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Statement Of Steven P. Wallace
Environmental Protection Agency
Aging Initiative Public Listening Session
Los Angeles, California
April 29, 2003
Steven P. Wallace, PhD
Professor, UCLA School of Public Health
Associate Director, UCLA Center for Health Policy Research
Co-PI, Resource Center for Minority Aging Research Coordinating Center
Professor, UCLA School of Public Health
Associate Director, UCLA Center for Health Policy Research
Co-PI, Resource Center for Minority Aging Research Coordinating Center
Good afternoon. On behalf of the School of Public Health, I would like to welcome everyone to the UCLA campus for this Public Listening Session by the Environmental Protection Agency's about their new Aging Initiative. The School of Public Health is pleased to cosponsor this event given its research and teaching strengths in both environmental health and in gerontological health.
The mission of public health is to "fulfill society's interest in assuring conditions in which people can be healthy." Clearly a healthy environment is a central condition for population health, and the elderly population is the most rapidly growing segment of the population. Everyone here knows, I'm sure, that the number of older persons will double in the next 30 years and that during that time the elderly population will become more racially and ethnically diverse. In many ways the very old and the very young are our sentinel populations. The oldest old are the most likely to have multiple chronic conditions and the least resistance among adults to environmental assaults. So by attending to the effect of the environment on the elderly, we are looking out for us all. The UCLA School of Public Health looks forward to advancing our knowledge in these areas, and training the next generation of leaders who will help solve those problems.
I would like to spend the next two minutes giving examples of the relevance of this new EPA initiative in emerging issues of how the environment affects the elderly, and of how the elderly affect the environment.
First, gerontologists have spent much time and effort on respiratory conditions such as influenza and pneumonia, but little on asthma.1 Asthma has been associated with both indoor and outdoor environmental factors. Persons with asthma may experience life threatening exacerbations. However, symptoms not severe enough to require a visit to a physician can still substantially impair quality of life.
According to the new statewide California Health Interview Survey2, asthma is more common among children but more severe among the elderly3. Among children under age 18, 13.6% have ever been diagnosed with asthma compared to 10.1% of those age 65 and over. But elderly adults are more likely to have daily or weekly symptoms, 34.8% for adults age 65 and over, versus 17.4% for ages 18 24 and 8.4% for younger children (ages 0 11). In addition, older persons with asthma are twice as likely to be hospitalized for asthma as younger adults (4.25% vs. 1.85%). So when we examine the link between air quality and health, it is critical that we take into account its effect on asthma in the elderly as well as the young.
What about the effect of the elderly ON the environment? This is an issue that does not receive much attention, but there is at least one important area where an aging population could have a significant negative impact on the environment - solid waste generated by incontinence supplies. According to the Medicare Current Beneficiary Survey4, about 17% of older women and 7% of older men involuntarily lose their urine at least monthly. The adult incontinence market for disposable products is estimated at $1.1 billion and growing at 10% per year5. Disposable diapers, mostly from infants but increasingly from adults too, are estimated to account for 1.5-2% of municipal solid wastes contributing to the existing problem of landfill availability and escalating cost of solid waste management6. It is estimated that 80% of adults affected by urinary incontinence can be cured or improved7, but this won't happen if we have to rely on the marketing campaigns of companies that profit only from selling adult diapers. This is a potential win-win situation for both the elderly and the environment - if the government undertakes educational and treatment campaigns to reduce the problem we create a better quality of life for older persons and protect the environment.
In summary, the rapidly growing older population has important implications for the environment. The older population is particularly sensitive to the health of the environment, and if our older population stays healthy it will put less strain on the environment! Since many of the interventions are possible only if the federal government takes a leading role, it is critical that the EPA develop this new aging initiative. Thank you.
2 http://www.chis.ucla.edu/
3 http://www.healthpolicy.ucla.edu/pubs/pubList.asp?topicID=4&subTopicID=11
4 http://cms.hhs.gov/mcbs/default.asp
5 http://nonwovens-industry.com
6 Characterization of Municipal Solid Waste in the United States: 1990 Update. 1990. U.S. Environmental Protection Agency, EPA 530 SW 90 042
7 http://www.nafc.org/about_incontinence/treatment.htm