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Review

Health and Aging in British Columbia: Vulnerability and Resilience

By Denise Cloutier-Fisher, Leslie T. Foster, David Hultsch

November 4, 2013

Review By James Thornton

Health and Aging in British Columbia: Vulnerability and Resilience, edited by Denise Cloutier-Fisher, Leslie T. Foster and David Hultsch, is a collection of 17 chapters on health and aging in British Columbia prepared by 30 authors with multiple academic, research, professional and policy perspectives of health and aging. Each chapter is grounded in one or more academic disciplines involved in studies of healthy aging: regional geography, human and social development, psychology, anthropology, sociology, physical education, aboriginal, and environmental issues. The collection is based on notions of vulnerability and resilience. The editors suggested that these complex ideas vary across multiple social configurations: individuals, families, communities, health regions and are essential in studies of physical, mental and social health. The editors suggested that the collection is weighted more toward resiliency and “…this is important as a more authentic and defining characteristic of today’s older adults, who are more resilient than vulnerable” (2).  The majority of authors are from the University of Victoria and associated with its Centre on Aging and the BC Ministry of Health. Their data are extracted from recent studies and reports specific to British Columbia.

            The book is organized in three parts. The editors’ introductory chapter is in Part One outlines the thematic scope of the volume. They sketch the conceptual foundation of ‘vulnerability and resilience’ in healthy aging and the major issues presented by authors in each chapter. Three chapters in Part One provided a demographic profile of BC’s population over the age of 65 based on 2001 and 2005 data;  a methodology for developing a framework to plan and evaluate health services; and a research study of primary health care versus primary care in Richmond, BC.  Part Two: Social, Cultural, and Cognitive Influences on Vulnerability and Resilience is a collection of nine chapters. Topics covered are aging, agency and intentional communities; aboriginal elders health in remote regions of BC; predicting and preventing falls among older persons; the ‘mothering work’ of grandparents raising grandchildren; mental health practices, policies and research supporting older adults; cognition and older driver safety; benefits and correlates of physical activity of older adults; reducing social isolation and enhancing friendships of vulnerable older women; and older adults’ attitudes to their own aging. In Part Three: Social Policy four chapters explored geography, home care and health care reform in BC; an exploration of healthy living for healthy aging; a wellness-based approach to resilience and vulnerability; and a final critique and discourse on social issues, now and in the future, for an aging population. This is an outstanding collection and solid foundation for studies on health and aging. Each chapter is an essential read for anyone hoping to understand the views on healthy aging, professional responses, and public policies needed to enhance personal health and social wellbeing.

            As I reviewed this collection, it became clear that the boundaries surrounding academic disciplines, interdisciplinary research topics, professional territories and public policies have changed dramatically since early 1990s. Then interdisciplinary studies of aging were not readily supported in developing studies shaping gerontology or geriatrics. At the time, however, conceptions of the life course, life span and life cycle were robust offering cross paradigmatic views of human development for studies and research of aging and health that would reshape the boundaries, reluctantly in some cases, of academic and professional education, community practices, and public policy.  In this 2009 collection, authors have penetrated further into these boundaries. Nonetheless, Chappell (Chapter 17: The Way Ahead) noted “There has also been widespread recognition of the need to dismantle the fragmented silos within which the health care system operates, but there is little evidence to date that this is happening and some evidence that greater fragmentation may be occurring” (371).        

            The collection is timely as the major demographic shifts projected in 1980s and their social-economic impacts suggested in 1990s are here: the ‘age-quake’ is a reality. The baby boomer generation’s impact on health and social programs at the beginning of the 21st Century was anticipated, but ‘social lag’ hinders initiatives in education, research, program development and public policy. Health and aging are developmental issues with personal and social depth, width, and complexity over time. It is hoped that the editors and authors will continue to explore these complexities including lifelong learning and educational initiatives for individuals, families, communities and professions in a future volume.

            It’s appropriate that I share some personal information which shapes my views of aging and health as I read this book. I am 84 years old, retired in 1993, and have dealt with vulnerability and resilience in my life. While at UBC I promoted gerontological studies and lifelong learning during the last 20 years of an academic career in adult education and educational gerontology.  Then and now, programmatic methods of accessing new knowledge, innovation, adaption, and adoption, and essential for personal and social development at all levels interest me.