1225: How States Are Making Healthy Aging a Public Health Priority

JOHN SHEEHAN: 

This is Public Health Review Morning Edition for Thursday, October 15, 2026. I'm John Sheehan for the Association of State and Territorial Health Officials.

States are taking a broader approach to healthy aging with new policies focused on prevention, dementia awareness, caregiving, and long-term support for older adults. Lana McKinney, senior analyst for State Health Policy at ASTHO, discusses emerging trends in state healthy aging and dementia-related legislation, including new advisory councils, caregiver support programs, public education efforts, and requirements for dementia-capable training across healthcare, public safety, and direct care settings. She recently authored a Health Policy Update on the topic.

LANA MCKINNEY: 

At ASTHO, our Health Improvement and Healthy Aging teams work to really provide direct capacity building support, technical assistance, and policy analysis for state and territory health departments as they navigate growing needs of older adults. So while state legislatures are really enacting incredible frameworks, when health agencies need, you know, more tools to implement them. ASTHO actively facilitates peer-to-peer learning and capacity building. So, in fact, right now we have two active requests for applications that I really want to highlight for public health leaders listening today. So, first, we have a falls prevention community of practice, which is really a cohort-based learning initiative that helps state agencies build cross-sector partnerships. Really look at evidence-based screening and implement fall risk reduction strategies. And the other is the Brain Health and Caregiving Virtual Learning Community. So this Community is designed to assist health departments in implementing the Brain Health Initiative roadmap, really expanding dementia capable care and supporting caregivers, and so health departments and staff can visit ASTHO's website or contact healthyaging@astho.org to apply.

SHEEHAN: 

Okay, and speaking of healthy aging, you know the blog describes it as being on a continuum that spans prevention, supportive care, and long-term services. How can states balance those preventive initiatives with safety net services? That sort of reactive, those reactive services for older adults that are maybe experiencing decline or need long-term care.

MCKINNEY: 

So really, state legislative frameworks approach it sort of in two distinct policy levers, so really, upstream wellness and then the downstream safety net infrastructure. So proactively, state laws invest in community infrastructure frameworks, social engagement grants, sort of like age-friendly planning, community, and brain health education for older adults to maintain independence at home, and then on the safety net. And when they do experience cognitive decline or physical limitations, the legislatures really pivot towards structural protection. So mandates for long-term care, dedicated advisory councils, looking at financial relief for family caregivers, and regulatory standards really for memory care.

SHEEHAN: 

And several states have enacted Alzheimer's and dementia awareness campaigns. What is the role of education, and why are policymakers turning to it?

MCKINNEY: 

So, really, states are scaling public education around like cognitive decline. The 'why' is yet to be seen. Obviously, we all know that it's important, and public health departments and legislatures are finding it important. So they're really increasing mandated partnerships, dementia organizations. They carry out community reach, and then finally, legislatures are requiring state and adult divisions to systemically update and modernize their public outreach materials to improve community-level awareness. So that's really how they're expanding public health education.

SHEEHAN: 

Gotcha. And what are you seeing in terms of trends for states and how they're approaching healthy aging and dementia-related legislation?

MCKINNEY: 

So, in some of the recent tracking and trends that we've seen, states are really institutionalizing these advisory bodies, so it really expands operational scopes and permanent advisory councils. Policies are really shifting towards direct caregiving and moving away from the informal guidance that provides, you know, sort of direct microgrants for unpaid family caregivers, and then legislatures are really looking to enact mandates that standardize required training. So for both direct caregivers who hire law enforcement personnel, and looking at comprehensive, really multi-state aging plans, looking at the sector for aging.

SHEEHAN: 

You also highlight, in the blog, new councils and advisory bodies that states are enacting. Why are these governing structures important policy tools for addressing aging populations?

MCKINNEY: 

I think legislatures have found them important. Because they have seen in certain states that they work, and so, governance structures could serve as sort of like the central hub to align state agencies and kind of get rid of the duplicative efforts. Several states created councils, like you mentioned, and infrastructure systems. They're really trying to align aging policy with the aging population, with a review of service delivery. So, seeing that the plans, councils, and bodies are a governance structure that can empower states and state health departments doing the work.

SHEEHAN: 

You also note, in the piece, how states are moving away from viewing, you know, caregiving and caregiving for aging family members, that's shifting from being a family responsibility and more of an actual public health priority. Talk about that shift, and what are the benefits there?

MCKINNEY: 

So really, I think the legislatures are establishing some of these programs, shifting away from sort of individual care to more institutionalized. I think that's happening because it is becoming more and more of a need, and states are recognizing; to ensure resources and to ensure sort of the requirements that state aging and long-term care networks need for support and maybe specific options. It is important to sort of empower those who are doing the caregiving, and so I've seen caregiving counseling, navigation of services. Some state bodies are looking at an isolation task force, and they're looking at state agency councils to really support those who are doing the caregiving work, and then understanding how caregiving is now really a public health need, and how they can support some of that work.

SHEEHAN: 

Yeah, and to your point, you know, that workforce needs to be specialized in dementia-capable services, what is happening on the policy front to help those workers?

MCKINNEY: 

So, a lot of states and legislatures recently, that we've seen, a trend is they're building this dementia care-capable workforce across public safety, across health care, across administrative settings using mandatory training hours, also for direct care workers, EMS, sort of direct care hired staff, and then requiring home services to complete sort of this annual continuing education as well around communication, safety, behavior management, and then also really looking at first responders. So in having an understanding of what dementia care looks like, or maybe understanding the Alzheimer's-related and dementia-related diseases, having just sort of a general, basic understanding is how states are looking to empower those and to support those who are in that work or who essentially could engage with that type of work, or those patients.

SHEEHAN: 

And you know, listeners should read your full recent Health Policy Update on supporting healthy aging, but, you know, at the risk of spoilers, where do you see health policy heading in the future?

MCKINNEY: 

I think health policy is really going to be robust when it comes to older adults. I think the frameworks that are now set up, looking at community-level aging and looking at authorizing grants or putting in multisector plans for aging, is where the legislature and public policy is going. I think they really are looking at care coordination within health departments and finding ways to not only support the work that's being done there, but create additional policies to sort of broaden those frameworks that are available. And so, seeing the direction really going into more policy work around how to, you know, recognize, do training, and public health education across all age groups, and really making it more in the forefront of public health.

SHEEHAN: 

Lana McKinney, thanks so much.

MCKINNEY: 

Thank you. It was great chatting with you.

SHEEHAN: 

Lana McKinney is a senior analyst for State Health Policy at ASTHO.

ASTHO is accepting applications for the 2027 Falls Prevention Virtual Community of Practice. This cohort-based learning experience will provide a platform for participating teams to exchange insights, develop action plans, refine implementation approaches, and strengthen planning for expanding falls prevention through community clinical linkages. Participants will engage in a series of virtual sessions to learn from fellow teams and experts, and receive technical assistance to implement STEDI-based strategies for preventing falls among older adults. Learn more at the link in the show notes.

ASTHO's Power Hour PLUS: Expand Your Impact series equips public health leaders with strategic insights, practical tools, and real-world strategies needed to lead with confidence and drive meaningful change. The second session, Conversations That Move Work Forward: Influence Through Conflict, builds on crucial conversation skills by introducing the "Third Space" as a psychologically safe way to navigate disagreement, competing interests, and emotionally charged moments with greater influence. Register at the link in the show notes.

This has been Public Health Review Morning Edition. I'm John Sheehan for the Association of State and Territorial Health Officials.