By 2031, Statistics Canada (2005) has estimated that there will be nine million adults over the age of 65 in this country. The goal of public health as it relates to the aged population is to provide and maintain the health of those people and to promote and sustain functional independence. This new book by Prohaska and colleagues addresses those tasks. A caveat: Throughout this book, the authors have relied largely on U.S.-based data. Although Canadian readers might appreciate data specific to our different cultural and demographic composition, many critical issues facing public health programs are universal and global. Such issues include problems of chronic and infectious disease and health care disparities, and the development of health and wellness promotion and disease prevention initiatives.

The four papers in Part I, “Fundamentals”, introduce core public health functions as well as two relevant conceptual models: the population perspective and the social/ecological approach. A particular strength of Part I is its excellent descriptive material on population aging from a global perspective, which highlights the challenges facing all public health providers everywhere. The paper on new metrics to guide public-health decision making can be commended for identifying key priorities for developing age-friendly cities and communities. Unfortunately, discussions about training and organizational issues in health and long-term care have little applicability to the Canadian situation. Additionally, the last paper in Part I addresses the quality of life for older populations, and its strengths include its discussion not only of general concepts (such as successful aging, and a broad definition of health), but also of measures and reporting mechanisms specific to assessing the U.S. public health system and related challenges faced in interpreting and applying data about quality of life. The paper relies on the aforementioned social/ecological model of aging, a model which overlaps with other key gerontological theories (such as the determinants of health) and is further referenced elsewhere in the book (e.g., a paper on the epidemiology of aging).

Part II, “Social and Behavioral Factors”, concentrates on social and behavioral determinants of public health. The first of three papers addresses social determinants, including a good presentation and discussion on health equity and public health programs. Of course, the U.S.-based examples are most relevant to that country’s unique health service arrangements, health insurance programs, and distribution of health services. Aspects with broader application include a description of a 2008 World Health Organization report and its specific action principles. The take-away message of this paper is that no single public health agency or policy alone will be able to address health inequalities driven by class, race, and gender.

A strength of the second paper on disability and decreased functional status is its description of risk factors, rooted in specific conceptual models (e.g., the four-stage linear progression model, person-environmental fit). There is also good material on stages of the disability process, and measurement and data-related concerns. The identification of public health challenges and goals in relation to disability may be extrapolated for application and consideration in more-general contexts. This is followed up in the subsequent paper by an overview of primary, secondary, and tertiary prevention strategies.

The final paper, on behavioral risk, highlights issues related to physical inactivity, poor diet, body weight, tobacco use, and alcohol consumption. Tables (e.g., those summarizing the National Cancer Institute’s research on behavioral change and theoretical frameworks) are universally applicable. Similarly, the sections on design, testing, and efficacy in public health programs are also widely applicable. This information blends nicely with much of the health promotion material currently being used in Canadian gerontology education and adds 12 new objectives, including three focusing on developmental risk (i.e., derived from the U.S. Healthy People 2010 report).

Part III, “Societal Applications”, includes four papers. The first, dealing with dissemination and implementation, raises many issues for teachers and practitioners, and refers to interventions discussed in Part I, many of which have not yet been translated into effective programs (in the United States or elsewhere). This paper examines problems of transitioning from research into practice and subsequent evaluations of effectiveness. A model for evaluating public health impact is proposed: the RE-AIM framework (which assesses the impact of initiatives on community programs). The second paper in Part III posits family caregiving as a public health issue for an aging society. Despite the prevalence of U.S. sources cited, descriptive material on care provision (including health effects of care demands) and care trajectories can be more broadly applied. A public health infrastructure is recommended to support family caregiving, a point which resonates across many industrialized countries. In this regard, benchmarks, linking mechanisms, family-centred care models, and training programs are key underpinnings of successful approaches.

Social engagement, the topic of the third paper, is also an issue of gerontological concern, although it is unclear how public health should venture into this area (if at all, as it diverges from the current spectrum of public services). The final, fourth paper reviews the role and past successes of evidence-based policy in preventing disease, chronic conditions, and disability in older adults, illustrated through case studies (e.g., on tobacco use and on flu vaccines). The authors cite U.S. examples to demonstrate policy initiatives targeting older adults, though there is a helpful examination, with more general appeal, of promoting healthy aging in retirement communities.

Part IV’s focus is “Public Health Infrastructure for an Aging Society”. The first paper is an excellent review of the role of technology in public health, such as in remote monitoring, health information, mobile devices for health delivery, and promoting independence in the home and community. It examines barriers to the use of technological innovations; its suggestions for future directions tend to focus on U.S. environment and business models. The next paper considers public health workforce issues (e.g., training and education). Although this paper, too, concentrates on U.S. situations, my sense is that the authors’ findings would apply generally to North America and much of Europe. Finally, the last paper addresses disaster preparedness specific to older persons. An excellent discussion deals with community and residential care of the elderly during disasters but will primarily be of interest to U.S. readers because of its context.

Part V, “Emerging Issues”, covers the planned and built environment, and the interplay between biological, environmental, and behavioral factors. “Planned and Built Environments in Public Health” offers a strong applied focus with relation to practice and policy, and discusses primary, mediating, and moderating effects. A solid review of environmental modifications is also offered in that discussion. The next paper, “Genomics and Aging”, although presenting the state of the art of this public health issue, tends to be overly technical and detailed. Readers not well versed in this topic may find this paper less helpful, particularly in the absence of specific applied examples of the implications for public health programs and delivery systems.

The final two papers are “Global Perspectives on Public Health and Aging” and “Resource Allocation in an Aging U.S. Society”. Clearly, the latter paper will be less relevant for Canadian readers; however, the global perspectives paper deals with broader public health concerns related to trends in global life expectancy and life span (e.g., the impact of extended life expectancies on retirement) and thus will be of significant interest.

Overall, this edited volume collects the work of several leading thinkers who have approached the subject through a variety of lenses on the public health and aging field in the United States. The book will be especially useful for educators who can select appropriate sections and apply them to their particular locations and delivery systems.