Constructing the Community-Level Successful Aging Indicators for the Local Government in Taiwan

[[abstract]]Objective: Successful aging is an important topic in elderly health. However, appropriate community-level indicators for assessing successful aging are unavailable. To construct area-level indicators of successful aging will be useful for the local government to develop policies to optimize the health of the elderly. Methods: Initial community-level successful aging indicators were selected from literature review, and then the modified Delphi method was used to select the appropriate dimension and responding indicators. Three interviews of eight experts, who were from the field of public health, social work, health improvement and demography, were conducted. The analytic hierarchy process (AHP) was used to recognize the relative importance of each dimension and thus to get the weights. And next, according to the indicators, this study used the data from Nation Health Interview Survey, 2002, as well as other government statistics to describe the current successful aging status for all the counties/cities in Taiwan. Results: The community-level successful aging was constructed of six dimensions and measured by sixty-five indicators. The most importance dimension is ?health status? for evaluating the elder health. The other five dimensions included ?life style? for assessing the elder health behaviors; ?health care resources and utilization? as the adequacy of health care resources; ?social participation? representing local social support resources for elderly participation; ?social environment? indicating the public infrastructure of health promotion, and ?natural environment? as the ecological environment. The data showed that the cities of the less urbanization, located middle or southern Taiwan, or higher aging population proportion were more likely to be successful aging. Among the cities, the elderly in Miaoli County showed the best health status. The elderly in Taipei City and Kaohsiung City had better life style. Chiayi City owned the most sufficient health care resources and more utilization. The elderly living in Yunlin County participated in the social activity the most. The best social environment for successful aging was in Tainan County, while the best natural environment was in Keelung City. Conclusions: Health status and life style can be seen as internal factors of successful aging; meanwhile, health care resources and utilization, social participation, social environment and natural environment are attributes of external factors. Internal factors are more important than external factors. We suggest that the short-term and immediate policies for promoting successful aging should focus on health status and life style. In the long run, the local governments should improve the external factors through revolution of the system and social education