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• W804959881 abstract "Sensory loss among older people is relatively common and often has serious consequences. The social and functional implications of loss of vision or hearing, or both, are well documented in small-scale and population-based studies as well as personal accounts of people who have lived these experiences (Crews and Campbell, in press). It is striking to note, however, that the overall health of older people with vision and hearing loss is generally poorer than that of the general population. People with sensory loss have higher rates of hypertension, heart disease, stroke, and broken hips than people without sensory impairments. These disparities in health have multiple consequences including decreased ability to perform valued activities and participate in social roles. Historically, rehabilitation programs, medicine, and the aging network have in one way or another addressed the needs of older people who experience either vision or hearing loss. Each of these disciplines, representing differing points of view, is valuable. Rehabilitation may seek to restore function, usually by technology or compensatory strategies. For example, vision rehabilitation employs rehabilitation teachers, low-vision specialists, and orientation and mobility instructors to address an array of skills promoting independence. Medicine seeks to cure. And the aging network seeks to assure that all older people have the broad social supports that allow them to participate in society-through housing, transportation, nutrition, and support to families. These are all worthy efforts. But what might public health bring to this constituency? A PUBLIC HEALTH PERSPECTIVE A public health perspective may well be the means to illuminate strategies for understanding the circumstances of older people with sensory impairments and to define some avenues for social, health, and rehabilitation interventions. Increased independence is likely to be gained through the confluence of multiple efforts-for example, implementation of technology, training, peer support, and modifications to the environment-not a single intervention. The perspective provided by the field of public health could be an important aspect of such an endeavor. Public health provides a science to better understand the magnitude of aging and sensory loss,a conceptual framework for the multidimensional qualities of these very human experiences, and public health points to a number of concrete opportunities to change behaviors and environments with the potential to achieve better health outcomes. DEFINING, QUANTIFYING, AND ADDRESSING IMPAIRMENT Pope and Tarlov (1991) assert that disability ranks as the nation's largest public health problem affecting not only individuals with disabling conditions and their immediate families, but also society at large. Those concerned with policy and services for elders experiencing sensory loss have faced several challenges that might likely be addressed by public health. At the macro level, great uncertainty remains regarding the number of people classified as experiencing visual impairment or hearing loss. The estimates, for example, vary considerably, even among this collection of essays. There are at least two reasons for this uncertainty. One problem has to do with the definition of vision impairment or hearing loss. The inability to read newspaper print with best correction comes close to a gold standard definition of visual impairment. Issues of contrast sensitivity and illumination influence visual performance, leading to further imprecision. Second, because definitions vary, national estimates of the number of people who are visually impaired differ as well. Estimates regarding the number of people experiencing vision impairment have been debated for decades (Kirchner, 1988; Lighthouse Research Institute, 1995; Crews, 1991; Prevent Blindness America, 1994), by and large with the underlying assumption that the larger the number the more likely it is that public policy will attend to the needs of older people who are visually impaired. …" @default.
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• W804959881 title "The Role of Public Health in Addressing Aging and Sensory Loss" @default.
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