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US Healthy People 2030 includes goals for older adults

The United States Department of Health and Human Services (HHS) recently released Healthy People 2030, which sets “data-driven national objectives to improve health and well-being over the next decade.” Every 10 years the Healthy People initiative sets “measurable objectives to improve the health and well-being of people nationwide” to address “the latest public health priorities and challenges”. Healthy People 2030, the initiative’s fifth iteration, includes multiple objectives aimed at improving the health and well-being of older adults.

Linking to the physical dimension of wellness
Many of the Healthy People 2030 objectives for older adults (https://health.gov/healthypeople/objectives-and-data/browse-objectives/older-adults) address the physical dimension of the International Council on Active Aging’s seven dimensions of wellness. Objective OA-01 calls for an increase in the proportion of older adults with physical or cognitive health problems who get physical activity.

A number of other Healthy People 2030 objectives for older adults target preventive care that can be linked to physical inactivity as well as to malnutrition, particularly because malnutrition can diminish immune response, delay wound healing and increase rates of infection, chronic disease, functional disability, frailty and falling. See Table 1 for details about some of the objectives that can be linked to physical inactivity and/or malnutrition.

Table 1

Objective OA-04
Reduce the rate of pressure ulcer-related hospital admissions among older adults
Linked to physical inactivity | Linked to malnutrition

Objective OA-07
Reduce the rate of hospital admissions for urinary tract infections among older adults
Linked to malnutrition

Objective OA-06
Reduce the rate of hospital admission for pneumonia among older adults
Linked to malnutrition

Objective OA-05
Reduce the rate of hospital admissions for diabetes among older adults
Linked to physical inactivity | Linked to malnutrition

Objective IVP-08
Reduce fall-related deaths among older adults
Linked to physical inactivity | Linked to malnutrition

Objective OA-03
Reduce the rate of emergency department visits due to falls among older adults
Linked to physical inactivity | Linked to malnutrition

Objective O-02
Reduce hip fractures among older adults
Linked to physical inactivity | Linked to malnutrition

Objective O-D02
Increase the proportion of older adults who get treated for osteoporosis after a fracture
Linked to physical inactivity | Linked to malnutrition

Focusing on social determinants of health
Healthy People 2030 has an increased focus on the social determinants of health — the environments where people are born, live, learn, work, play, worship and age that impact their health, well-being, and quality of life. Among the specific examples of social determinants of health outlined by Healthy People 2030 are “access to nutritious foods and physical activity opportunities.”

Graphic from Healthy People 2030, U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion.

US government agencies provide multiple resources to support access to nutritious foods for older adults:

A number of these programs have received increased attention and funding during the COVID-19 pandemic. They continue to prove essential for older adults, particularly those challenged by social isolation and food insecurity.

Using Healthy People 2030 Objectives
Healthy People 2030 describes how the objectives can be used at the local level and outlines these steps:

  1. Identify needs and priority populations to make the case for your program, secure resources and build partnerships.
  2. Set your own targets, realizing local targets contribute to national success.
  3. Find inspiration and practical tools. Visit here to get started.
  4. Monitor national progress and use Healthy People 2030 data as a benchmark.

For example, two of the Healthy People 2030 objectives for older adults address the risk of falls. Your facility or organization could adopt these objectives and implement a program that addresses the links between malnutrition and falls. A nutrition component, such as “Stepping Up Your Nutrition,” could then be included as part of a fall prevention program.

Advancing policy opportunities to support older adult nutrition
The Healthy People 2030 objectives can also be linked to broader policy opportunities focused on older adult nutrition. The Defeat Malnutrition Today coalition has said that up to fifty percent of older adults are either malnourished or at risk of becoming malnourished. It has outlined specific goals and strategies to help overcome malnutrition in its National Blueprint: Achieving Quality Malnutrition Care for Older Adults, 2020 Update.

One of these strategies addresses the important gap in connecting nutrition and healthcare for older adults, noting that the Centers for Medicare & Medicaid Services (CMS) does not include malnutrition care in the quality measures it uses to help assess healthcare value and effectiveness. This gap was underscored in a recent US Senate resolution that encouraged the “adoption of malnutrition electronic clinical quality measures.”

A Global Malnutrition Composite Score has been developed with four quality measures focusing on malnutrition risk identification, diagnosis and treatment for hospital patients. The Measures Application Partnership Hospital Workgroup is set to review this composite measure in early 2021 for its appropriate inclusion in CMS Hospital Inpatient Quality Reporting Program. The National Quality Forum is also reviewing the measure to endorse its use.

Now is the time to advocate for endorsement of the Global Malnutrition Composite Score to help ensure nutrition is part of high-quality, safe and coordinated healthcare for older adults. More focused nutrition care will also support Healthy People 2030’s goal of improving health and well-being for older adults.

Meredith Ponder Whitmire, JD
Policy Director
Defeat Malnutrition Today

Note: This information is not intended to replace a one-on-one relationship with a qualified healthcare professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from research. The view expressed here are not necessarily those of the ICAA, we encourage you to make your own health and business decisions based upon your research and in partnership with a qualified professional.

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