Public Health and Aging Quality of Life at the End of Life: The Public Health Perspective

The promotion of '= quality of life for dying individuals and their survivors is integral to the achievement of the Healrhy People 2010 goal of increasing the quality and years of healthy life. With death from chronic terminal illness common, individuals and families frequendy experience the negative consequences of terminal decline for long periods of time, and our healthcare system often does not adequately address these consequences. In this article we discuss ongoing efforts and programs to promote higher quality of life for dying individuals and their families/significant others, and we propose an expanded public health paradigm that recognizes the birth-to-death need for public health surveillance, education, and intervention. The major achievements in the U.S. Public Health system from 1900-1999 highlight the importance of activities that prevent illness and disability and premature mortality and promote health (Morbidity and Mortality Weekly Report, 1999). These activities have resulted in improved quality of life and longer life expectancies and thus can be said to have contributed to human flourishing, which is at the core the goal of medicine and public health. But what about the specific challenges to quality of life in the last For the community