How 51�� is improving the health of Ohio’s aging population

A photo of people at an Age-Friendly Athens County community meeting

Ohio is experiencing a large growth in the number of people over the age of 60, with an expected 33 percent increase in this population by 2030. With leading research, technology development, infrastructure changes and community support, 51�� (OHIO) is taking significant strides in improving the health of the state’s older residents.

“Here we have strong faculty in health-related fields and strong research initiatives with a focused effort on supporting the communities from the top down,” said Richard Hodges, director of the 51�� Health Collaborative and The Ohio Alliance for Population Health.

Increasing healthy, independent years

The Ohio Musculoskeletal and Neurological Institute (OMNI) pulls together scientists from across OHIO and partners with healthcare organizations and pharmaceutical companies to accomplish its mission to improve the diagnosis, treatment, and prevention of musculoskeletal and neurological disorders. Through the Center for Healthy Aging, one of two centers within OMNI, researchers are investigating age-related declines in cognitive function and physical function as well as testing interventional strategies to address those declines and enhance quality of life.

“Forty percent of older adults report limitations performing tasks that are needed to maintain their independence,” said Brian Clark, Ph.D., Osteopathic Heritage Foundation Harold E. Clybourne, D.O. Endowed Research Chair, professor of physiology and neuroscience in the Department of Biomedical Sciences, and OMNI executive director. “Strength is a vital factor for health and longevity. A greater understanding of the causes of weakness is needed to develop targeted interventions to enhance strength and function.”

Much of OMNI’s work is looking at how to improve healthspan rather than lifespan. In the past, there has been a heavy focus on increasing people's lifespan, or the length of time an individual lives; however, now through a slow cultural shift driven by research, there is a new focus on healthspan, the number of independent, healthy years in one's life. Addressing a population’s healthspan can improve the number of quality years an individual lives, reducing health care costs and leading to better health outcomes.

Clark’s recent research focuses on improving the diagnosis of osteoporosis, the age-related loss of bone integrity or bone strength. In partnership with the 51�� Innovation Center, Clark is developing new diagnostic approaches to identify people who have fragile or weak bones. Early detection of osteoporosis can lead to interventions that improve one’s physical function and strength. Clark noted that weakness is a key risk factor that prevents people who are older from living independently.

“Enhancing physical function and muscle strength is a major public health priority. It could drastically reduce health care costs and improve quality of life for people,” Clark said.

OMNI is just one of the groups at 51�� looking for ways to improve health outcomes for people who are aging. Through collaborative research, the Heritage College of Osteopathic Medicine is exploring various aspects of age-related health concerns such as dementia and early disease detection.

Dementia risk reduction methods varies by population

Graciela Muniz-Terrera, Ph.D., Heritage College professor of social medicine and Osteopathic Heritage Foundation Ralph S. Licklider, D.O., Endowed Professorship in Health and Aging, conducts research on aging and dementia prevention in marginalized communities. Muniz-Terrera is in the early stages of developing research in Ohio that will determine how older adults can make behavioral changes to reduce the risk of developing dementia.

Muniz-Terrera explains that there are three major modifiable factors that can be addressed to reduce the risk of dementia including cognitive engagement, physical activity and diet. Muniz-Terrera's research, which is being done within OMNI and the Appalachian Institute to Advance Health Equity Science will investigate how infrastructure and culture contribute to those modifiable risks. She hopes the results of the study will lead to clinical recommendations for patients that consider cultural diet preferences and affordable food options as well as how infrastructure and environment facilitate physical activity within a patient’s community.

“Every population is different,” Muniz-Terrera said. “We need to understand the local communities to ensure that when things move from science to population, we are providing individuals with tools they can actually use.”

Age-Friendly communities benefit everyone

Many initiatives at OHIO are working towards the goal of creating sustainable systems to support Ohio’s aging population that are relevant at the community level.

“51�� understands its community mission better than any other, with an emphasis placed on community outreach,” said Hodges.

Through a series of surveys and community feedback, the College of Health Sciences and Professions has started the Age-Friendly Athens County (AFAC) certification process. Rebecca Robison-Miller, senior director of community relations at the College of Health Sciences and Professions, is leading AFAC, a community action group working toward making Athens City and County a certified age-friendly community through the (WHO) and .

To be certified, a community must fulfill WHO’s eight domains of livability, which include access to outdoor and public spaces, transportation, housing, social participation and inclusion, respect, communication, work and civic engagement, and health services. Additionally, AFAC has identified a ninth domain of sustainability and climate resiliency, an important issue for the local community. Through a series of surveys and community conversations regarding these domains, AFAC is responding to specific needs in the county.

Robison-Miller said the age-friendly community certification must be renewed every five years.

“The idea is that we are always aware and responding to what is needed in the Athens area communities. This is not dictated by anyone except the community,” Robison-Miller said.

To make impactful changes to infrastructure and accessibility, AFAC in partnership with the Athens City-County Health Department, is creating a community development plan from the feedback received from the community to foster sustainable improvements to Athens and the surrounding areas.

“There are a lot of underserved people in rural communities across the state, especially in Appalachia,” Robison-Miller said. “Anything we can build that will be beneficial to the aging population will benefit us at a state level.”

Participants learn CPR at a Community Health Worker training program

Community Health Workers support their neighbors

The OHIO Alliance for Population Health, works collaboratively with partners across the state to improve the health of all Ohioans by utilizing combined resources to address common determinants of health.

Melissa Kimmel, executive in residence and aging lead for the Alliance for Population Health, described some of the social determinates of health facing Ohio’s aging population including food or housing insecurity, a lack of basic needs, social isolation, kinship care issues and a lack of needed medications among other challenges. Removing these barriers can result in healthier communities.

“Aging is so broad, it encompasses every aspect of somebody’s life,” Kimmel said. “There are a lot of needs that need to be addressed. We are figuring out how we can take the resources that are in southeastern Ohio and have them work together.”

Facilitated by 51��, the Alliance has partnered with more than 40 affiliated universities, hospitals and healthcare providers to solve pressing population health concerns. Taking the lead to address those health concerns are community health workers, trained individuals who are “frontline public health workers” with a deep understanding of the community they serve. Community health workers connect individuals to resources, such as health and social services, and provide social support.

“During COVID especially, the aging population was really isolated,” said Kerri Shaw, associate professor of instruction with the CHSP and community health worker program coordinator with the Alliance for Population Health. "A lot of the programming that they had relied on was no longer available.”

Through a partnership with the , the Alliance placed student community health workers with older adults. Through this effort, students received valuable practical field experience and the region’s aging population benefited as well.

“Their jobs were specifically to address social isolation, focused on helping people know what resources are available, and making sure that we’re addressing social determinants of health through health outreach and education,” Shaw said.

Autonomous vehicles being tested with a focus on rural, older-adult users

Access to reliable transportation is a key factor that helps aging adults retain independence. Through a collaboration with CHSP and the Russ College of Engineering and Technology, Julie Brown, Ph.D., associate professor of gerontology with CHSP, is part of a team conducting usability research on an OHIO pilot-program testing autonomous vehicles. The initiative hopes to better understand how these vehicles can transform the lives of older adults and those with mobility and functional challenges.

Brown explained that autonomous vehicles will one day help people in rural communities physically connect with health care services and facilitate relationships that combat social isolation, which the aging population is vulnerable to and can lead to serious health consequences.

This initiative will be tested state-wide through funding from the Ohio Department of Transportation.

"That’s the beauty of collaborations at 51��,” Brown said. “There is tremendous synergy between experts looking at things that can be beneficial for all people.”

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