Remarks as Prepared at the Global Aging Summit

Thank you, Paula [Dobriansky, Under Secretary of State]. Thank you especially for bringing us all here today to address the emerging concern of global aging.

Last December I visited China as part of the administration's new Strategic Economic Dialog. While there, I had a chance to meet with a little girl who had survived avian influenza. She lived in a little village in Szechuan Province. I visited the village and met her parents and grandparents.

I learned there that many villages in China are mostly just grandparents and children. The children's parents are often away working in a nearby city. They depend on their own parents to look after their children.

It is not a bad arrangement - having grandparents look after the kids. Many American families do the same. My wife Jackie and I just became grandparents last year, so I can attest to what a joy it is to be one.

The problem for China and for many other countries, including the United States, is how to care for the grandparents when they can no longer care for themselves. It is a growing problem because, thanks to modern medicine, grandparents are living longer and longer these days.

As a result, societies on average are getting older.

By 2030, nearly 20 percent of Americans will be 65 or older.

Older societies mean fewer family members to care for elderly parents. They also mean fewer workers to pay for the pensions and health care than many elderly have come to expect.

Older societies also mean a shift in the kinds of care that societies will need to provide - less child care and more elder care, more concern for the diseases and disabilities that come with age.

Unfortunately, the focus of many health officials is still only on the young.

That is slowly changing. We all need to recognize the changing needs of the world's older population.

In 2002, my Assistant Secretary for Aging, Josefina Carbonell, attended the Second World Assembly on Aging in Madrid. The Madrid assembly produced an International Plan of Action on Aging.

Josefina's office has been reviewing our progress on the issue. In November I will be sending her back to Spain for another meeting.

The action plan for the United States stresses a "bottom up" approach, starting with the elderly themselves. Our aim is to give people more choices and greater control over their own health.

The "bottom up" approach to aging is consistent with the New Freedom Initiative the President ordered soon after taking office. The initiative was designed to provide more choices to people of all ages with disabilities.

That means dismantling the bias toward institutional care, encouraging competition, and seeking local solutions, not simply federal mandates.

In the United States today, families provide long-term care for 80 percent of the nation's elderly. One in five American households provides some form of long-term care.

They are not doing this because they have no other alternative. They are doing it because the elderly would rather live in their own homes and communities and be cared for by their own loved ones.

My department estimates that the dollar value of family care is around $306 billion a year. But that doesn't tell the whole story. You can't really put a value on keeping several generations within the same family together.

HHS responds to global aging through the work of the National Institute on Aging, which is part of the National Institutes of Health. NIA has been a world leader in aging research.

Surveys designed by NIA track the health and retirement of Americans over time and have been used as models for similar surveys around the world. NIA also funds cross-national research and hosts foreign scholars as visiting fellows. It is important that we continue to support cross-national research.

NIA co-published, with the State Department, the report Why Population Aging Matters: A Global Perspective.

So I would like to thank NIA Director Dr. Richard Hodes and his staff for their leadership on this issue and for helping to put together this summit.

In addition to research, the administration's concern for global aging goes beyond research. It also involves translating research into practice. In the Western Hemisphere in particular, the United States is actively involved in improving health care for all ages.

Last week the President shared with the people of Latin America his commitment to improving the region's education, housing, and health care.

Next week I will follow up with a week-long tour of Central America as part of the President's Health Diplomacy Initiative. I will visit five countries: Costa Rica, Nicaragua, Honduras, El Salvador, and Guatemala.

Assistant Secretary Josefina Carbonell, whom I mentioned earlier, will travel with me to El Salvador. We will visit a home for the elderly and meet with the country's Minister of Health and National Secretary of the Family.

Health care is a universal language - a language of caring. The U.S. Government invests millions of dollars each year in health programs in other countries. Since 2001, the United States has spent almost $1 billion on health programs in Latin America and the Caribbean.

This new effort in the Americas will focus on three main objectives:

• Increasing direct patient care provided by U.S. personnel,
• Improving the training of local health-care workers, and
• Working closer with U.S. NGO's to provide more and better health care.

U.S. personnel from HHS and the Department of Defense will become more directly involved in treating and healing the poor in Central America.

The President is sending the USNS Comfort - a Navy medical ship - to Latin America and the Caribbean. The Comfort will make port calls in 12 countries. Its doctors, nurses, and healthcare professionals expect to treat 85,000 patients - and conduct up to 1,500 surgeries.

Dental care is an area of special concern. So, this summer, HHS dentists of the U.S. Public Health Service Commissioned Corps will join military dentists from the U.S. Southern Command on humanitarian missions to the region.

They will perform basic treatments like filling cavities, treating infections and pulling teeth. They will also offer preventive education on oral health and hygiene to children and their parents and grandparents.

To improve local health care, HHS is working with other countries to start up a regional training center in Panama. The school will train a range of health-care workers-community health workers, sub-physicians, sub nurses, technicians-so they can provide better basic care in rural areas and poor neighborhoods.

Much of the ground work for this effort has already taken place.

• Last September, I met with Health Ministers from Central America at the annual Directing Council of the Pan American Health Organization in Washington.
• In December, I visited the site of the regional training center in Panama.
• In January, I visited Nicaragua for President Ortega's Inauguration, and had the opportunity to meet with many Central American Heads of State.

Now, we are ready to get to work.

• While in the region, I will meet with the Heads of State to formalize our discussions in September, and to sign letters of intent between HHS and their Ministries of Health to establish the regional training center.
• The first training module for health-care workers at the training center is scheduled to take place next month. The faculty will-at least initially-consist of experts from Central American countries and HHS.

By providing direct patient care and training local health workers, the President's initiative can help to build a strong partnership with Central American countries. Together, we can help to improve the health of the people of all ages in Central America and our friendship with them as neighbors.

These are some of the things this administration is doing to improve care for the elderly and respond to the graying of America and the world. We will continue to invest in research on aging. We will also keep working to raise awareness of aging's global impact.

Last revised: March 13, 2008