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dc.contributor.authorDrennan, Vari
dc.contributor.authorWalters, Kate
dc.contributor.authorAvgerinou , Christina
dc.contributor.authorGardner , Benjamin
dc.contributor.authorGoodman, Claire
dc.contributor.authorFrost , Rachael
dc.contributor.authorIliffe , Steve
dc.contributor.authorKharicha , Kalpa
dc.contributor.authorManthorpe , Jill
dc.date.accessioned2018-07-31T12:29:23Z
dc.date.available2018-07-31T12:29:23Z
dc.date.issued2018-07-01
dc.identifier.citationDrennan , V , Walters , K , Avgerinou , C , Gardner , B , Goodman , C , Frost , R , Iliffe , S , Kharicha , K & Manthorpe , J 2018 , ' Moving upstream in health promoting policies for older people with early frailty in England? A policy analysis ' , Journal of Health Services Research and Policy , vol. 23 , no. 3 , pp. 168-175 . https://doi.org/10.1177/1355819617752971
dc.identifier.issn1355-8196
dc.identifier.otherPURE: 13069007
dc.identifier.otherPURE UUID: 427c89db-0a51-4cbe-ba06-fb4efcb9e05e
dc.identifier.otherScopus: 85057068530
dc.identifier.urihttp://hdl.handle.net/2299/20295
dc.descriptionThis article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (http://www.creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).
dc.description.abstractObjectives: Globally, populations are rapidly ageing and countries have developed health promotion and wellbeing strategies to address increasing demand for health care and old-age support. The older population is not homogeneous however, and includes a large group in transition between being active and healthy to being frail, i.e. with early frailty. This review explores the extent to which policy in England has addressed this group with a view to supporting independence and preventing further progression towards frailty. Methods: A narrative review was conducted of 157 health and social care policy documents current in 2014–2017 at three levels of the health and social care system in England. Findings: We report the policy problem analysis, the shifts over time in language from health promotion to illness prevention, the shift in target populations to mid-life and those most at risk of adverse outcomes through frailty, and changes to delivery mechanisms to incentivize attention to the frailest rather than those with early frailty. We found that older people in general were not identified as a specific population in many of these policies. While this may reflect a welcome lack of age discrimination, it could equally represent omission through ageism. Only at local level did we identify some limited attention to preventative actions with people with early frailty. Conclusion: The lack of policy attention to older people with early frailty is a missed opportunity to address some of the demands on health and social care services. Addressing the individual and societal consequences of adverse experiences of those with the greatest frailty should not distract from a more distinct public health perspective which argues for a refocusing upstream to health promotion and illness prevention for those with early frailty.en
dc.format.extent8
dc.language.isoeng
dc.relation.ispartofJournal of Health Services Research and Policy
dc.rightsOpen
dc.subjectEarly frailty
dc.subjectHealth promotion
dc.subjectOlder people
dc.subjectPolicy analysis
dc.subjectPrevention
dc.subjectHealth Policy
dc.subjectPublic Health, Environmental and Occupational Health
dc.titleMoving upstream in health promoting policies for older people with early frailty in England? A policy analysisen
dc.contributor.institutionSchool of Health and Social Work
dc.contributor.institutionCentre for Research in Public Health and Community Care
dc.contributor.institutionOlder People's Health and Complex Conditions
dc.description.statusPeer reviewed
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85057068530&partnerID=8YFLogxK
dc.relation.schoolSchool of Health and Social Work
dc.description.versiontypeFinal Published version
dcterms.dateAccepted2018-07-01
rioxxterms.versionVoR
rioxxterms.versionofrecordhttps://doi.org/10.1177/1355819617752971
rioxxterms.licenseref.urihttp://creativecommons.org/licenses/by-nc/4.0/
rioxxterms.typeJournal Article/Review
herts.preservation.rarelyaccessedtrue
herts.rights.accesstypeOpen


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