthcare professionals, patient advocacy organizations, employers concerned about the health and employability of older employees, and other societal stakeholders to join us in advocating for the adaptation and prioritization of Fracture Liaison Services to prevent secondary fractures.

On June 6, 2023, Global Coalition on Aging Alliance for Health Innovation and Georgetown University convened a roundtable in Washington, D.C. on innovation and equity for healthy aging. During this roundtable, policymakers, experts, and patient advocates gathered to address innovation and its impact on health equity and healthy aging. This policy brief provides insights from the roundtable, including four policy principles that can guide future policy developments and highlight steps that policymakers can take to ensure everyone can access the innovations that allow people to live longer and healthier than ever:

1. Individuals should be at the center of our thinking when discussing healthcare innovations. We need to engage with individual patients in their communities to ensure they can access the healthcare services and support they need.
2. Medical innovation must be sufficiently valued and incentivized.
3. Medical innovation must be accompanied by process innovation across the healthcare ecosystem.
4. Better awareness is needed on the return on investment of innovation and the benefits of distributing funding for healthcare services to the communities and support programs where it’s most beneficial.

The Global Coalition on Aging Alliance for Health Innovation brings together over 20 patient advocacy organizations, scientists, and policy specialists to establish awareness of the importance of innovation in achieving healthy aging through investments, policy reforms, and strategic partnerships – both for the value to patients and for health system sustainability.

A July 2023 report from GSK, in collaboration with the IQVIA Institute for Human Data Science and the Global Coalition on Aging (GCOA) examined the impact of the COVID pandemic on the uptake of adult vaccination around the world. The report estimated approximately 100 million fewer doses of some adult vaccines (excluding Covid-19 vaccines) were administered in 2021 and 2022 than anticipated, compounding already low adoption rates pre-pandemic. Data also showed that investment in adult vaccines represent less than 2% of total pharmaceutical spending in all regions. The analysis provides new evidence on why changes are needed, given existing data that show adult vaccine-preventable diseases are a major cause of morbidity, mortality and healthcare cost.

A June 2023 report from Bank of America and the AgingWell Hub at Georgetown University explored how Millennials and Gen Z are redefining “workplace wellness.” The report was based on a survey of attitudes and priorities among 1,032 working-age Gen Z and younger millennials (ages 24-35) as these young adults return to the office. The survey found that young adults are struggling financially  – only 52% are confident they can retire at an age they desire. The report also found that this segment of the workforce does not have strong loyalty to their current employer – 46% say they definitely or probably will look to change jobs in the next 12 months. The report concluded that employers need to be aggressive with progressive benefits to attract and retain younger adult employees. Top priorities for young adults are flexible work schedules, better-quality benefits, employer culture/values, childcare assistance. Interestingly, 73% of young adults want benefits that are portable.

In June 2023, GCOA released its report, “Healthy Aging in Practice: How Age-Friendly Cities & Communities Can Contribute to an Age-Friendly World,” following a roundtable held in New York City with Age Friendly Ireland, along with the United Nations Department of Social and Economic Affairs (UNDESA), the New York City Department for the Aging, and other stakeholders.

The report builds upon the discussion and a Twinning Agreement signed by Ireland and New York City, providing examples of age-friendly innovation in New York, Ireland, and around the world.

Key takeaways include:

• The value of bone health is underrecognized.
• Adult vaccination is a key part of a community’s healthy aging strategy.
• Age-friendly environments protect the health and wellbeing of older adults.
• Older adults must be included in community planning.

A June 2023 study by the AgingWell Hub at Georgetown University and the TIAA Institute finds many young people struggling financially: many live paycheck-to-paycheck, feel finances control their lives, and doubt they will do as well economically as their parents. This report examines attitudes and perceptions of young adults regarding global issues and their own financial future and highlights substantial differences across demographic lines. The report also provides recommendations to young adults, their employers, financial advisors, and society to help young adults secure their financial future.

In June 2023, a new Bank of America report revealed striking disconnects between employer and employee perceptions of support around menopause. The report, developed in partnership with the National Menopause Foundation, surveyed 2,000 female workers and 500 benefit managers on menopause and its impacts in the workplace. Half of peri- and post-menopausal women (51%) reported that menopause negatively impacted their work life, yet only 14% believe their employers recognize the need for menopause-specific benefits. The underrecognized need for menopause-specific benefits comes as 20% of the workforce is in some phase of menopause transition and the number of post-menopausal women is expected to reach 1.1 billion by 2025 globally.

The research demonstrates the value of a menopause-specific benefit program as an imperative for future female employees and a point of differentiation in becoming an employer of choice.

A May 2023 study by the Transamerica Institute and the Transamerica Center for Retirement Studies revealed gaps between employer offerings and employee needs in the post-pandemic workplace. Sixty-nine percent of employers cite one or more workforce-related issues as major concerns for their company’s leadership, and more than six in 10 (61%) reevaluated their health, retirement, and other benefit offerings in 2022.

Stepping Into the Future: Employers, Workers, and the Multigenerational Workforce examined employers’ benefit offerings, identified employees’ unmet needs, and outlined recommendations, including best practices for the multigenerational workforce, such as flexibility and benefits to support employees who are also caregivers. The report is based on a survey of 1,800 for-profit U.S. employers including small, medium, and large companies (<100, 100 to 499, 500+ employees, respectively), and a survey of 5,700 workers in for-profit companies.

In April 2023, the Global Coalition on Aging (GCOA) convened a private workshop of experts and officials from Japan, Sweden, the United Kingdom, Italy and the United States to discuss how pull incentives within Japan and around the G7 could reinvigorate antibiotic innovation.

They found that:

• The antimicrobials market can be revitalized by pull incentives worth between US$2.2 and US$4.5 billion per drug, paid over 10 years. This can be achieved if G7 countries contribute their fair share of funding to new incentives. As this year’s G7 Leader, Roundtable Participants called on Japan, especially, to meet its fair share of global funding (US$443 million per drug).
• It is estimated that the world needs at least six new antimicrobial innovations per decade to make serious progress to solve the AMR crisis. This will only be possible through further funding for “pull” incentives, which delink revenue from sales volume, making it possible for manufacturers to support continued antimicrobial innovation without needing to actively sell new antimicrobials.
• Antimicrobial incentives produce tremendous returns on investment for the societies that create them. Pull incentives will help countries around the world avoid serious economic and fiscal problems in the future due to AMR.

In December of 2022, Global Coalition on Aging and Global Heart Hub jointly convened a roundtable of global, multi-disciplinary experts from healthcare, patient advocacy, policy organizations, and the private sector to discuss the challenge of heart valve disease in the context of aging societies and their evolving needs.

This position paper, Heart Valve Disease: Harnessing Innovation to Save Lives, Mitigate Costs, and Advance the Healthy Aging Agenda, is the result of the roundtable discussion and consultation with additional global experts. These experts identified critical issues to address, as well as a need for greater urgency to ensure patients and families, health systems and societies reap the full benefits of innovation, requiring:

• greater awareness globally and across stakeholder disciplines.
• equitable access, reimbursement, and encouragement from health systems for the use of innovations
• the global recognition of heart valve disease as a central element of the Decade of Healthy Ageing.

In December 2022, the Global Coalition on Aging announced the release of its roundtable report, “AMR & Japan’s G7 Presidency: A Call for Pull Incentives to Drive Innovation.” The report is based on a small, private roundtable of leaders from the United Kingdom, the United States, and Sweden, alongside Japanese decision-makers and experts.

AMR is a crisis for all of society, but older adults are most at risk, making AMR a critical priority for super-aging Japan, where close to 40% of the population is over 60. Experts at the roundtable identified four critical actions that Japan must take to urgently address AMR as Japan assumes the 2023 G7 Presidency.

1. Implement a pilot pull incentive to stimulate antibiotic innovation based on best-fit model for Japan, building on the experiences provided by the UK subscription pilot and the U.S. PASTEUR Act.
2. Build policy guidance on AMR into the Health and Finance Ministers’ meetings and communiques.
3. Communicate the urgency for AMR policy action through Japan’s G7 Presidency at the Summit level, which will underscore the Health and Finance support for G7 AMR actions.
4. Invite collaboration and partnership with other countries, both those already leading on AMR action and those seeking inspiration and guidance.