SURGEON GENERAL'S
WORKSHOP
Health Promotion and Aging

Proceedings

Edited by: DEP SG Faye G. Abdelk&
       SR PHARM Steven R. M-

Note:

AU opinions contained in these contents represent the
vkwpoint solely of tbe authors and participants and do not
necessarily represent the viewpoint of tbe Office of the
Surgeon General, tbe Public Health Service and its
constituent Agencies, or the Editors.

7 for this Workshop are Administration on Aging. Health Resources and Services
dmtnismw Food and Drq Admioistntion, National h~~timte on &iog. the Off3ce of Minority
Health, Ollkx of Diseae Ptwentioo and Health Promotion, Cents for Di Control. National
bt.stitutc of Mental Health, National Institute on Alcohol Abuse and Alcoholism, the Brookdale
Foundation, and the Henty J. K&et Family Foundation.
Support for the printing of this publication is provided by the Henry J. Kaisr Family Foundation
of Menlo F'xk. California,


PREFACE

As with any effort that seeks to take a somewhat disparate body of
knowledge and attempt to create uniformity and concensus, the final
.product may not be exactly what was expected. In this instance of trying
to assimilate all of the scientific knowledge and experience about health
promotion activities in aging populations into a coherent body or recom-
mendations and policy options, the product is more than expected! In addi-
tion to the insight that the 180 invited guests for this Surgeon General's
Workshop on Health Promotion and Aging were able to provide individu-
ally, the cohesive and often synergistic results of their deliberations have
given the Public Health Service and the much larger aging audience a view
of what is possible.
Instead of individual agendas, the larger picture has been shaped before
us and the vision is clear. That vision is the ability to provide research,
support and services that will allow the years in later life to remain as full
and fruitful as those in the earlier years. Although the prospect of death
is certainly inevitable to all of us, that period prior to death may well afford
some of the truly golden years of life. In addition to these years being
golden for the individuals, the ability to use their wealth of personal
knowledge and experience to enrich society and the extented family units
and communities is immense.
The seed of ideas and potential areas of activity are presented in this
final report with its recommendations. The participants at the Workshop
present to the much larger audience of interested parties our blueprint for
the nation in health promotion and aging. I join with you in seeking now
to implement these ideas and options so that our aging society is provided
with the maximum impact of our corporate knowledge for the benefit of
the health of all senior members.

C. Everett Koop, M.D., Sc.D.
Surgeon General


CONTENTS

opting Plenary Session

Keynote Address

Surgeon General C. Everett Koop . . . . . . . . . . . . . . . . . . . . . . . . . . .
United States Public Health Service

1

Address

Carol Fraser Fisk, Commissioner . .`. . . . . . . . . . . . . . . . . . . . . . . . . .
Administration on Aging

5

Address

Assistant Surgeon General T. Franklin Williams . . . . . . . . . . . . . .
Director, National Institute on Aging

9

Plenary Session

"Health Promotion and Surgeon General's Workshop" . . . , . . .
Assistant Surgeon General David Sundwall, Administrator
Health Resources and Services Administration

14

"Year 2ooO Health Objectives for the Nation" . . . . . . . . . . . . . . , .   2o
Assistant Surgeon General J. Michael McGinnis, Director
Office of Disease Prevention and Health Promotion

"Legislative and Administration Interests in
Geriatric Health Promotion". . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   26

Roger Herdman, M.D.,

Assistant Director for Health and Life sciences,
Office of Technology Assessment
U.S. Congress

"Setting the Pace in Geriatric Health Promotion"

.

"Healthy Older People"  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Susan Maloney
Office of Disease Prevention and Health Promotion

"Project Age Well"   . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Anthony Vuturo, M.D.
School of Medicine, University of Arizona

.

"International Geriatric Health Promotion Study/Activities"
David Macfayden, M.D., former Manager
WHO Global Progra.mme for Health for the Elderly

. . . .   35







. . . .   41






. . . .   49


Charge to Participants

Surgeon General C. Everett Koop  , . . . . . . . . . . . . . . , . . . . . . .
United States Public Health Service

54

Plenary Session

Recommendations of Working Groups:
Alcohol . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Dental (Oral) Health           ;
                      . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Physical Fitness and Exercise . . . . . . . . . . . . . . . . . . . . . . . . . . . .   63
Injury Prevention . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
  Medications .:.........................................  Fi
  MentalHealth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   74
  Nutrition  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   80
  Preventive Health Services . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .   84
Smoking Cessation                             88
                     . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Response to Recommendations  . . . . . . . . . . . . . . . . , . . . . . . . . . . . .
Surgeon General C. Everett Koop
  United States Public Health Service

94

List of Participants  . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . *  103