FOREWORD

As a nation, the United States is literally growing older. Persons aged greater than or equal to 65 years constitute the fastest-growing segment of the U.S. population. Because aging has been associated with increased prevalence of chronic disease, disability, and death, a public health goal for older adults is to maintain health, independence, and function. Health promotion efforts can help to accomplish that goal; however, such efforts traditionally have targeted only younger persons (e.g., public education to prevent smoking among young adults and campaigns to lower cholesterol and increase exercise for middle-aged persons). CDC seeks to expand the traditional scope of health promotion to include older adults, specifically by initiating efforts to prevent ill persons from becoming disabled; to maintain capacity in frail elderly persons; and to enhance functional level in all persons, not just currently healthy ones.

Although public health interventions have been credited with the increase in life expectancy among U.S. residents, other important public health missions include improving health and quality of life during those years of extended life. To enhance these interventions, efforts to expand the scope of health promotion to the elderly must begin with surveillance.

During the preceding 40 years, public health surveillance at CDC has evolved and expanded from activities that focus primarily on the prevention and control of acute infectious diseases to a much broader focus, including chronic diseases, injuries, risk factors, and health practices. Surveillance data can be used to identify needs, inform policy, and guide action to improve the health status of older adults. Although some infectious disease agents, such as Streptococcus pneumoniae (pneumococcus) and influenza virus, are major causes of morbidity and mortality among older adults, other public health indicators affect this population over a longer duration, negatively influencing health and quality of life. This publication focuses on several public health indicators affecting this population: surveillance; leading causes of morbidity and mortality; injuries and violence; use of health-care services; five health risks; and sensory impairment, activity limitation, and health-related quality of life. Publication of this collection of surveillance summaries focuses needed attention on some of the health concerns affecting older adults and will stimulate additional research and reports on other public health indicators affecting this population. The surveillance summaries in this publication reflect CDC's participation in the United Nations' celebration of the International Year of Older Persons and further commits our efforts to improving the health status of older adults.

Jeffrey P. Koplan, M.D., M.P.H.
Director, Centers for Disease Control and Prevention
Administrator, Agency for Toxic Substances and Disease Registry

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