Remarks of the Assistant Secretary Carbonell to the Mexican International Aging Conference on June 16, 2004 in Mexico City, Mexico

Madame Secretary, participants of this Congress, I am delighted to be here today and honored to represent the United States government at this important meeting. I bring you greetings from our Secretary of Health and Human Services, Tommy Thompson.

I extend my great appreciation to the Ministry of Social Development and its National Institute on Aging for convening this meeting. I want to particularly thank
Mr. Pedro Borda for organizing this event. We have had the pleasure of working with him on multiple occasions. I am amazed at his tireless energy, and admire his commitment to older people everywhere, particularly in Mexico.

I am also very impressed with the program for this Congress. First for the breadth of the subject matter and second for the people who have been invited to attend and speak. I expect we will have a very fruitful dialogue here with government officials, practitioners, researchers and the non-profit sector. This is important because aging is everyone’s business.

I am very pleased to continue the dialogue started at the World Assembly on Aging, the ECLAC conference and other regional conferences. This is a wonderful opportunity for us to continue to share our experiences; to learn from one another; to form new links and partnerships and to continue to implement the goals of the International Plan of Action on Aging.

In the last few years we have created a solid dialogue on aging issues with Mexico - first by working with the Mexican Ministry of Health, and its aging program, and more recently, working with the National Institute on Aging. We are also very excited about working with Mexico on the first US/Mexico Border Binational Health Week, which will take place on October 11 through 17 of this year. The theme will be “Families in Action for Health.” The US/Mexico Border Health Commission is coordinating this event, and we are working closely with them. We anticipate that 14 communities on both sides of the border will join in a number of health related activities across the lifespan.

The U.S. Census Bureau just came out with a new report entitled “Global Population Profile: 2002.” I will share with you a few statistics from this report as they underscore the importance of our meeting today.

In 2002, there were 440 million people age 65 or over – approximately 7 percent of the total population – in this world. By 2020, this population will almost double and more than triple by 2050.

Similarly, the relative size of the elderly population is expected to grow to over 9 percent in 2020 and to almost 17 percent by 2050. Population aging is nearly a universal phenomenon.

In the United States, less than eight years from now the first of the “baby boomers” – people born between 1946 and 1964 - will begin turning 65, and the number of Americans age 65 and older will more than double to over 70 million by 2030.

These figures provide a challenge for all of us – policy makers and practitioners. Today I will speak about how we are meeting the challenges of an aging population in the United States by creating healthy and caring communities across our country. For the United States, the improvement in the lives of older people and their families is a continued priority. We are committed to strengthening and modernizing our health insurance program for the elderly, improving access to health care, expanding prescription drug benefits and preventing disease. We are reshaping our current system of long-term care so people may stay in their own homes and communities as long as possible.

I am going to talk about some of these priorities. But before I do so, let me briefly tell you about my own agency and its mandate, as it plays a major part in creating these healthy and caring communities for seniors and their families.

The Administration on Aging is charged with promoting the development of a comprehensive and coordinated system of care at the community level that will help older people remain active and healthy and able to remain in their own homes for as long as possible.

We carry out our mission by working with and through a nationwide network - known as the Aging Services Network. Each year, we channel about $1.4 Billion in federal funds through the states and tribes to support a wide array of home and community-based social service programs and interventions.

At the community level, our funds support over 29,000 service provider organizations such as senior centers, meals on wheels and congregate nutrition programs, specialized transportation services, home care agencies, and adult day care centers.

Our most recent data shows that our community providers served approximately 7.5 million elderly individuals and over 550,000 family caregivers.

Together with these state and local partners, we are helping older people in the United States to remain healthy, independent, actively engaged, and productive at home and in the community. We are doing this in several ways.

One way is by creating a long-term care system that provides people of all ages with more choices and opportunities to receive support in their own homes and communities.

Our vision of a “Community of Care” is one that supports individual choice, easy access to a full range of health, social and environmental supports, quality of care, and one that encourages people to plan ahead for their long-term care needs.

Through the President’s New Freedom Initiative, agencies throughout our Department of Health and Human Services and across the Federal government are working to break down the barriers to independent living and community participation for people with disabilities of all ages, including older adults.

This initiative encompasses all aspects of community living for people with disabilities—including employment, education, housing, transportation, assistive technology, and the range of home and community-based services essential in maintaining independent living.

In the last three years, our Department has invested over one half billion dollars in new funding to support new community options, to streamline access and improve the quality of care to make it easier for states and communities to provide more flexible, and more integrated models of care.

One component of this initiative is the creation of “one stop shop centers” which will help consumers learn about and access long-term supports ranging from in-home services to nursing facility care.

These new centers will serve as visible and trusted places where people can turn for information on the full range of long-term support options, as well as assistance in accessing those options.

The goal of this program is to empower consumers to make informed decisions about their care options. The program will help our states and communities eliminate the fragmentation in their service systems.

To date, we have funded Aging and Disability Resource Centers in 24 states to develop streamlined access to long-term support services under this program.

Another component of the Department’s initiative is aimed at supporting families in caring for their loved ones.

In the United States, more than 44.4 million households provide unpaid care for loved ones. One of every 4 persons is a caregiver for a family member or friend. The average caregiver is a 46-year old married female who is also employed outside the home.

In talking to caregivers across the country, they told us that with a little bit of help they could continue to take care of their loved ones at home. We are providing that help through the National Family Caregiver Support Program, which began in 2001.

The program provides critical support to family, friends and neighbors who provide care for their loved ones, including spouses, parents, and even grandchildren. This program provides the help and relief that caregivers need to care for their loved ones at home.

Another way that we are keeping older people healthy and independent is by focusing on good health. The President’s HealthierUS initiative encourages all Americans to take steps to improve personal health and fitness through exercise, nutritious diet, preventative screenings and healthy choices. At the heart of this initiative lies both personal responsibility for the choices that we make and social responsibility to ensure that policy makers support programs fostering healthy behaviors and disease prevention.

Tommy Thompson, my boss and the head of the Department of Health and Human Services, is encouraging us to put the President’s initiative into practice. As Secretary Thompson has said, “As life expectancy increases, we need to make sure we’re adding quality to those added years of life.”

In my own agency, the Administration on Aging, I have made prevention one of my top priorities. As the baby boomers age, we will need to do every thing we can to reduce both the incidence and severity of disease and disability during the later stages of life.

We are very fortunate to have a growing body of science in the area of prevention as it relates to older people. This science clearly shows that it is not too late for older persons – even for older persons with impairments - to obtain substantial health benefits by making lifestyle changes. The science also provides evidence that we can achieve substantial savings by targeting prevention programs at older people.

To advance our prevention agenda, last year we launched an Evidence-Based Prevention Grants program to demonstrate how we can translate the Department’s research into practice through our community service provider agencies, such as senior centers, nutrition programs and senior housing projects.

We find that successful interventions in disease self-management, fall prevention, nutrition, physical activity and medication management require a team approach. Our social service agencies, working with healthcare provider organizations, prove to be a good vehicle for the delivery of health interventions, and they also save money. Social service agencies are particularly effective in reaching the underserved elderly who often need such programs the most.

One example of the types of projects we are funding is taking place in San Antonio, Texas. Our local aging program is helping low-income Hispanic elders to reduce their risk of developing diabetes through an exercise and nutrition program that is being delivered in senior centers and churches.

Another project targets sedentary older adults in the Los Angeles area. This project is being delivered through senior centers and is designed to help people become and stay physically active by assisting them in setting realistic goals and providing them with a strong social support network.

And finally, in Miami, Florida, dietitians in 14 senior centers are leading education/counseling group sessions to increase knowledge of nutrition among Hispanic elders at risk for cardiovascular disease and obesity, and to foster behavior change through group sessions and interactive activities.

We’re very excited about this prevention initiative and the potential it holds for improving the lives of large numbers of older people in this country.

I’m also committed to raising awareness among the senior population throughout our nation about the importance of prevention and the small steps that older people can take to maintain and improve their health.

This year, we are launching a national outreach and public awareness campaign to get the Secretary’s prevention message about eating better and exercising more out to seniors all across the country.

We’re calling it the “You Can! Steps to Healthier Aging Campaign.” The “You Can! Steps to Healthier Aging” campaign is designed to mobilize communities to create awareness and make programs available to help older Americans eat better and move more. The campaign will promote the availability and use of community-based nutrition and physical activity education programs for older adults as a way to highlight steps that can be taken to prevent and manage chronic diseases. We will provide our partners with tools for conducting outreach activities, educational materials, and information about available programs. We hope to enlist at least 2,000 organizations as You Can! Partners and to have at least 2 million older Americans participate in nutrition and physical activity programs by October 1, 2006.

In closing, I would say that in the United States, we are striving to build a good community support system for older persons and their families. May is celebrated as Older Americans Month in the United States, a month in which we honor older senior citizens. This year's theme, "Aging Well, Living Well," reflects the many ways that older Americans contribute to our national character. Many are working beyond traditional retirement age, while others volunteer their time serving worthy causes. President Bush pledged to continue working to enhance their quality of life. I would hope that in all of your countries, Aging well will also mean Living Well.

Together, we can find ways to improve societies and ensure that the twenty-first century will be a good time to grow old in the Americas.

Pictures from the Conference:

(Pictured L to R): Josefina G. Carbonell Assistant Secretary for Aging, U.S.A.; Albina Cruces Vazquez 101 Year Old Educator, Mexico; Adriana Borda, President, Voluntary Group, National Voluntary Group, National Institute on Aging, Ministry of Social Development, Mexico; Pedro Borda Hartmann, Director, National Institute on Aging, Ministry of Social Development, Mexico.

Plenary Session. (Pictured L to R): Manuel Sánchez-Montañés Ramos, Executive Director, Iberoamerican Intergovernmental Cooperation Network, Spain; Josefina G. Carbonell Assistant Secretary for Aging U.S.A.; Albina Cruces Vazquez, 101 Year Old Educator, Mexico; Carmen Largaespada Fredersdorff, Nicaraguan Minister of Families, Adriana Borda, President, Voluntary Group, National Voluntary Group, National Institute on Aging, Ministry of Social Development, Mexico.

Josefina G. Carbonell, Assistant Secretary for Aging in front of mobile medical/social unit from Mexican National Institute on Aging

Josefina G. Carbonell, Assistant Secretary for Aging, and Mrs. Borda with canteen worker, Medical/Social Service Center, INAPAM.

Josefina G. Carbonell, Assistant Secretary for Aging, Mr. Borda with medical staff, Medical/Social Service Center, INAPAM.

Josefina G. Carbonell, Assistant Secretary for Aging, with resident of assited living facility, INAPAM.

Secretary, Ministry of Social Development, presents materials developed by her Ministry.

Josefina G. Carbonell, Assistant Secretary for Aging with Dr. Rodolfo Tuirán, Under Secretary for Urban Town and County Planning, Mexican Ministry of Social Development.

Disclaimer: This text is the basis of the oral remarks of the Assistant Secretary for Aging. It should be used with the understanding that some material may be added or omitted.