Active and Successful Aging: A European Policy Perspective

Abstract

Over the past two decades, “active aging” has emerged in Europe as the foremost policy response to the challenges of population aging. This article examines the concept of active aging and how it differs from that of “successful aging.” In particular, it shows how active aging presents a more holistic, life course–oriented approach than successful aging. We provide a critical perspective on active aging too by, first, tracing its emergence in Europe and then showing how, in practice, it has been dominated by a narrow economic or productivist perspective that prioritizes the extension of working life. It has also been gender blind. Nonetheless, it is argued that an active aging approach has the potential to enable countries to respond successfully to the challenges of population aging because of its comprehensive focus and emphasis on societal as well as individual responsibility. Finally, we set out the basic principles that need to be followed if the full potential of active aging is to be achieved.

Policy responses to population aging globally comprise both negative and positive strands: on the one hand, old age is commonly portrayed as a period of inactivity and dependency while, on the other, often simultaneously, older people are viewed as a social and economic resource. Both successful and active aging derive from the same scientific root, the activity perspective. Both have been employed, in research as well as policy, as alternatives to the inaccurate deficit model of older age, albeit on different sides of the Atlantic Ocean (Strawbridge, Wallhagen, & Cohen, 2002; Walker, 2009). Sometimes, the two terms are wrongly used as synonyms. The main purpose of this article is to examine the idea of “active aging.” We do so from a European vantage point where it has become the leading scientific and policy conceptualization of a later life characterized by well-being. Active aging is contrasted with “successful aging,” prevalent in aging discourses in the United States, and shown to represent not only a more holistic, life course–oriented approach but also one which, in policy terms, enlists organizational and societal actions as well as individual ones. In practice, however, active aging policies have been dominated by a narrow economic or productivist perspective that prioritizes the extension of working life and, therefore, overlooks those not involved in paid employment. This bias is illustrated with reference to European policy developments. Thus, in practice, active aging actually comprises two distinctly contrasting policy frameworks—one narrowly economic focusing on older workers and the other social, encompassing the whole life course. Then, it is argued that a comprehensive life course active aging strategy can provide a sound basis for countries to respond to the challenges presented by an aging population. This strategy should be based on a partnership between citizens and society and aim for a comprehensive, noncoercive, and inclusive approach to active aging. Finally, drawing on the strategy outlined by Walker (2002, 2009), it extends the criteria for a comprehensive approach to active aging and sets out the basic principles that need to be followed if policy makers are to achieve the full potential benefits of active aging.

The Emergence of Successful Aging

There is wide global variation in the terms used to encapsulate the notion of “aging well.” These include successful aging, active aging, healthy aging, positive aging, productive aging, and competent aging. Each one of these concepts implies a (sometimes subtly) divergent approach to the gains and potential of aging (Barrett & McGoldrick, 2013). The most prevalent terms employed over recent decades have been successful aging in the United States and active aging in the Europe (Constança, Ribeiro, & Teixeira, 2012). Although these terms are often used interchangeably (Lloyd et al., 2013), they are inherently different (Deeming, 2009) and neither is without criticism (Villar, 2012).

Active aging is concerned with facilitating the rights of older people to remain healthy (reducing the costs of health and social care), remain in employment longer (reducing pension costs), while also participating in community and political life. However, despite its wide currency, the concept of active aging lacks a precise universally agreed definition and is commonly used to mean “all things to all people” (Walker & Maltby, 2012). This lack of uniformity can make the aim of developing and comparing policy implementation more complex, both internationally and nationally (Sidorenko & Zaidi, 2013). Notwithstanding this deficiency, it has been used widely in the past 10 years in Europe in particular, largely as a result of the efforts of the World Health Organization (WHO) and European Commission (EC).

The emergence of successful aging and active aging can be traced back to the activity perspective in the United States, during the early 1960s, as the antithesis of disengagement, the mutual withdrawal between aging persons and society (Walker, 2002). Cumming and Henry (1961) assumed disengagement to be universal and inevitable. This first major gerontological theory was criticized for largely ignoring older adults’ own perceptions about what engagement entailed and enforcing a deficit model (Hochschild, 1975). The model of successful aging developed out of the activity perspective. To age well, individuals were to lead lives that avoided disability and disease, and thereby maintain mental and physical capacities that facilitated productive and social engagement in society (Rowe & Kahn, 1987, 1997). The key to “successful aging” (Pfeiffer, 1974; Rowe & Kahn, 1987) was seen as the continuation of activity in older age and retention of values typical of those in middle age (Havighurst, 1963) denying the onset of old age (Walker, 2002). Productive aging followed a decade later, in the United States, and, after another decade, the global concept of active aging (WHO, 1994).

Successful aging and active aging challenge the dominance of the deficit model. Along with some variants of productive aging, they challenge the expectation that older people would exit the labor force at fixed (arbitrary) ages and exchange wages for pensions. There is a concern that this detachment from employment creates a situation in which older people are no longer in a socially defined “productive” sector of society (Estes, 1979; Phillipson, 1982; Walker, 1981), which leads to a more general devaluation of the worth of older people (Walker, 1980). Rather than equating the oldest phase of life purely with a period of rest, active aging and successful aging discourses seek to enable the participation of older adults in society (Barrett & McGoldrick, 2013). However, if narrowly applied, both risk the creation of a two-tiered view of the older population with a minority of people (predominantly the young-old) aspiring to meet standards of success or activity (linked to employment), which remain unattainable for many (old-old) due to severe illnesses or disabilities (Holstein & Minkler, 2003; Scheidt, Humpherys, & Yorgason, 1999).

First coined 40 years ago by Butler (1974), successful aging began to increase in popularity following an article by Rowe and Kahn (1987) where it was argued that aging and illness are distinct processes. Aging research tends to focus on notions of loss and decline, with the product of illness being attributed to aging. Rowe and Kahn (1997) elaborated on their initial model of successful aging to include three main components: low probability of disease and disease-related disability, high cognitive and physical functional capacity, and active engagement with life. In United States, successful aging began to become a reference point in discourses around aging, contributing to the rejection of older age as being inextricably linked to an inevitable succession of losses (Boudiny, 2013). This has changed the focus of research from those who suffer illness and disabilities as they age to those who experience positive outcomes. This also led to a shift in focus from those “doing poorly to those doing well” (Strawbridge et al., 2002).

Successful aging prioritizes the achievement of clinical and medically inspired criteria, whereas social aspects (engagement with life, in Rowe and Kahn’s model) occupy the lowest position in the hierarchy of success. As such, Rowe and Kahn’s (1987, 1997) model of successful aging has the potential to lead policy makers and older people themselves to aspire to an unrealistic ideal of aging. Rowe and Kahn (1987) overestimated the prevalence of older individuals progressing through old age disease-free when evidence from centenarian studies shows that reaching old age without ill health or disability is uncommon (Motta, Bennati, Ferlito, Malaguarnera, & Motta, 2005). “Successful” implies there are winners and losers, all too often true in policy developments, but most gerontologists are uncomfortable with labeling someone unsuccessful because they are disabled or have ill health (Strawbridge et al., 2002). The processes of defining and measuring successful aging have been problematic as they have been concerned with how older individuals should age, rather than with how people come to view themselves as aging successfully (Chapman, 2005; Pruchno, Wilson-Genderson, Rose, & Cartwright, 2010). For instance, even if older adults experience ill health or disability, they may not identify themselves as aging unsuccessfully and may still engage in a variety of activities (Tate, Leedine, & Cuddy, 2003). There is a risk that it is reduced to an exclusionary, ageist, and even discriminatory perspective—a professional dogma with no room for human agency.

Successful aging is an individualistic concept because it does not take into account the fact that changes in people’s lives and in social structures are fundamentally interdependent (Riley & Riley, 1994). In practice, aging is a social process that involves the interplay between human development and the complementary dynamic of structural change (Depp & Jeste, 2006). Various improvements in older people’s lives are contingent upon societal interventions and measures including lifelong education (Davey, 2002), antiage discrimination policies (Walker & Maltby, 2012), leisure (Walker, 2009), and opportunities to volunteer (Deeming, 2009). In practice, there is a “dependence of successful (and active) aging upon structural opportunities in schools, offices, nursing homes, families, communities, social networks, and society at large” (Riley, 1998, p. 151). Social and cultural settings contextualize individual aging and vary considerably in terms of the demands they involve and the opportunities and resources they offer (Villar, 2012).

The Concept of Active Aging

The concept of active aging began to develop in the 1990s with an emphasis on the link between activity and health (WHO, 1994). It emerged at a time when the issue of global graying resulted in the dismantling of the traditional conception of the life course that equated the oldest phase of life with inactivity (Boudiny & Mortelmans, 2011). The active aging discourse focuses on encouraging the participation of older adults in society and emphasizes the competence and knowledge that older people possess (Daatland, 2005). The most widely used definition is from the WHO: as “the process of optimizing opportunities for health, participation and security in order to enhance quality of life as people age.” Importantly “active” was defined as “continuing participation in social, economic, cultural, spiritual and civic affairs, not just the ability to be physically active or to participate in the labour force” (WHO, 2002, p. 12). This perspective further challenged stereotypes of older age characterized by passivity and dependency, placing an alternative emphasis on autonomy and participation. Active aging refutes the “decline and loss paradigm” commonly associated with the consequences of physical decrescence (Townsend, 2007) and emphasizes the active roles older people occupy in society. It highlighted the need for a distinction between notions of activity and passivity, where being active involves living by one’s own rules as opposed to being “normalized” by others in order to avoid denunciation (Walker & Foster, 2013). It also includes the need for activities designed to ensure the protection, dignity, and care of older people (Stenner, McFarquhar, & Bowling, 2011). In theory, at least, it emphasized the need for a departure from notions of aging in purely economic terms toward a more holistic approach including quality of life, mental and physical well-being, and social participation (Foster & Walker, 2013; Walker, 2002). Therefore, it is important that activity aims to enhance well-being if it is to be incorporated into an active aging model. Increasing employment of older people in itself is not a holistic active aging measure; it needs to be accompanied by measures to combat age discrimination in the workplace and promote age diversity, more flexible forms of employment, and/or training opportunities (Corsi & Samek, 2010).

Like successful aging, the notion of active aging is not without criticism. For instance, it has been suggested that a process of idealization of active and (successful aging) might end up being counterproductive and oppressive (Holstein & Minkler, 2007). There is a danger that policy makers will overemphasize physical activity to the neglect of mental capacity and overidealize a productive model of active aging (Barrett & McGoldrick, 2013; Walker & Maltby, 2012). Thus, there needs to be room for alternative lifestyles and definitions of activity (Calasanti, Slevin, & King, 2006). Even advocates of active aging recognize the risk “that this sort of strategy will become coercive” (Walker, 2002, p. 134). Therefore, it is necessary to avoid the imposition of top–down generalities by attending to the specificities of varied positive and negative lived realities of older people (Stenner et al., 2011). The expectations for active aging are typically framed by policy makers and researchers, who tend to define activity according to middle-aged or youthful perspectives that may not be congruent with the experiences of older people (Reed, Cook, Childs, & Hall, 2003). Therefore, there is a need for older people themselves to be more closely involved in determining what role active aging could play in their lives (Walker & Foster, 2013).

The heterogeneity of the older population means that it is difficult to measure the concepts of successful and active aging. A strict rubric of success or activity excludes too many and fails to embrace differences observed in older people. However, more comprehensive definitions of active aging seem less deterministic, either as an outcome or as a process of achieving it (Constança et al., 2012). It is a broader-based concept than successful aging (Boudiny & Mortelmans, 2011) and, as such, appears to offer greater positive policy potential than other aging discourses.

Active Aging Policy in Europe

Aging first arose as a central European policy issue in the early 1990s, when the EC established an “observatory” to study the impact of national policies on aging. The first proclamation at this level of the key elements of a new active and participative discourse on aging was found in the European Year of Older People in 1993 (Walker & Maltby, 1997). There was an emphasis on discourses of deservingness and the inclusion of older workers through equal opportunities measures. The United Nations’ (UN) Year of Older People 1999 was the next major step in the development of a European active aging agenda outlining the significant challenge Europe faced to reverse its early exit labor force culture (EC, 2001; Kohli, Rein, Guillemard, & Van Gunsteren, 1991). The active aging strategy and employment strategy were justified by the need to raise employment levels, especially given aging populations and projected pension cost increases (Carmel, Hamblin, & Papadopoulos, 2007).

The policy document, “Towards a Europe for all Ages” (EC, 1999), identified four challenges: the decline of the working-age population; expenditure on pensions systems and public finances; the increasing need for care; and diversity among older people’s resources and risks. These challenges in turn led the Commission to four policy conclusions: to increase the employment rate in Europe (by promoting lifelong learning, flexible working arrangements, and improving work incentives); to improve social protection policies and reverse early retirement trends; to support research relating to health policies and old age care; and to develop policies against workplace-based discrimination and social exclusion. However, despite the all-encompassing potential of active aging, it was subsequently narrowed as employment became the Commission’s main focus (Walker, 2009). In doing so, those not in paid employment are excluded from aging actively, and the valuable contributions they could make to society risk being ignored, reducing the discourse to its precursor “productive aging” (Boudiny, 2013). This productivist and rather utilitarian vision advocates the need for older workers to be “activated” to enhance economic growth. At the same time, an individualization of the responsibilities of the activated older worker is promoted (Casey, 2012). Longer employment is advocated in an increasingly insecure labor market (Carmel et al., 2007), and pensions have been increasingly subject to individualized exposure to financial market risks (Ebbinghaus & Wiß, 2011; Foster, 2012). In practice, retirement is influenced by a variety of factors including health, wealth, work decisions including involuntary redundancy, caring obligations, and job satisfaction (Brown & Vickerstaff, 2011).

Although some European Union (EU) documentation considers a wider range of measures and services, such as lifelong learning, engaging in capacity-enhancing and health promoting activities, and being active after retirement (CEC, 2002), the aim is overwhelmingly to extend the working lives of older people (Hamblin, 2010). This focus was reflected in the so-called Lisbon target to raise the employment rate of those aged 55–64 to 50% by 2010, a target which none of the EU countries managed to attain (Zaidi & Zolyomi, 2011). In 2009, the EC’s “Ageing Report” emphasized a productivist approach to aging maintaining that increasing the retirement age, limiting access to early retirement schemes, and stronger links between pension contributions and pension benefits may provide a better incentive to remain in the labor market (EC, 2009; Walker, 2009). Yet, a year later, a more comprehensive approach was highlighted by the European Council (2010, p. 5):

active ageing means creating opportunities for staying in the labour market longer, for contributing to society through unpaid work in the community as volunteers or passing on their skills to younger people, and in their extended families, and for living autonomously and in dignity for as much and as long as possible.

In sum, EU policy discourses on active aging over the last two decades have comprised two contrasting models. The more dominant emphasis has been on a narrow productivist approach focusing on the extending working life. In contrast, there is also a comprehensive approach to active aging supported by the WHO and UN, as well as some parts of the EC. Although there is some evidence that these two approaches are starting to come together, in practice, the actual policy instruments still focus primarily on employment (Walker, 2009). For the first time since 1993, the European Year of 2012 focused on aging. The European Year of Active Ageing and Solidarity Between the Generations provided the potential to implement a more comprehensive approach to active aging. Unfortunately, however, although a range of themes were identified, the employment one was dominant: the aim was “to help create better job opportunities and working conditions for the growing numbers of older people in Europe, help them take an active role in society and encourage healthy ageing” (EC, 2010). Thus, in the European heartland of active aging policy, there appears to be, at best, ambivalence about its focus and potential. Therefore, in the last section, we outline a vision for a comprehensive strategy for active aging.

A Vision for Active Aging in Europe

Although the EC has played a major role in framing active aging, a comprehensive policy approach has not yet materialized. To fully comprehend the scope and prospective impact of active aging, it is necessary to outline what a comprehensive strategy should constitute and its underlying principles. Building on and expanding the WHO (2002) definition, Walker (2002, 2009) proposed seven key principles as the basis for a comprehensive strategy on active aging. First “activity” should include all meaningful pursuits that contribute to individual well-being. Therefore, activities such as volunteering should be as valued as paid employment and should be characterized by a removal of age barriers, against which no legal protection exists in many countries (Boudiny, 2013; Deeming, 2009; Lloyd et al., 2013). There is also considerable evidence that increased engagement in leisure activities has the potential to improve health and well-being (Boudiny & Mortelmans, 2011). This wider focus is particularly important for many older women (and men) who fulfill important unpaid roles in society including caring responsibilities and are often excluded from productivist definitions of active aging (Foster & Walker, 2013). Older adults may stop work in order to care for their grandchildren and by doing so enhance the workability of the intermediate generation (Eurofound, 2011).

Second, it should be largely a preventative concept, involving all age groups in the process of aging actively across the life course. Within this context, the promotion of preventative health interventions to tackle the lifestyle, diet, and consumption patterns are influential in determining ill health at all ages (ActivAge, 2005). Third, active aging should encompass all older people, including those who are frail and dependent. A focus only on the “young-old” is likely to exclude the “old-old.” Active aging in practice in the EU has largely been concerned with the young-old rather than the old-old where the probability of experiencing sizeable losses in cognitive and physical potential increases substantially (Baltes & Smith, 2003). Fourth, intergenerational solidarity should be a key feature of active aging involving fairness between generations.

Fifth, the concept should include both rights and obligations. Therefore, rights to social protection, lifelong education, and training should be accompanied by obligations to take advantage of education and training opportunities and, wherever possible, to remain active in other ways. Sixth, active aging strategies should be empowering with top–down policy action to facilitate activity, but also opportunities for citizens to take action from the bottom–up. The ability to make use of personal freedom to participate in activities is in part dependent on financial status, health, and mobility (Bowling, 2005). Therefore, encouraging older people to be actively engaged with their local communities requires the input of resources (Lloyd et al., 2013).

Seventh, and lastly in Walker’s (2002) model is the importance of active aging respecting national and cultural diversity. There are large variations across Europe in both activity patterns and norms concerning activity. Within countries, there are also large variations between ethnic groups in their preferences for different forms of activity. Active aging policy should take account of diversity but should not go so far as to condone practices that transgress national and international equality and human rights objectives and laws (Bowling, 2009). At the same time, it must be recognized that implementing such a principle is difficult without first deciding what national and international equality, human rights objectives, and laws are to be held as standards. Beyond Europe and Westernized contexts, there is evidence of cultural difference and divergence in ideas about active aging, which are linked to socioeconomic conditions (Danyuthasilpe, Amnatsatsue, Tanasugarn, & Kerdmongkol, 2009). Indeed, a lack of financial support in older age is likely to lead to working longer but, depending on occupation, may also be detrimental to health and well-being in older age (Lloyd et al., 2013).

In its most comprehensive form, active aging has the capacity to embrace structural and economic issues that affect older people. Economic resources should be interpreted as determinants of active aging given that an individual’s financial situation influences their ability to afford elements of active aging (Boudiny, 2013). Furthermore, longevity differs substantially between socioeconomic groups and is unequally distributed spatially both within and between countries: “death is not democratic” (Esping-Andersen, 2009, p. 147). Tackling these inequalities is an important part of a comprehensive active aging strategy that aims to provide normatively fair solutions. It must also recognize country-specific challenges to the implementation of particular active aging policies including those associated with extended employment when levels of unemployment remain high, such as in Spain, Greece, and Italy (EC, 2011).

Building on these challenges, we suggest the addition of an eighth principle to active aging. It is vital that a comprehensive approach is flexible. It must contend with individual aging throughout the life course and changing notions of what active aging means to different people and the resources required to age well. Activities also change with increasing age due to alterations in preferences and constraints. Boudiny (2013) states that adaptability is required; active aging policies need to assist people to accept changes and integrate them into their lives. Unfortunately, current approaches to active aging (and successful aging) tend to set relatively high standards or expectations and fail to fully grasp the impact of structural inequities and changing circumstances (Depp & Jeste, 2006). Policy can promote new ways of aging actively and assist people to integrate changes into their lives. This may be in the form of practical training interventions (and not only those associated with employment) (Davey, 2002), information technology (Corsi & Samek, 2010), environmental modifications, and assistive devices (Schieber, Fozard, Gordon-Salant, & Weiffenbach, 1991). In addition, active aging must be flexible with regard to cultural and religious differences while embracing human rights, flexible in comprehending how socioeconomic status influences aging and resources, and flexible in understanding the gendered nature of aging.

Summary

An effective active aging strategy should be based on the combined contributions of the citizen and society. In EU policy terms, the promotion of active aging involves linking hitherto independent policy domains: employment, health, social protection, pensions, social inclusion, technology, and economic policy for instance (Walker & Foster, 2013). The translation of this approach into concrete social policies would mean the transformation of a wide range of policy arenas, such as the labor market and health, toward more active interventions to prevent the causes of individual loss of function and loss of skills in the latter part of the life course. At the policy level, a redistribution of resources from acute to preventative health is essential, as are pension policies that do not create a barrier between employment and retirement and that facilitate postwork participation (Foster, 2014). Underpinning this focus is the belief that chronological age is not an effective predictor of performance (Walker, 2002). In fact, a life course perspective reinforces the preventative dimension of the active aging agenda in that aging well requires strategies to promote health and well-being prior to older age being reached. However, the new active aging paradigm set out here seeks to facilitate the maintenance of both physical and mental capacity, which would enable older people to work longer if necessary, but also create healthier and more fulfilled postemployment years (Walker & Foster, 2013).

Conclusion

A comprehensive concept of active aging can provide a framework for the development of global, national, and local strategies relating to population aging. It has the potential to unify the interests of all key stakeholders: citizens, nongovernmental organizations, business interests, and policy makers (Walker & Foster, 2013). However, in its current form, it overemphasizes employment (Walker & Maltby, 2012). The active aging strategy outlined here operates simultaneously at the micro, meso, and macro levels reflecting the need for a partnership between citizen and society. It is a flexible approach to active aging, which recognizes diverse needs in policy and practice in a noncoercive and inclusive fashion. It is also in line with the desires of aging workers for more flexibility in retirement (Smeaton, Vegeris, & Sahin-Dimen, 2009) and those not in employment for a recognition of the diverse nature of activity (Boudiny, 2013). Therefore, to be a more effective policy tool, active aging should be a “dynamic, life course-driven concept that taps into people’s perceptions and enables them to create their own forms of activity, instead of focusing on a predetermined, limited number of domains, usually developed from an ‘expert’ perspective” (Boudiny & Mortelmans, 2011, p. 12).

Active aging provides a potential platform for consensus building in aging policy that addresses the concerns of multiple individuals, sectors, and regions. However, policy proposals and recommendations are of little benefit unless they are accompanied by appropriate actions (Kalache, Barreto, & Keller, 2005). The short history of active aging has seen it rise to a prominent rhetorical position in European policy agendas but, unfortunately, very few resources have been devoted to it beyond the labor market (Barrett & McGoldrick, 2013). Like successful aging, active aging is too often focused on “youthful” activities that emphasize health and independence (Reed et al., 2003). Overly ambitious formations of active aging are problematic (as is the case with successful aging), as they may serve as a form of ageism (Boudiny, 2013). There is also a danger that the “health and well-being” narrative retreats to become the preserve of a “fourth age” characterized by biological decline and consumption of welfare resources (Moulaert & Biggs, 2013). There is also a concern that the economic downturn in different parts of Europe and beyond will result in material hardship and a consequent loss of opportunities for activity. Therefore, these structural and economic barriers to active aging must be addressed for a comprehensive approach to work in practice.