Older Adult Health and Well-being in the Context of Population Aging: Opportunities and Challenges for Policy and Practice

Governments today face a range of complex policy challenges, including maintaining financial sustainability, ensuring solvent health systems, and strengthening social insurance programs. As the global population ages, with both the number and proportion of older adults steadily increasing, policymakers must act to develop strategies that enhance the health and well-being of this growing demographic. Approaches to addressing the health, economic, and social needs of older populations vary significantly across states and nations, reflecting diverse delivery systems that are continually evolving. These efforts are further complicated by broader social and geographic challenges, such as rural health disparities, education gaps, health outcomes, and social issues such as ageism. Together, these factors influence the capacity of national and state systems to effectively support aging populations.

This issue of Public Policy & Aging Report charts a course through many American policies that influence the health and well-being of older adults. The articles in this issue address a wide range of policies and programs, offering insights into their impacts on older adults across diverse American communities. With lessons for national and state policies, the articles address key health issues for older adults, such as opioid use disorder and brain health; they highlight differences in aging across communities, including rural and urban contexts, and communities with different levels of social vulnerability; and they identify impacts of government programs on older adult engagement in activities, like education and work, and the potential for large-scale educational programs to combat societal ageism.

In the first article of this issue, Dr. Shannon Monnat (2025) from Syracuse University explores rural population health and aging in the United States, highlighting the distinct and growing disparities in health and longevity between rural and urban American contexts. Her analysis considers the impacts of multiple factors on the health and well-being of older adults—including natural disasters, the opioid crisis, and climate change—emphasizing the need for the unique realities of rural and urban communities to be considered when developing policies intended to support the health and well-being of older adults.

Although the opioid crisis is one of several challenges facing rural America, opioid use disorders among older adults is a national crisis, highlighting the urgent need for public health, health care, and social service policies to address gaps to support communities nationwide. A novel study by Dr. Tse-Chuan Yang at University of Albany and Dr. Carla Schoff (2025) leverages a longitudinal county-level dataset that shows the opioid use disorder rate has increased among older adults in the United States since 2011 and reveals that this rate has a greater impact on more socially vulnerable communities. Policy and practice implications of this novel study are addressed for the medical treatment of opioid use disorder, including federal regulations pertaining to the ability of health care providers to offer telehealth services, and for the education of medical providers to treat and to prevent opioid use disorder.

Whereas addressing opioid use disorder requires attention to treatment and prevention, Drs. Ernest Gonzales at New York University, Yeonjung Jane Lee at University of Hawaiʻi at Mānoa, and Cliff Whetung at the University of Minnesota Medical School (2025) bring attention to how policies and programs that support involvement over the life course in productive activities like education, work, caregiving, and civic engagement have potential to enhance brain health, cognitive functioning, and emotional well-being. The authors highlight how an intergenerational program like Experience Corps can support civic engagement and bring attention to a wide range of legislation in the United States that can support older adults’ engagement in work, such as Protecting Older Workers Against Discrimination Act (S. 1030, H.R. 6581), engagement in caregiving such as the Social Security Caregiver Credit Act (S. 1211, H.R. 3729), and engagement in education such as the Family Leave for Parental Involvement in Education Act (H.R. 7978). Although such policies and programs have potential to support later life productivity and cognitive health in the United States, Gonzales and coauthors (2025) emphasize the importance of confronting the structural lags and gaps by which social changes fail to keep pace with demographic realities and cultural demand.

Major contributors to such structural lags and gaps include broad-based incompetence regarding aging and what Drs. Sheri Levy & Lauren Morrison (2025) at Stony Brook University identify as the “lack of formal system-wide aging education,” which they explain, “has propelled a serious crisis of ageism (stereotyping, prejudice, and discrimination toward older adults) that costs lives, livelihood, and billions of dollars.” Ageism has achieved crisis proportions through its adoption and dissemination by mass media, which commonly represents older adults stereotypically, misrepresents science, misuses data to bolster negative stereotypes of older adults, and more broadly reinforces and normalizes negative stereotypes of older adulthood. As Levy & Morrison (2025) make the case for establishing a national policy for educating the populace about aging over the lifespan, they offer a strategy for a new societal grounding to be established that would allow for undoing the negative stereotypes of older adulthood that have long been fostered by popular ignorance and reinforced by mass media. With popular mass media commonly spanning nations and feeding off lack of education and misinformation about aging, such a national policy for educating the populace about aging as proposed in this article would have international implications as well as potential for the emergence of distinct national approaches to aging education.

Whereas a national education program on aging may be one lever for undoing societal ageism, another important consideration is the engagement of older adults in work and appropriate training programs. In the United States, AmeriCorps is the federal agency for national service with a mission of improving lives, strengthening communities, and fostering civic engagement through service and volunteering. AmeriCorps Seniors, which is one of five program offices within AmeriCorps, aims to support the needs of older adults in their programs. Given challenges faced by older workers, such as age discrimination and ageist assumptions that influence hiring practices, as well as ageist attitudes and behaviors of younger workers that older people commonly experience on the job, AmeriCorps’ 2022–2026 Strategic Plan includes piloting national service as a pathway back into the workforce.

In the final article of this volume, scholars from the University of Maine, including Mary Lou Ciolfi, and Drs. Jennifer Crittenden and Lenard Kaye, and Atalaya Sergi (2025), the National Director of AmeriCorps Seniors, review the AmeriCorps Seniors workforce development demonstration programs, which marry training, volunteer work, and employment placement, and highlight preliminary implications for federal, state and local policy, which include considerations for (i) incentivizing community service organizations; (ii) addressing ageism and supporting workplace diversity, including age diversity; (iii) embedding flexibility, such as in hours and in scheduling; (iv) supporting and encouraging local networks, and (v) bridging service silos; (vi) supporting the sharing of data on older workers, such as by federal and state agencies; and (vii) acknowledging the need for investment in relationship building among program participants and community partners. Such lessons learned from AmeriCorps Seniors have direct value to steering the future of this national program and have potential benefits for other countries that seek to bolster older adult engagement in work.

As this issue highlights integrated policy challenges within and across American communities, we encourage readers to consider the international implications that should also be addressed. Dr. Shannon Monnat (2025) touches on the international aspects of these political and social phenomena, noting, “Rural areas have nearly 35% fewer home health aides and 17% fewer nursing assistants than urban areas… Policies that tackle these domains, including immigration policy, could increase the rural workforce necessary to support aging populations.” Drs. Yang and Schoff (2025) suggest that their findings on opioid use disorder and social vulnerability can serve as indicators for identifying communities at greater risk of higher opioid use disorder rates, a framework that could be applied in other national contexts. As both global and national populations age, with increasing numbers and proportions of older adults, policymakers could craft policies that ensure this demographic shift is accompanied by improvements in the health and wellbeing of older populations. We hope this issue underscores the diverse range of challenges policymakers must address and encourages a broader discussion of these issues through an international lens.

Funding

None.

Conflict of Interest

None.

References