Shownotes
In this episode of 'What the Health,' John welcomes Dr. Leanne Clark-Shirley, President and CEO of the American Society on Aging, to discuss the multifaceted concept of healthy aging in America. They delve into the various definitions of healthy aging, the pervasive issue of ageism and how societal structures and policies support or hinder the aging population. Dr. Clark-Shirley shares her journey into gerontology and provides valuable insights on how individuals and society as a whole can better prepare for and support an increasingly older population. Learn more about the ongoing efforts and initiatives to promote healthy aging and the importance of shifting perspectives away from youth obsession.
00:00 Introduction: The Inevitable Aging Process
01:03 Defining Healthy Aging
02:05 Guest Introduction: Dr. Leanne Clark Shirley
03:22 Diverse Perspectives on Aging
05:57 The Impact of Ageism
10:25 Economic and Social Implications
23:26 Societal Support and Policy
26:58 Innovative Approaches to Healthy Aging
32:02 Conclusion and Final Thoughts
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Connect with WellWell USA:
- Website: https://wellwellusa.com/
- Join WellWell-Being: https://wellwellusa.com/register/
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Connect with the American Society on Aging:
- Website: https://www.asaging.org/
- Twitter: https://x.com/asaging
- Facebook: https://www.facebook.com/asaging/?ref=sgm
- LinkedIn: https://www.linkedin.com/company/american-society-on-aging/
Connect with Dr. Leanne Clark-Shirley:
Other Resources Mentioned in the Episode:
- AARP's Brain Health Action Collaborative: https://www.aarp.org/brain-health-action/
- Sound Health Network: https://soundhealth.ucsf.edu/
- SAGE (Services & Advocacy for LGBTQ+ Elders): www.sageusa.org
- Aging While Black: https://agingwhileblack.co/
- National Indian Council on Aging: www.nicoa.org
- The Third Act: https://thirdact.org/
Transcripts
No one can avoid aging. Okay, maybe Dorian Gray, but he was a rarity, plus he had a lot of help. For the rest of us, getting older and all that comes with it is inevitable. It is also an increasing consideration for America. Like many countries, the United States is graying as the average age of its population rises.
All this begs the questions of whether we are aging well. And whether America is prepared for an increasingly older population. These are important questions that don't have easy answers. We are undeniably living longer than our parents and grandparents, but whether we are living better is uncertain.
**John Salak [:The main reason for the ambiguity is that not everyone defines aging well the same way. For some, it is simply a numbers game. The longer they survive, the better. Others, instead, equate aging well with being physically active and mentally alert as the years roll on. And then there are those who view the definition through an economic lens.
Do they have enough financial resources to allow them to live comfortably in the world we live in as they age? All of these differences come against a backdrop of whether America is structurally prepared for an increasingly older population. Again, the answers are somewhat unclear and likely depend on personal definitions and experiences.
**John Salak [:Our upcoming guest, thankfully, is here to offer some insights and shed some light on all of these questions and considerations. The answers may not all be reassuring, but they are definitely enlightening.
**John Salak [:All right, as always, this is the best part of our podcast. That's when we get to dive into issues more deeply with a well-known authority on whatever we're talking about that day. Today, we have Leanne Clark Shirley, who is President and CEO of the American Society on Aging.
Of course, we're going to talk today about what healthy aging is and how we're defining it. There are a lot of topics to go into. So first off, Dr. Clark Shirley, welcome to our podcast.
**Leanne Clark Shirley [:Thank you so much, John. I am delighted to be here. As a gerontologist, it's always my true pleasure to talk about anything related to aging.
**John Salak [:I was reading your bio this morning. How did you get into gerontology? You're aging very well yourself, I might add.
**Leanne Clark Shirley [:It's kind of a funny story. The simple answer is that I needed to fulfill a couple of requirements in my undergraduate degree program. I saw this class called "Our Aging Society," and it ticked off two or three boxes. I thought, “Huh, can you really talk about aging for an entire semester?”
The joke is that, well, I've got three degrees in it and have worked for 25 years in the field. So it turns out you can.
**John Salak [:You really can. Okay. So here's the starting point. How are we doing? Is America aging well? Is it aging in what we might describe as a healthy manner?
**Leanne Clark Shirley [:The simple answer to that question is some of us are, and many of us are not. And that's sort of the first thing I think is important to acknowledge about how we even view aging in this country.
There's a tendency for us to define it as one thing or think there's one way to age or that aging healthy means something in particular. I don't think any of that's true. In fact, older people—the older we get, the more diverse we become—not only in our social identities but in our needs, wants, skills, abilities, and interests.
Putting one 75-year-old person next to another 75-year-old person doesn’t tell you much just based on how many candles are on the birthday cake. It goes deeper than that.
**John Salak [:Given the fact that it's so diverse and affects people differently, is there a general definition for aging healthy, or is it impossible to define?
**Leanne Clark Shirley [:Yes, there are definitions that we talk about. Some folks frame it as living as long as you can disease-free. Others define it from an economic perspective—are you able to live where you want and have enough money to continue the lifestyle you enjoy?
But that's just it. Who defines healthy aging really matters here. If a marathon runner defines healthy aging, I'm already out of luck. If someone defines healthy aging without including listening to music or pulling weeds in the garden, I’m out too. It’s not relevant to me.
On one hand, there are population-level indicators—like the incidence and prevalence of dementia, cancer, and obesity. But when it comes down to it, our own experiences of growing older should define healthy aging for us.
**John Salak [:How many people can create their own definitions for healthy aging, given that we live in a culture obsessed with youth?
**Leanne Clark Shirley [:There's no question—we get daily messages from media, movies, the grocery store, and even ourselves about how youth is an ideal to keep chasing. Many of these messages come from people trying to sell us something to “fix” ourselves.
But when we step away from that, I think we aren’t as youth-focused as it might seem. Look at our communities and families. Older people are meaningful participants, bringing things younger folks can’t.
That said, these messages harm us. They lead to discrimination, what we call ageism. Ageism isn’t just external—doctors do it, employers do it, and we do it to ourselves. It's a cycle we perpetuate, and it harms us.
**John Salak [:Can you go into more detail about ageism? What forms does it take, beyond things like job discrimination or assumptions about physical abilities?
**Leanne Clark Shirley [:Ageism has two main forms. One is explicit exclusion, based on assumptions about what someone can or should do at a certain age. For example, paternalism often emerges—this idea that older people need to be “protected” overrides their ability to make their own choices.
A common example is when families discuss senior living. There’s a constant dance between wanting a parent to be safe versus respecting their autonomy. Often, autonomy is overridden.
Then there’s benevolent ageism, which can seem kind but is still harmful. For instance, using terms like “honey” or “young lady” with older adults. It might seem sweet, but it minimizes their value as humans.
**John Salak [:It’s funny you mention that. My daughter grabs my arm every time we cross the street in Manhattan, as if I haven’t been doing it for 50 years.
**Leanne Clark Shirley [:Exactly. That kind of paternalism can erode a person’s confidence over time.
**John Salak [:What does this paternalism or ageism do to a mature adult emotionally or mentally?
**Leanne Clark Shirley [:It can erode their sense of self and confidence. That impacts their decision-making. For instance, if someone keeps hearing, “You shouldn’t drive anymore,” they might stop driving—even if they’re capable.
This limits independence and social interaction, which are critical for health. Social isolation and loneliness have strikingly negative impacts on older adults.
**John Salak [:On the economic level, I can see why businesses phase out older employees—they’re more expensive. But the paternal aspect within families, even with good intentions, feels like it’s been around forever.
**Leanne Clark Shirley [:It’s not a new phenomenon. The earliest recorded example of this is from 600 BC in Greek writings, mentioning frailty and the need to protect older adults.
Families historically felt obligated to take care of elders. But the rise of assisted living facilities reflects that many families are no longer equipped to do so.
**John Salak [:So, are assisted living facilities a modern substitute for traditional family care?
**Leanne Clark Shirley [:Not entirely. There’s a romanticized idea of “the good old days” when families cared for their elders. But even historically, there were gaps. What we’re seeing now is a shift.
At the same time, there’s a return to multigenerational households. Younger people are also starting to see the value of including older adults in conversations and decision-making.
**John Salak [:We are living longer than ever. Where does this extended longevity fit into your view of healthy aging?
**Leanne Clark Shirley [:Longevity gains are significant but not universally accessible. Recent trends—like increases in deaths of despair and COVID-19 impacts—have reduced life expectancy in the U.S.
It’s also critical to recognize that living longer doesn’t always mean living well. Chronic health challenges often accompany long lives. The goal should be to delay the onset of these conditions and maintain quality of life for as long as possible.
**John Salak [:Does living longer necessarily mean living better?
**Leanne Clark Shirley [:Not always. It depends on your perspective. For some, living with mobility issues or chronic illness still allows for a fulfilling life. For others, losing certain abilities might diminish quality of life.
A theory called "compression of morbidity" suggests we should aim to delay chronic disease’s onset as much as possible. This applies at any age—whether you’re 20 or 95, you can take steps now to set yourself up for better health in the future.
**John Salak [:Do we view mature adults differently today?
**Leanne Clark Shirley [:To some extent, yes. The baby boomer generation is so large that we see more examples of older adults in various roles—working, volunteering, and innovating.
However, harmful stereotypes persist. For example, rhetoric surrounding older political figures often reinforces negative stereotypes about aging.
**John Salak [:Is America in a good place to deal with an aging population?
**Leanne Clark Shirley [:We’ve made progress in some areas, like the aging network established through policies like Social Security, Medicare, and the Older Americans Act. These programs provide vital support to older adults.
However, funding for these services has remained flat, and workforce shortages limit access. Additionally, we lack a coordinated national long-term care plan, leaving many families struggling to navigate an almost impossible maze when care is needed.
**John Salak [:What can we do to improve healthy aging and support older adults?
**Leanne Clark Shirley [:We need to recognize that healthy aging is about more than just medical care—it’s about connection, purpose, and addressing disparities.
For example, organizations like AARP are promoting brain health through initiatives like the Brain Health Action Collaborative. Groups like SAGE and Aging While Black are addressing inequities and elevating the unique experiences of LGBTQ+ and Black older adults.
**John Salak [:What’s the biggest misconception about aging well?
**Leanne Clark Shirley [:The idea that there’s only one way to age well. Aging well is deeply personal and changes over time.
Some also believe aging well isn’t possible at all, which I’d challenge younger listeners to reconsider. Healthy aging is achievable, but it requires societal and individual effort to address barriers and create opportunities.
**John Salak [:Thank you, Leanne Clark Shirley, for this insightful discussion. We hope to have you back to dive deeper into these important topics.
**Leanne Clark Shirley [:Thank you, John. It was a pleasure to join the conversation.
**John Salak [:Before we close, remember to explore the discounts available on health and wellness products at WellWellUSA.com. Sign up is easy and free—just visit WellWellUSA.com and click “Milton’s Discounts” in the top menu bar.
**John Salak [:Aging is inevitable, but how we prepare for it and define it is up to us. Healthy aging is personal, evolving, and influenced by societal and structural factors. Let’s continue the conversation and work towards a better future for all generations.
