Community-based prevention for disadvantaged older people: The link between participation and health

Introduction:
Epidemiological research shows the untapped potential of primary prevention for older people. Particularly groups of lower socioeconomic status could benefit from prevention efforts, given that health inequalities persist well into the later years. Knowledge from health promotion and gerontology show a strong linkage between topics of health and those of participation. Prevention for socially disadvantaged populations therefore requires interventions in the relevant social contexts. For older people this is mainly the neighbourhood, since mobility declines with age and networks decrease. Despite the growing political and scientific interest in prevention for older people in Germany, concepts regarding disadvantaged groups of older people are not yet sufficiently devveloped.
Methods:
A search of German databases listing community-oriented health promotion projects revealed that preventive efforts for disadvantaged groups of older people are still rare, however, several innovative initiatives exist. Interviews with leaders from established projects identified models of good practice, providing information on several topics: the groups targeted for intervention, strategies to engage the target groups, emerging issues in project development, and factors related to the success and failure of interventions.
Results:
Successful prevention interventions address directly the needs of specific target groups of disadvantaged older people (e.g. minority ethnic elders, elders living in poverty, or older homosexuals) and rely on participation and empowerment. Supporting social networks emerged as a key issue for capacity-building and for opening up other topics linked to health. Organisational networking was needed as well to maximise a neighbourhood's resources and to foster sustainability.
Conclusion:
In general, the neighbourhood is a suitable starting point for prevention interventions for socially disadvantaged elders as it constitutes their most important social context. Aspects of civil society and health are closely related. Researchers and practitioners need to cooperate on developing new intervention concepts.