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Depiction of Health. 2024;15(1): 114-128.
doi: 10.34172/doh.2024.09
  Abstract View: 275
  PDF Download: 127

Health Care System Management

Original Article

A Comparative Study of the Coverage of the Concept of Successful Aging in the Health Programs of Iran and Selected Countries

Raana Gholamzadeh Nikjoo 1 ORCID logo, Hossein Matlabi 2 ORCID logo, Ziba Mazrooei 1*

1 Department of Health Policy and Management, Tabriz Health Services Management Research Center, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
2 Research Center for Integrative Medicine in Aging, Aging Research Institute, Department of Geriatric Health, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran
*Corresponding Author: Email: zibamazrooei@yahoo.com

Abstract

Background. Successful aging is the feeling of inner satisfaction and happiness of the person from his/her current and past life. Implementation of this concept in societies requires attention in macro plans and policies. This study, therefore, aimed to study the coverage of the concept of successful aging in the health programs of Iran and selected countries.

Methods. In this comparative study, the literature was first reviewed. To this end, the internal websites were searched and the documents and circulars of the Ministry of Health along with the developed and implemented programs regarding the elderly were extracted. Then, the components highlighted in each program were identified. Finally, the elements and components of the coverage of the concept of successful aging in the health programs of Iran was investigated with other selected countries in this field and the existing gaps were compared.

Results. Elements and components of the successful aging in all programs were determined after examining the country's health programs. The sub-components of health promotion, provision of appropriate health services, as well as medical and treatment services were highlighted in most of the country's health program packages; however, the sub-components of disease prevention, long-term care, adherence of the elderly to the application of provided services, social support, education and literacy, income, insurance and social support, as well as employment were not taken into consideration in any of the programs. The health programs of the two countries (i.e., Canada and the United States) out of all other examined countries were highly compatible with the components of successful aging in the framework developed by the World Health Organization.

Conclusion. Since no importance was attached to the components such as prevention of diseases, long-term care, and adherence of the elderly to the application of provided services, it was recommended that the health policy makers should fill the existing gap by following the examples of successful old age programs in the selected countries. Moreover, it was found absolutely necessary to provide components such as social support, education and literacy, insurance and employment, as well as inter-sectoral conflict at the welfare, education, economy, and finance ministerial levels.


Extended Abstract

Background

Iran is one of the developing countries, which has recently faced an increase in the number of elderly people along with a decrease in the fertility rate due to the changes and developments in age groups. Surveys and statistical indicators have confirmed the rapid growth of the aging phenomenon. One of the new topics in the field of politics and social welfare of the elderly, is the concept of successful aging. Right implementing of this concept in the societies reduces the costs of healthcare sector, in particular.

Although successful aging has positive effects on the lives of the elderly and other members of the family and society, no conclusive evidence has been produced regarding the implementation of successful aging in the country's health system. This study, therefore, aimed to investigate the coverage of successful aging in the health programs of Iran and selected countries.

Methods

To conduct the present study, an eclectic approach (i.e., review and comparison) was employed. First, the internal websites were searched and the documents and directives of the country's Ministry of Health about successful aging programs were studied. Then the components of successful aging programs were entered into the extraction table, which included the sections discussing the type of program, target population, strategies, and related activities in each program. In order to analyze and report the data obtained from the upstream documents/circulars and the website of the Ministry of Health, the main areas were identified, and the themes related to each area were extracted using the content analysis method.

Then a comparative method was adopted to compare the executive status of successful aging in Iran and those of the proposed countries in this field. To this end, first, six countries implementing the components of successful aging were selected, and then their models for the implementation of the aforementioned components were examined (i.e., comparative study of a specific issue in different countries). The question of the qualitative comparative study was as follows: for each component of the successful aging, what strategies have been considered or are currently being implemented in each country for its establishment and implementation? The required data were extracted from the reference books, reliable websites, published reports of the World Health Organization, academic and research centers, databases of the articles, and accessible materials/documents, etc. An information form was used to collect the data about the countries under study. Comparative tables were also used for analyzing the data.

Results

In total, the country's health programs were assigned to 10 categories. As for the health programs of the country's Ministry of Health, the following sub-components were considered: physical and physical activities, healthy and proper nutrition, reduction of tobacco and alcohol consumption, health promotion, mental health services, medical and therapeutic services, social activities and relations, psychological factors, physical environment, provision of the appropriate health services and promotion of health, and healthy and appropriate nutrition (based on the components of the World Health Organization framework). Furthermore, the sub-components of health promotion, provision of appropriate health services, as well as medical and therapeutic services were included in most of the program packages. The health issues of the country were highlighted in the programs, but the sub-components of long-term care, adherence of the elderly to use the services provided, social support, education and literacy, income, insurance and social support, and employment were not considered in them. According to the results from surveys, Canada and USA stood higher than other countries in this regard.

Studies from the United States demonstrated that the sub-components of health promotion, prevention of diseases, provision of appropriate health services, long-term care of the health component and health services, the sub-components of physical and physical activity, healthy and appropriate nutrition, medical and therapeutic services relating to the component of behavioral factors, psychological factors relating to the component of individual factors, the sub-components of activity and social relations and social support relating to the component of social environment factors, as well as the sub-components of insurance and social support and employment relating to the component of economic factors had a high priority compared to other components. Studies on health system of Canada also revealed that the sub-components of health promotion, prevention of diseases, provision of appropriate health services, long-term care of the health, and health services component, the sub-components of physical and physical activity and medical and therapeutic services relating to the behavioral factors component, psychological factors relating to the component of individual factors, the sub-components of activity and social relations and social support relating to the component of social environment factors, as well as the sub-components of income, insurance and social support, and employment relating to the component of economic factors were highlighted. In general, the long-term care of the elderly and economic support was determined as the hallmarks of successful aging models in Canada. According to a published report of Persian Canadian Comprehensive Portal magazine, elderly people needing special care are transferred to institutions, where nurses and trained staff are ready to serve them.

Conclusion

In Iran, a greater focus was placed on the subcomponents of successful aging such as appropriate provision of health services, medical and therapeutic services, and physical environment; however, successful aging has not been prioritized in policies and macro-planning. Most of the successful aging components were not implemented. It was found that the country's population tripled over the past 30 years, and it was predicted that Iran would enter a super-old age stage in the following 30 years due to a four-time increase in the population of the elderly. It was recommended that Iran's Ministry of Health should prioritize the issue of successful aging when formulating the policies on aging, use the components of successful aging by involving the private sector, and develop basic plans based on the successful global models.

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Submitted: 28 Aug 2023
Revision: 04 Dec 2023
Accepted: 27 Jan 2024
ePublished: 16 Mar 2024
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