European countries are becoming longevity societies, with the number and proportion of older citizens steadily increasing. However, not all of these additional years are spent in good health, and inequalities across socioeconomic groups and regions remain significant. In order to ensure that longevity becomes a shared opportunity rather than a source of strain, policy frameworks must evolve to adopt a comprehensive life-course perspective.
Addressing challenges related to poor health and health inequalities requires cross-sectoral coordination, a long-term commitment to prevention and initiatives that enhance social inclusion and autonomy in later life, as highlighted by experts convened to discuss policy frameworks and findings from the Age-It project with us.
Promoting Healthy Lifestyles Across the Life Course
Evidence consistently shows that physical activity, good nutrition, restorative sleep and social participation are central to maintaining health and well-being in later life. However, sedentary lifestyles, chronic conditions and social isolation continue to pose major challenges. Public policies must therefore not only encourage healthier lifestyles, but also enable them.
This involves supporting daily physical activity as part of ordinary life, for example, through walking, gardening or community exercise initiatives, as well as designing exercise-friendly living and working environments. One promising approach is the development of clinics that prescribe physical activity and exercise, supported by multidisciplinary teams and reimbursed by health systems, similar to dietary or pharmaceutical interventions. Such policies should be embedded in prevention strategies, recognising that habits formed earlier in life strongly influence health outcomes in later life.
A cornerstone of this strategy is promoting prevention: regular screening programmes, routine medical check-ups and adopting healthy lifestyles can significantly delay or prevent the onset of chronic diseases such as diabetes, cardiovascular conditions and dementia.
Not only are preventive interventions effective in improving individual health outcomes, they also reduce the long-term burden on healthcare systems. For this reason, policymakers should prioritise prevention by providing targeted incentives, community-based programmes and awareness campaigns that make healthy choices easier and more accessible. Strengthening prevention-oriented policies today can yield substantial health and economic dividends in the future, fostering a more sustainable model of healthy ageing.
Breaking Down Policy Silos
Ageing is all too often addressed solely within the health sector, yet its determinants extend across housing, transport, labour markets, social protection and education. Therefore, mainstreaming healthy ageing into all policy domains is essential.
Research shows that investment in social services reduces pressure on health systems by preventing escalating needs from leading to hospitalisation. Effective policy frameworks should therefore strengthen horizontal coordination between ministries and vertical coordination between national, regional and local government levels. It is crucial to ensure coherence between strategic objectives and local implementation, as municipalities are often the ultimate providers of support to older citizens.
Furthermore, clear definitions and measurable indicators of 'healthy', 'active', and 'successful' ageing are necessary to enable policies to be monitored, evaluated, and improved over time.
Supporting People Ageing Without Children
A growing number of older adults are ageing without children, whether by choice, circumstance, estrangement or geographical distance. This group faces distinct vulnerabilities, including an increased risk of loneliness, a reduced amount of informal care, and difficulties with end-of-life planning, including questions of decision-making authority, care arrangements, and inheritance.
Policymakers should ensure that their needs are clearly recognised in policy design and implementation. Health and social care provision should not assume the presence of family carers, but instead ensure access to formal support networks, legal advice, and community-based services. Age-friendly environments and targeted outreach programmes can mitigate the risks of isolation and exclusion among this group.
At the same time, tackling loneliness must be viewed as a crucial aspect of healthy ageing. Beyond clinical or care responses, initiatives that foster connection, such as community groups, intergenerational programmes, volunteering and accessible public spaces, can strengthen social bonds and promote a sense of belonging. The overarching goal is to create environments where people can remain active, connected and supported throughout later life.
Harnessing Digital Innovation Responsibly
Digital health technologies, including artificial intelligence and wearables, offer opportunities for personalised prevention, continuous monitoring and improved service delivery. They can also support social participation, as demonstrated by digital platforms that combine health tracking with community engagement.
However, significant risks must also be acknowledged. Digital exclusion remains a barrier for many older adults, particularly in regions with poor connectivity or among those with limited digital literacy. Therefore, safeguards must ensure accessibility, affordability, and user-friendly design. Crucially, digital tools should complement, rather than replace, human care, preserving the relational dimensions that are fundamental to quality support. Strong protections are also needed to uphold the privacy of users and ensure the ethical use of sensitive data.
Reducing Inequalities and Ensuring Independence
Not everyone ages in the same way. Socio-economic status, geography, gender and cumulative disadvantage all influence the conditions of later life. Policies that address inequalities early on, through education, employment and health promotion, are vital to ensuring that older age is not marked by disproportionate vulnerability. Public services should therefore guarantee equitable access to healthcare, particularly for disadvantaged groups and regions, from an early stage.
Equally important is supporting independence and self-determination in older age. Accessible housing, safe transport, access to continuous education opportunities, and inclusive community design all contribute to maintaining autonomy. Additionally, combatting ageism is essential to ensuring that older people, including those with disabilities, can retain choice and control throughout their lives.
Conclusion
The transition towards longevity societies demands a reorientation of policy, shifting the focus from viewing ageing as a sectoral challenge to recognising it as a cross-cutting societal issue. Policies must promote healthy lifestyles throughout the life course, ensure coordination across sectors and levels of government, provide support regardless of family circumstances, use technology responsibly and address structural inequalities.
Action Points
- Adopt a life course approach to ageing policy, ensuring that prevention, health promotion, ageing-friendly environment design, and early interventions are supported from childhood through to later life.
- Mainstream ageing across policy sectors to ensure that housing, transport, labour, education and social protection systems are aligned with the goal of healthy and inclusive ageing.
- Improve governance and coordination between national, regional and local authorities and establish clear indicators to evaluate progress towards healthy ageing.
- Recognise the specific needs of people ageing without children by ensuring they have access to formal care, legal support and community services that do not assume family-based caregiving.
- Strengthen measures to prevent loneliness and social isolation by expanding group-based interventions, peer support networks, volunteering opportunities and age-friendly community spaces. Support digital tools and apps that promote social interaction, such as the Singapore 'Healthy 365' model.
- Promote physical activity through community initiatives and medically supported 'exercise prescriptions' that are reimbursed within health systems and embedded in broader prevention strategies.
- Leverage digital health and social innovations responsibly by promoting inclusive accessibility, digital literacy, affordability and robust safeguards for data privacy while preserving high-quality human care.
- Address inequalities across the life course by targeting early interventions in education and employment, and guaranteeing equitable access to healthcare in later life.
- Promote autonomy and dignity in older age by investing in accessible housing, safe transport, inclusive community design and anti-ageism measures.
Acknowledgment:
This publication is part of the Age-It project: Ageing Well in an Ageing Society, funded by Next Generation EU, in the context of the National Recovery and Resilience Plan, Investment PE8 – Project Age-It: “Ageing Well in an Ageing Society” [DM 1557 11.10.2022]. Age-It is an alliance of Italian universities, research centres, private firms, public institutions and civil society, covering, among others, demography, geriatrics and gerontology, neurology, cardiology, immunology, data science, education science, epidemiology, biology, genetic research, engineering, sociology, law, political science, and economics - https://ageit.eu