The AgeFLAG seed money project funded by the Swedish Institute and the German Ministry of Health focused on challenges and needs of the ageing populations in the Baltic Sea Region. The topic of active and healthy ageing is more important today than ever before. Approximately a fifth of the population in Northern Europe and the Baltic Sea Region is aged 65 and over. Maximising the healthy years for all into old age is a cornerstone to prosperous and flourishing societies.

The aim of the AgeFLAG -project was to contribute to the health and wellbeing of older adults and to make our societies inclusive. With over 200 individuals from the Baltic Sea Region contributing, we held seven national needs assessments, identified four regional priority areas for further action, and generated numerous creative ideas for transnational activities. The roadmap produced through this process presents the first steps towards establishing the NDPHS as a thought leader on healthy ageing.

The life expectancy rate is increasing throughout the world, also in the Northern Dimension area. According to the World Bank data, the life expectancy rate at birth, which estimates the number of years a new-born would be expected to live if the mortality patterns at the time of birth would remain constant throughout life, was 72,6 years on average in the region (including Germany and Norway) in 1990.

As of 2018, the life expectancy at birth has increased by six years, standing at 78,6 years, indicating that people are generally living significantly longer than only 30 years ago.

The life expectancy in years in 2018 compared to 1990 per project country

Simultaneously, the share of older adults in the population and the older age dependency ratio is increasing, indicating an ageing population. According to the World Bank data from 2019, on average almost a fifth (19,4%) of the population in each country of the Northern Dimension area was aged 65 and above. This share has rapidly increased since 1990 when old adults made up 13,0% of the population in the region.  With the old age dependency ratio standing at 30,3%, for every two working-aged people, there currently is roughly one dependent older adult. The population has, thus, aged in the past 30 years. This trend is also expected to continue in the near future.

It is prospected that, in 2030, 27,4% of the population in the region are aged 65 or older and that, with the old age dependency ratio at 51,5%, for every one working-aged person there is one dependent older adult.

Therefore, the region is currently experiencing a significant societal and demographic transformation. The rapid increase in the share of older adults aged 65 and above is demonstrated below.

The share of older adults aged 65 and above in the population in 2019, 1990 and 2030

According to the most recent data retrieved from the Global Health Observatory, people aged 60 still have 22,6 years ahead of them with 17,2 of them in “full health” on average. This corresponds to 5,4 years lived with some form of morbidity or disability at an old age. A well-functioning health care and social system that is prepared to meet the complex needs of older adults is a cornerstone for an appropriate response to the ageing society.

With this demographic change in mind, this project seeked to identify the most acute regional needs regarding healthy ageing and to prepare for a joint future activity for improving the health and wellbeing of older adults in the Northern Dimension area.

In the context of active and healthy ageing on November 23 2021, the NDPHS Secretariat organized an online conference “Connecting minds across the ages”. During the conference, the NDPHS Manifesto was presented and together with policy makers and civil society representatives from across the region, two central themes were discussed:

1. Combating ageism: transforming public attitudes and addressing ageism in healthcare and at the workplace. We will explore how and why people feel, think and act on ageing and how to switch mindsets to more open modes. A person-centred approach is the key, everyone’s contribution to society shall be recognized and no person should be treated as an invisible particle of a homogenous group. How do we systematically recognize potential inequalities and blind spots and address them?
2. Connecting ages: promoting intergenerational contacts and inclusivity of older people in service design and policymaking. We will discuss how to fundamentally and systematically revise the modes of thinking to step out of silos towards a co-creation that is inclusive across sectors and society and engages nontraditional partners. New developments such as digitalization of health and social care shall not lead to more inequalities and must be co-designed with all users, making extra effort to empower and involve people from marginalized and vulnerable groups in a meaningful way.

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Flagship Background

Active and healthy ageing is a cross-cutting theme that touches upon all of the Partnership’s focus areas. Considering this wide relevance to the work of nearly all of the Expert Groups, there was a call for horizontal action that tackle the challenges of the ageing population. In 2018, several planning workshops were carried out using the logic framework approach for the development of project ideas for this horizontal action. The AgeFLAG seeks to identify the most important issues in relation to active and healthy ageing that countries in the region are facing.

The project partners in Estonia, Finland, Latvia, Lithuania, Poland, Russia and Sweden organised national needs assessments in 2020. The consortium of partners was formed from regional stakeholders with a mandate to work with policies surrounding the topic of ageing. They expressed strong interest as well as demonstrated capacity in contributing to the development of the Roadmap for a Flagship project on active and healthy ageing.

The WHO defines Healthy Ageing “as the process of developing and maintaining the functional ability that enables wellbeing in older age”.

Functional ability refers to the capabilities that allow people to be and do the things they value, for example, meeting basic needs, learning, growing and making decisions, being mobile, building and maintaining relationships, and contributing to society.

According to the WHO, “functional ability is made up of the intrinsic capacity of the individual, relevant environmental characteristics and the interaction between them”. Intrinsic capacity refers to mental and physical capacities that are essential for basic functions, such as walking, talking, seeing and remembering. The presence of diseases, injuries and age-related changes may compromise the level of intrinsic capacity. In addition to the intrinsic capacity, the surrounding environments, including home, community and broader society, and all factors within them, such as the physical aspects of space, people and their relationships, attitudes and values, health and social policies, the systems that support them and the services implemented, influence functional capacity. An environment that supports intrinsic capacity and functional ability is essential for healthy ageing.