Abstract
In the next few decades the U.S., including the
Commonwealth of Massachusetts, will experience a rapid aging of its population and related rises
in chronic illnesses, disability, health care and long-term care costs, and demands on family
caregivers. The changes will challenge our care and financing systems. However, this should not
be seen as a gloom and doom scenario.
Rather, we should celebrate the advances in health care, public health, and economic status that
have made it possible to extend life expectancy far beyond what it was a century ago. Moreover,
there is ever-stronger evidence that the "price of success" for living longer does not need to be
added years of chronic illness and disability, as some feared (Cassel, Rudberg et al. 1992). There
is a growing campaign to promote "healthy aging" (HA), which can help many individuals avoid
or delay disability and the worst consequences of illness as they age, and even help those who are
ill and disabled to better manage their conditions and live meaningful and involved lives.