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American Foreign Policy and Adult Vaccinations

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What was most remarkable about the third presidential debate was the extent to which both President Obama and Governor Romney agreed that the U.S.'s foreign policy strategies hinged upon domestic economic success. Sure, both Obama and Romney have poll-tested talking points on the domestic economy, so both will "pivot" to these points whenever they can. Nonetheless, this overlapping strategy shared by two very different candidates reveals that the U.S.'s global strategy in the coming years will based upon the country's domestic economic performance.

There is no richer potential for economic growth than keeping older adults integrated in the heart of the economy. By 2015 -- halfway through the next president's term -- a full 20% of the U.S.'s population will be over 60. If this portion of the population is herded into traditional roles of retirement roles of inactivity and withdrawal, then any trend of economic recovery in the next few years will amount only to a fleeting blip. Indeed, it is impossible to build a sustainable recovery if one-fifth of the population departs the labor force because they have reached an age that was identified as "old" almost one century ago.

It's a shame that this argument wasn't made by President Obama or Governor Romney -- or put into a question by moderator Bob Schieffer, who is himself thriving at 75 and working past "retirement" to stay in the national nucleus of politics and media. But for all of the candidates talk about teachers unions, auto bailouts, and five-point plans, neither candidate addressed the white elephant sitting at the table between them. If the candidates were concerned about pandering to their constituencies or winning the independent voters, there are any number of angles from which they could have approached the argument.

How, for example, can older Americans be kept vital in the workplace to take the strain off Medicare and Social Security? How can these age-related entitlements be reformed so they can continue to provide services to those truly in need? How can the U.S. economy as a whole be strengthened by re-imagining what it means to age? How can education and vocational training better meet the needs of adults who need to plan to stay in the workforce for up to sixty years? How should all people begin to think about financial planning differently now that it is common for families to have four generations alive at one time?

The possible answers to these questions are many, of course, but there is one architectonic variable that arches over them all. If older adults lose their health, they lose their ability to be active, productive and socially valuable. Health underscores everything, and the U.S. can only break out of its prolonged economic slump if the growing number of its aging population maintains good health as a basis for active and productive aging.

Indeed, it could even be argued that age-related entitlements are not about age at all. They're about health, and the arbitrary age at which they kick in was established decades ago against a median age at which people saw their health deteriorate. Today, thanks to miraculous advances in health and medicine, we are staying vibrant and vital far later into life. Thus, if we look to extend good health for everyone later into life, what are the solutions?

While both Romney and Obama may have been mum on this question, The Economist Intelligence Unit offers an intriguing solution. The report, "Preventive Care and Healthy Ageing: A Global Perspective," shows how preventive care keeps older adults healthier while creating "up to a fourfold return on investment."

This is a two-tiered win. Most obviously, preventive care decreases health costs and creates immediate relief for strained entitlement systems. But, more significantly, preventive care increases the health of older adults and creates residual relief for the long-term by transforming a population from economic dependent to economic contributor.

As The Economist points out, one of the most promising instruments of preventive care is adult vaccinations. Throughout most of the world, it has become common practice -- and common sense -- to vaccinate children, but "adult vaccinations" remain rare. Why? Even with guidance from the World Health Organization, countries around the world have not been adequately vaccinating their adult populations. We have no adult immunization program parallel to the public health core principle of childhood immunization. Such a program could become the benchmark for other preventive approaches emerge that would aim to maintain healthy vision, mobility, and other avoidable age-related burdens.

This is a major loss. Millions of older adults continue to suffer and often die from diseases that could be prevented by inexpensive, scalable, cost-saving and life-saving vaccinations. Personally, this loss is devastating. Economically, the loss is crippling. Older adults -- the greatest untapped economic resource -- are falling to the wayside while a solution sits underutilized. The Economist, quite rightly, calls adult vaccinations "low hanging fruit," and now the politicians need to connect the dots. It's only one example of the shifting priorities demanded by the structural demographic changes of our century. Getting this one right will lead to approaches to other key aspects of health, like vision, mobility and skin health,, which can have positive impacts on keeping us healthier even as we age to be more active and productive.

A sustained recovery in the U.S. and around the world depends upon the growing 60+ population being integrated into the heart of social and economic life. But this integration requires that older adults remain in good health. Adult immunization is one piece of this puzzle. In two weeks, the presidential election will be over, and the president-elect would be wise to broaden his strategy for economic recovery to include improving health of older adults.

This is an area where the U.S. can show real global leadership. Public health strategies for prevention and wellness, through simple solutions like adult immunization, are just as much a piece of the U.S.'s foreign policy as drone strikes or Iranian sanctions. Too bad Bob Schieffer didn't ask about it.

Michael Hodin writes the Age and Reason blog for The Fiscal Times