1. Ingrid Ulrey, Policy Director Ingrid.Ulrey@kingcounty.gov
Talk for Today –
What Public Health Does
Age Wave - rapid aging of the population
Longevity Bonus - Longevity Gap
Public Health Threats – decreasing the number of healthy years lived
Recipe for Living Long, Living Well
Ingrid Ulrey, Policy Director

2. What does Public Health do?
Health protection 
Health promotion
Health provision 

3. The Age Wave

4. Born: 1900
Life Expectancy at Birth: 47

5. Life Expectancy at Birth: 77
Born: 2000
Life Expectancy at Birth: 77

6. The Longevity Gap
= 87 years
Average = Years
= 74 years

7. Four Top Public Health Threats: Impacts on Older Adults
1. Dementia
2. Opioid Crisis
3. Gun Violence
4. Homelessness

8. 1. Alzheimer’s Disease and Related Dementias
How can I prevent it?
Why get screened ?
How do I get help?

9. Racial and Ethnic Disparities

10. Alzheimer’s disease deaths, King County 2011 – 2015
Average:
41.5 deaths per 100,000 people
Most recent:
deaths

12. 2. Opioids & Older Adults
Older adults often use opioids to cope with painful, chronic conditions.
Opioids have a stronger impact on older adults because bodily processes slow as people age.
Older adults are uniquely vulnerable to challenges associated with Opioid Use disorder and to death due overdose.

13. Opioid prescriptions and side effects
Prescription opioids
Oxycodone
Hydrocodone
Codeine
Morphine
Fentanyl
Carfentanil
Sufentanil
Etc.
Generally used for:
Pain for acute or chronic symptoms
Active-phase cancer treatment
Palliative care
Hospice and end of life care
Can be an essential part of a comprehensive pain care plan
Side effects of opioids
Constipation
Dry mouth
Nausea and/or vomiting
Loss of appetite
Drowsiness
Confusion
Impaired cognition
Tolerance
Dependence

14. Overdose deaths increasing for people age 60+
Source King County Medical Examiner's Office

15. Prevention and Treatment: Key Issues
Appropriate Chronic Pain Management: stepped therapy
Medication Management, whole person care
Treatment tailored to older adults, peer mentors
Medication Assisted Treatment such as buprenorphine
Overdose reversal - naloxone distribution

16. Don’t Hang on to Meds: Safe Disposal
Problematic Access & Disposal
Safe Disposal
Leftover pills get into the wrong hands
Don’t flush prescriptions
Don’t throw away in household trash
Use Secure Medicine Return

17. 3. Gun Violence – Concern for All Ages
In King County, more people are killed by firearms than by car crashes

18. King County firearms deaths from 2012 to 2016
King County had a total of 747 deaths by firearms.
There were nearly three times as many suicides as homicides.
Homicide and suicide rates have remained steady.
Homicide rates are highest in high-poverty neighborhoods

19. Homicide and Suicide Rates by Age
Young adults most likely to die by firearm homicide.
Adults age 65+ most likely to die by firearm suicide.
Statewide data suggest that suicide methods vary by age, with older adults more likely to use firearms.

20. 3. Firearms and Older Adults
Nearly a quarter of adults aged 65 and older in Washington State live in households that store their firearms unlocked and loaded. 
Given the elevated prevalence of dementia, depression and suicide in older adults, these findings raise concerns.
THE NEW OLD AGE
In Elderly Hands, Firearms Can Be Even Deadlier

21. Use Locks and safes to secure firearms
Why lock it up?
Prevent your gun from being stolen
Prevent children from finding and using your gun
Prevent suicide in a moment of crisis
Prevent guns from going to school

22. 4. The Aging Homeless Population
National data indicates that over 50% of the homeless population are above 50 years old. This has grown from only 11% in 1990.

23. The Impact of Homelessness on Health
Higher rates of chronic disease, mental health and substance use disorders.
One out of five people living homeless have a communicable disease.
Homeless mortality rates are 3-5 times higher than the general population
Life expectancy is years in comparison to nearly 80 years

24. Public Health Approach for People Living Homeless
What we do:
Provide Health Care
Ensure Sanitation & Hygiene
Prevent Communicable Disease
Prevention Division
Support Care Transitions
Jail Health Services
Emergency Medical Services
Inform Policy and Systems Change
Root causes
Housing Affordability
Behavioral Health challenges
Racism
Income inequality
ACES
More
Public Health
Approach
Settings we work in
Streets
Encampments
Shelters
Supportive Housing
Clinics
Jail
Environmental Health Preparedness
Community Health Services

25. Social Determinants of Healthy Aging
Living long and living well is most realistic for those who are socially engaged, who adopt healthy living behaviors and who are able to build financial security.
- Stanford Center on Longevity